Multicenter evaluation of the hemolysis index in automated clinical chemistry systems

Lippi, Giuseppe; Salvagno, Gian Luca; Blanckaert, Norbert; Giavarina, Davide; Green, Sol; Kitchen, Steve; Palička, Vladimír; Vassault, Anne; Plebani, Mario

doi:10.1515/cclm.2009.218

Cited by 95 publications

(66 citation statements)

References 11 publications

(16 reference statements)

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“…Olympus AU640 is equipped with automated system for semiquantitavie detection of lipemic, icteric and hemolyzed samples (LIH index). Lippi et al compared the efficiency of different analyzers including Olympus AU680 to evaluate the hemolyzed samples and found that results were satisfactory [12]. In another study, Simundic et al assessed the comparability of automated spectrophotometric detection by Olympus AU 2700 and visual inspection of hemolyzed samples and showed a comparable rate of detection for hemolyzed samples [13].…”

Section: Discussionmentioning

confidence: 99%

Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Özcan¹,

Karakas²,

Yücel³

2012

Turk J Bioch

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Aim: The aim of the study was to investigate the effects of in vitro hemolysis on serum creatine kinase and creatine kinase MB isoenzyme activities with creatine kinase MB mass, troponin I and myoglobin measurements. Materials and methods:We prepared serum pools having analyte concentrations at normal and pathological values. Hemolysate was added into serum pools to obtain aliquotes with final hemoglobin concentrations of 21, 10.5, 5.25, 2.625, 1.312, 0.656, 0.328, 0.164, 0.08 and 0.041 g/L. Creatine kinase (by N-acetylcysteine-activated IFCC method) and creatine kinase MB activities (by immunoinhibition method) were measured in these pools. Creatine kinase MB (mass), troponin I and myoglobin concentrations were measured by chemiluminescence method. Mean percent changes were calculated and graphed as interferographs. Results: It was found that the positive interference due to hemolysis began to exceed the limit of 10% at lower Hb concentration for CK-MB activity than CK activity. When reference change value were considered, the critical effect of hemolysis began at higher hemoglobin concentrations. Hemolysis did not affect creatine kinase MB mass, troponin and myoglobin measurements when the limit of 10% change was considered. Conclusions: CK-MB activity is affected more profoundly than CK activity by hemolysis.

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Section: Discussionmentioning

confidence: 99%

Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Özcan¹,

Karakas²,

Yücel³

2012

Turk J Bioch

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“…Type 1: Registration of procedures could be done by circulation questionnaires, aimed at collecting information on how the laboratories handle different parts of the preanalytical phase, e.g., which criteria are used for sample rejection. Type 2: These schemes are similar to usual analytical EQAS, but the circulated material simulates some kind of preanalytical error (e.g., hemolyzed serum) [74]. Case histories can be distributed together with the EQA samples to elucidate how these samples are dealt with, and how the results are communicated to the physicians.…”

Section: External Quality Assessment Schemes For Preanalytical Phasementioning

confidence: 99%

Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE)

Lippi¹,

Banfi²,

Church³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Laboratory diagnostics develop through different phases that span from test ordering (pre-preanalytical phase), collection of diagnostic specimens (preanalytical phase), sample analysis (analytical phase), results reporting (postanalytical phase) and interpretation (post-postanalytical phase). Although laboratory medicine seems less vulnerable than other clinical and diagnostic areas, the chance of errors is not negligible and may adversely impact on quality of testing and patient safety. This article, which continues a biennial tradition of collective papers on preanalytical quality improvement, is aimed to provide further contributions for pursuing quality and harmony in the preanalytical phase, and is a synopsis of lectures of the third European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled 'Preanalytical quality improvement. In pursuit of harmony' (Porto, 20-21 March 2015). The leading topics that will be discussed include unnecessary laboratory testing, management of test request, implementation of the European Union (EU) Directive on needlestick injury prevention, harmonization of fasting requirements for blood sampling, influence of physical activity and medical contrast media on in vitro diagnostic testing, recent evidence about the possible lack of necessity of the order of draw, the best practice for monitoring conditions of time and temperature during sample transportation, along with description of problems emerging from inappropriate sample centrifugation. In the final part, the article includes recent updates about preanalytical quality indicators, the feasibility of an External Quality Assessment Scheme (EQAS) for the preanalytical phase, the results of the 2nd EFLM WG-PRE survey, as well as specific notions about the evidence-based quality management of the preanalytical phase.

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“…Nowadays, many automated chemistry analyzers are equipped with automated serum indices detection system. Such systems use a semiquantitative spectrophotometric measurement, and grade interfering substances into categories, usually reporting a qualitative or quantitative HI, which is proportional to the concentration of free hemoglobin in serum (34). The HI is then compared with alert values specific for the analyte.…”

Section: Detection and Management Of Hemolytic Specimensmentioning

confidence: 99%

“…Nevertheless, a globally agreed policy to deal with hemolyzed specimens is to always ask for new samples to replace those that are hemolyzed. When these cannot be obtained, it is the responsibility of the laboratory specialist to communicate the problem with the requesting physician and seek a solution that is best for patient care (e.g., suppressing all results affected by in vitro hemolysis) (34,35).…”

Section: Detection and Management Of Hemolytic Specimensmentioning

confidence: 99%

Preanalytical quality improvement: from dream to reality

Lippi

Chance

Church³

et al. 2011

Clinical Chemistry and Laboratory Medicine

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259

178

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Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as ''the brain to brain cycle'' by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be ''intercepted'' before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.

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Multicenter evaluation of the hemolysis index in automated clinical chemistry systems

Cited by 95 publications

References 11 publications

Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE)

Preanalytical quality improvement: from dream to reality

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