Managing hemolyzed samples in clinical laboratories.

08:00 EDT 11th October 2019 | BioPortfolio

Summary of "Managing hemolyzed samples in clinical laboratories."

Hemolysis is conventionally defined as membrane disruption of red blood cells and other blood cells that is accompanied by subsequent release of intracellular components into the serum or plasma. It accounts for over 60% of blood sample rejections in the laboratory and is the most common preanalytical error in laboratory medicine. Hemolysis can occur both and . Intravascular hemolysis () is always associated with an underlying pathological condition or disease, and thus careful steps should always be taken by the laboratory to exclude hemolysis with confidence. hemolysis, on the other hand, is highly preventable. It may occur at all stages of the preanalytical phase (i.e. sample collection, transport, handling and storage), and may lead to clinically relevant, yet spurious, changes in patient results by interfering with laboratory measurements. Hemolysis interference is exerted through several mechanisms: (1) spectrophotometric interference, (2) release of intracellular components, (3) sample dilution and (4) chemical interference. The degree of interference observed depends on the level of hemolysis and also on the assay methodology. Recent evidence shows that preanalytical practices related to detection and management of hemolyzed samples are highly heterogeneous and need to be standardized. The Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has published many recommendations for facilitating standardization and improvement of this important preanalytical issue. Some key EFLM WG-PRE publications related to hemolysis involve: (i) a call for more transparency and some practical recommendations for improving the harmonization of the automatic assessment of serum indices and their clinical usefulness, specifically the hemolysis index (H-index), (ii) recommendations on how to manage local quality assurance of serum or plasma hemolysis/icterus/lipemia-indices (HIL-indices) and (iii) recommendations on how to detect and manage hemolyzed samples in clinical chemistry testing. In this review we provide a comprehensive overview of hemolysis, including its causes and effects on clinical laboratory assays. Furthermore, we list and discuss the most recent recommendations aimed at managing hemolyzed samples in everyday practice. Given the high prevalence of hemolyzed blood samples, the associated costs, the great heterogeneity in how hemolysis is handled across healthcare settings, countries and continents, and increasing patient cross-border mobility, standardization and quality improvement processes aimed at combatting this important preanalytical problem are clearly warranted.


Journal Details

This article was published in the following journal.

Name: Critical reviews in clinical laboratory sciences
ISSN: 1549-781X
Pages: 1-21


DeepDyve research library

PubMed Articles [24217 Associated PubMed Articles listed on BioPortfolio]

Using the hemoglobin-binding Staphylococcus aureus protein IsdH to enable plasma analysis of hemolyzed blood samples.

Background Intravascular hemolysis and in vitro hemolysis are prevalent contributors to failed blood sample analysis in the routine hospital laboratory. Interferences by hemoglobin in spectrophotometr...

Serological diagnostics of Lyme borreliosis: comparison of assays in twelve clinical laboratories in Northern Europe.

Lyme borreliosis (LB), caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex, is the most common tick-borne infection in Europe. Laboratory diagnosis of LB is mainly based on ...

Characterization of Reference Materials for Genetic Testing of CYP2D6 Alleles A GeT-RM Collaborative Project.

Pharmacogenetic (PGx) testing is increasingly available from clinical and research laboratories. However, only a limited number of quality control and other reference materials (RMs) are currently ava...

External quality assessment of clinical diagnostic laboratories. Possible sources of error.

The purpose of this study was to assess the quality of laboratory research, its problem areas and potential improvements using the example of a number of regional clinical diagnostic laboratories in t...

Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma.

Background Although accumulating evidence suggests that the hemostatic balance is impaired in patients with hypertriglyceridemia, hyperbilirubinemia or hemolytic anemias, little is known on the underl...

Clinical Trials [5243 Associated Clinical Trials listed on BioPortfolio]

A Comparative Clinical Trial to Evaluate the Safety and Clinical Equivalence of Clotrimazole Troche/Lozenges USP, 10mg (Unique Pharmaceutical Laboratories, India) With Clotrimazole Troche 10mg (Roxane Laboratories Inc., USA) in Subjects With Oropharyngeal

The objectives of this study are to compare the efficacy and safety of Clotrimazole troche/ lozenges USP, 10 mg (Unique Pharmaceutical Laboratories, India) vs. Clotrimazole Troche/ Lozenge...

The Acquisition of Blood and Skin Samples From Normal Volunteers to Support Research Activities on Dermatologic Diseases

Background: -This protocol is concerned with the acquisition of blood, skin, or mucosal samples from healthy volunteers or patients with selected skin diseases to support the basic scienc...

Generation of Positive Biological Samples to Epoetin for Doping Control.

The study consists of generation of biological samples (in blood and urine) positive to Epoetin alfa for laboratories that wish to perform the analysis of doping controls and maintain accr...

DIAgnostics for Multidrug Resistant Tuberculosis in Africa

Recent advances in molecular diagnostics of tuberculosis, especially the GeneXpert Mycobacterium tuberculosis/Rifampicin test have reduced the time to diagnose Rifampicin Resistant Tubercu...

Biomarker Signature and Musculoskeletal Ultrasound Profile in Rheumatoid Arthritis Patients

The purpose of this study is to determine the kinetics of change in quantitative measures of joint inflammation by state of the art power Doppler vascular imaging and to identify biomarker...

Medical and Biotech [MESH] Definitions

Assessments aimed at determining agreement in diagnostic test results among laboratories. Identical survey samples are distributed to participating laboratories, with results stratified according to testing methodologies.

Programs and guidelines for selecting optimal ANTI-INFECTIVE AGENTS regimens in an effort to maintain antibiotic efficacy, reduce CROSS INFECTION related to ANTIBIOTIC RESISTANCE while managing satisfactory clinical and economic outcomes.

Techniques for using whole blood samples collected on filter paper for a variety of clinical laboratory tests.

Individuals professionally qualified in the management of patients' records. Duties may include planning, designing, and managing systems for patient administrative and clinical data, as well as patient medical records. The concept includes medical record technicians.

The planning and managing of programs, services, and resources.

Quick Search

DeepDyve research library

Relevant Topic

Blood is a specialized bodily fluid that delivers necessary substances to the body's cells (in animals) – such as nutrients and oxygen – and transports waste products away from those same cells.  In vertebrates, it is composed of blo...

Searches Linking to this Article