Interference of in vitro hemolysis complete blood count

Jonge, Gabriela de; Santos, Talita L. dos; Cruz, Bruno Ribeiro; Simionatto, Mackelly; Bittencourt, Jeanine Izabel Margraf; Krum, Everson Augusto; Moss, Mariane de Faria; Borato, Danielle Cristyane Kalva

doi:10.1002/jcla.22396

Cited by 19 publications

(22 citation statements)

References 20 publications

(45 reference statements)

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“…For this reason , it is important for the laboratory to ensure specimen integrity by assessment of specimen condition prior to testing . For example, assessment of a specimen for hemolysis is important when an assay requires that red blood cells be intact . Laboratories that serve multiple remote sites have additional challenges to address.…”

Section: Components Of Quality Assurancementioning

confidence: 99%

“…11 For example, assessment of a specimen for hemolysis is important when an assay requires that red blood cells be intact. 13 Laboratories that serve multiple remote sites have additional challenges to address. Examples of this include timeliness of specimen delivery via courier to avoid issues such as specimens overheating during extended travel by automobile or extended exposure to the elements at a loading dock.…”

Section: Monitoring Of Specimen Conditionmentioning

confidence: 99%

See 1 more Smart Citation

Quality management and accreditation in laboratory hematology: Perspectives from India

Pai

Frater

2019

Int J Lab Hematology

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Quality management (QM), including quality assurance and quality control, was developed in clinical laboratories in North America and Western Europe, but must be implemented worldwide to ensure accurate, reproducible, and clinically useful results. India, a middle income country with a population of over 1.34 billion, has limited budget allotted to health care. As yet accreditation for clinical laboratories is not mandatory, which contributes to challenges in implementing good laboratory practice. This review provides a summary of internationally laid down QM principles and their application in a middle income country like India.

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Section: Components Of Quality Assurancementioning

confidence: 99%

Section: Monitoring Of Specimen Conditionmentioning

confidence: 99%

Quality management and accreditation in laboratory hematology: Perspectives from India

Pai

Frater

2019

Int J Lab Hematology

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“…2,3 Reasons why haemolysis poses a great challenge in interpreting blood tests are twofold: the release of cellular components into the serum, and/or the interference with analytical methods and reagents. 1,4 Haemolysis is also thought to be a surrogate marker for post-mortem processes such as clotting, liquefaction and tissue necrosis, which may further complicate the interpretation of post-mortem biochemical tests. 5 In terms of post-mortem tryptase, haemolysis (amongst many other confounding factors) is described as a potential confounding factor that can alter and mostly increase its levels.…”

Section: Introductionmentioning

confidence: 99%

Levels of haemolysis have no effect on femoral vein post-mortem tryptase levels

et al. 2021

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Haemolysis is reported to be an artefact that may alter post-mortem tryptase levels. However, previous studies did not sample peripheral blood using newly standardised methods. Recent studies have shown that some previously recognised peri- and post-mortem confounders can be muted by careful sample collection with first clamping and then sampling the femoral vein. This prospective study investigated the relationship between the degree of haemolysis of the blood samples and femoral vein post-mortem tryptase levels when sampled using this recommended method. Seventy consecutive post-mortem tryptase levels in non-anaphylactic deaths were compared to the degree of haemolysis of these samples, and results showed no significant correlation between them. The mean post-mortem tryptase level was 9.5 μg/L. This study demonstrated that the effects of haemolysis on femoral vein post-mortem tryptase was negligible when the blood was sampled using the recommended sampling method. Future studies on post-mortem tryptase as well as other typically used blood markers in forensics are recommended to adopt this method of blood sampling in routine practice.

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“…However, recognition of haemolysis before analysis is unlikely and impractical for complete blood count (CBC) as whole blood specimens are used. For this reason concomitant serum or plasma samples may be evaluated for haemolysis or dramatically increased mean corpuscular haemoglobin concentration (MCHC) may be used as warning for the prevention of unnoticed haemolysis ( 10 , 11 ). Determining the effect of haemolysis on CBC parameters is crucial.…”

Section: Introductionmentioning

confidence: 99%

Effects of specimen haemolysis on complete blood count results by Abbott Alinity hq System

Ercan

Akbulut²,

Bayraktar

et al. 2021

Biochem. med. (Online)

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Introduction The current study aimed to assess the interference of in vitro haemolysis on complete blood count (CBC) using Abbott Alinity hq system, and to determine which haemolysis levels affect the reliability of sample results. Materials and methods Blood samples obtained from 25 volunteers in K3-EDTA tubes were divided into four aliquots. The first aliquot was not subjected to any intervention. The second, third and fourth aliquots were passed through a fine needle 2, 4 and 6 times, respectively. Complete blood count was performed by multi-angle polarized scatter separation technology and haemolysis index (HI) was assessed from the plasma samples separated by centrifugation. Five groups were formed according to the HI values. The percentage biases between the results of non-haemolysed and haemolysed groups were compared with the desirable bias limits from The European Federation of Clinical Chemistry and Laboratory Medicine database and reference change values (RCVs). Results In groups 1 to 4, the effects of haemolysis on CBC parameters were acceptable comparing to the analytical bias except for lymphocytes (7.26%-7.42%), MCH (2.59%), and MCHC (0.47%-2.81%). Results of group 5 (gross haemolysis) showed decreases in HCT(- 4.56%), RBC (- 4.07%) count and increase in lymphocyte (11.60%) count higher than the analytical performance specifications. Moreover, variations in MCH (4.65%) and MCHC (5.24%) were exceeding the RCVs. Conclusions Gross haemolysis (haemoglobin concentration > 10 g/L) is likely to produce unreliable CBC results on non-pathological samples. Further studies including pathological specimens are needed.

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Interference of in vitro hemolysis complete blood count

Abstract: This study demonstrated that in vitro hemolysis can decrease the clinical and analytical reliability of the assessment of the blood count.

Cited by 19 publications

References 20 publications

Quality management and accreditation in laboratory hematology: Perspectives from India

Quality management and accreditation in laboratory hematology: Perspectives from India

Levels of haemolysis have no effect on femoral vein post-mortem tryptase levels

Effects of specimen haemolysis on complete blood count results by Abbott Alinity hq System

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