Heparin is the anticoagulant of choice for which tests?

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The important idea is that the right anticoagulant must preserve the specific test conditions without altering what you’re measuring. Heparin works well for tests that need to keep cells and plasma in a state close to their native condition and that require accurate gas measurements. It prevents clotting without chelating calcium or otherwise changing the osmotic behavior of red cells, so it’s ideal for the osmotic fragility test. For blood gas analysis, heparinized samples are preferred because heparinization prevents clotting while avoiding interference with pH, pCO2, pO2, and electrolytes that could occur with other anticoagulants. In contrast, CBC typically uses EDTA to preserve cell morphology and prevent clumping, and many ESR methods rely on citrate or other anticoagulants, so heparin isn’t the standard choice for those. Therefore, the anticoagulant of choice applies to osmotic fragility testing and blood gas analysis.