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 preanalytic...
| Publicado en: | Critical Reviews in Clinical Laboratory Sciences Vol. 57; no. 1; pp. 1 - 22 |
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| Autores principales: | , , , , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jan2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=140999064&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 140999064 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10408363 1AV jtl: Critical Reviews in Clinical Laboratory Sciences issn: 10408363 maglogo: Y pubinfo: dt: Jan2020 vid: 57 iid: 1 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 140999064 140999064 140999064 10.1080/10408363.2019.1664391 140999064 ppf: 1 ppct: 21 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Managing hemolyzed samples in clinical laboratories. aug: au: Simundic, Ana-Maria Baird, Geoffrey Cadamuro, Janne Costelloe, Seán J. Lippi, Giuseppe affil: Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia sug: subj: Hemolysis Blood Clinical Laboratories Blood Specimen Collection In Vivo Studies In Vitro Studies Spectrophotometry Hyperlipidemia Jaundice Hemolysis Economics Quality Improvement ab: 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 in vivo and in vitro. Intravascular hemolysis (in vivo) is always associated with an underlying pathological condition or disease, and thus careful steps should always be taken by the laboratory to exclude in vivo hemolysis with confidence. In vitro 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. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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