Study of interference produced by hemolysis in 73 analytical tests

Douhal, Y.; Zamorano, V. Benito; Chacón, Luz del Mar Rivas; Galván, E.; Helguera, G. Sánchez; Hernández, Verónica; Carrión, R. Torrado; Durán, Tomás Pascual

doi:10.1016/j.cca.2019.03.1505

Cited by 1 publication

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“…Macroscopically, this does not indicate hemolysis but may show significant interference with LDH and AST. Regarding the other parameters, their sensitivity to cell-free Hb is generally consistent with previously observed results [ 44 ], meaning that a clinically significant bias occurs at Hb concentrations of 2 to 9 g/L; however, these values are higher for triglycerides, as also confirmed by our experiment.…”

Section: Discussionsupporting

confidence: 92%

“…A very significant linear correlation (r 2 > 0.98 for most of the examined parameters) was determined between the level of hemolysis and the bias of the examined parameters. High correlations and regression lines support the author’s previous results [ 16 , 43 , 44 ] and provide a framework for the use of interferograms to evaluate the effect of hemolysis on the development of bias. The concentration of cell-free Hb at which an analytically and clinically significant bias occurs is the lowest in the case of LDH and AST.…”

Section: Discussionsupporting

confidence: 82%

“…High sensitivity has also been confirmed in other experiments where an increase in the LDH value was established at a concentration of Hb = 0.25 g/L to 0.5 g/L [ 16 , 42 , 43 ]. Clinically significant deviations of AST due to hemolysis occur at a concentration of Hb = 2.18, while other studies have reported that hemolysis has a clinically significant effect on AST at Hb = 0.8–2 g/L [ 16 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

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Analytical and Clinical Interference of Sample Hemolysis in Evaluating Blood Biochemical and Endocrine Parameters in Cows

Kovačević,

Cincović,

Majkić

et al. 2024

Animals

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Hemolysis is a common cause of errors in laboratory tests as it affects blood parameters and leads to a positive or negative bias. This study aims to examine the relationship between the level of hemolysis (expressed as cell-free hemoglobin concentration, g/L) and the variability of metabolic and endocrine parameters and to determine the threshold level of hemolysis that causes an analytically and clinically significant bias for the twenty most frequently examined blood parameters in cows. Paired blood samples of 10 mL each were obtained from 30 cows. One was subjected to mechanical trauma and plasma was extracted directly from the other. Hemolyzed and non-hemolyzed samples from the same animal were mixed to obtain final samples with cell-free hemoglobin concentrations of 0, 1, 2, 4, 6, 8, and 10 g/L. Metabolic and endocrine parameters were measured in the samples and their deviation and the linear equation between the level of hemolysis and the deviation were determined. The following threshold values of hemolysis were determined, which correspond to the acceptable analytical (lower value) and clinical (upper value) levels of parameter variability: BHB 0.96 and 4.81; NEFA 0.39 and 3.31; GLU 0.38 and 3.90; ALB 1.12 and 6.11; TPROT 1.40 and 6.80; UREA 6.62 and 20.1; TBIL 0.75 and 5.65; AST 0.11 and 2.18; GGT 1.71 and 8.90, LDH 0.01 and 0.11, ALP 0.97 and 2.95; TGC 1.56 and 15.5; CHOL 1.29 and 8.56; Ca 5.68 and 25.7; P 0.57 and 8.43; Mg 1.10 and 8.47; INS 1.15 and 3.89; T3 8.19 and 15.6; T4 8.97 and 18.5; and CORT 2.78 and 11.22 g/L cell-free hemoglobin. Three decision levels are available for each metabolic and endocrine parameter: if hemolysis is below the lower (analytical) threshold value, results can be reported without restriction; if hemolysis is between the lower and upper thresholds, the results can be issued with guidance in the form of corrective linear equations; and if hemolysis is above the upper (clinical) threshold, the results and sample must be discarded. This method contributes to an optimal approach to hemolysis interference with metabolic profile parameters in blood samples from cows.

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Section: Discussionsupporting

confidence: 92%