Complete blood count (CBC) is one of the laboratory tests most often influenced by doctors. The use of a hematology analyzer offers a wider range of probe parameters. The pre-analytic stage accounts for 70% of errors, one of which is the delay of the examination. Changes in report results were reported due to changes in blood cell morphology due to EDTA additives and room temperature. The aim of this research is the disturbance of stability of the results of examination of various CBC parameters in blood samples that are left at room temperature for 24 hours using a hematology analyzer. This experimental laboratory research was conducted at the Pramita Jemur Andayani Clinical Laboratory. Blood samples were obtained from volunteers, stored at room temperature and subjected to immediate examination (control) and after a delay of 6, 12 and 24 hours (treatment). A total of 30 respondents, consisting of 8 men and 22 women. The mean age of the respondents was 22 ± 1 year. There was no difference in the results of the examination (p-value > 0.05) in the RBC, Hct MCV, MCHC, PLT and PDW. The results of the examination (p-value < 0.05) were found on Hgb, MCH, RDW, WBC, NEU, IG, MONO, EO, BASO, LYM, PLT and PDW. Delayed CBC examinations using the CELL-DYN Ruby hematology analyzer directly gave different results on several parameters ranging from 6 hours delay of examination.
Over the past few decades, diff count examinations have been performed using a hematology analyzer. It has been reported that delay in examination can change the morphology of leukocytes in peripheral blood smears. Cell-Dyn Ruby is a 5-part differential hematology analyzer with multiangle polarized scatter separation (MAPSS) technology that forms the WBC Differential scattergram and NEU-EOS scattergram. The purpose of this study was to obtain an overview of the Cell-Dyn Ruby scattergram diff count on the delayed examination material. The study used an Experimental Laboratory design, the examination used a Cell-Dyn Ruby hematology analyzer. 0 hours examination as a control, 6, 12 and 24 hours examination as treatment. A total of 30 respondents participated in this study and obtained a scattergram image after the delay in the form of an increase in the number of dots in black and pink, as well as a widening of the distribution of orange dots. Based on statistical tests, there were significant differences in the results of the examination (P <0.01) in all parameters of the leukocyte examination consisting of white blood cells (WBC), segmented neutrophils (SEG), band neutrophils (BAND), immature granulocytes (IG), monocytes (MONO), eosinophils (EO), basophils (BASO) and lymphocytes (LYM). Our results show that the examination delay can be detected by the Cell-Dyn Ruby scattergram especially the WBC Differential channel after a delay of 12 hours, and is noticeable after a delay of 24 hours. The suggestion of this research is the use of a scattergram for verification of the feasibility of examination materials and the need for further research to validate with blood smears and comparisons with other tools that have different technologies.
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