engleski

Detection and management of hemolysed sample

Hemolysis occurs as the consequence of the release of various components of the blood cells into the plasma. Involved are erythrocytes as well as other blood cells, like thrombocytes and leukocytes. In vivo hemolysis occures due to the various pathological conditions, whereas in vitro hemolysis occurs during sample collection, handlinh and transport into the laboratory. Improper procedures for venipuncture, specimen transport and processing have been implicated in the ethiology of in vitro haemolysis. In particular, blood aspiration technique, difficulty of blood draw, prolonged tourniquet time and the use of pneumatic tubes are among some of the most frequent causes of hemolysis. Blood collection is therefore considered as the most critical activity in the pre and postanalytical phase of the total testing process. The presence of cellular components in serum or plasma sample can cause a significant bias in various assays. When such interference exceeds a certain threshold, a clinically relevant bias in the measurement will occur. Hemolyzed specimens may be detected by visual inspection or by automated detection and the use of the hemolysis index (HI). Unfortunately, there is still no universally accepted recommendation on the hemolysis detection method, decision thresholds and the reporting policy. The visual detection of hemolysed samples is highly subjective, non standardized and un-reproducible. Many automated chemistry analyzers are equipped with automated serum indices detection system. Such automated detection of serum hemolysis is superior to manual detection, due to its reproducibility and sensitivity. If widely implemented, such systems could catalyse worldwide standardization and harmonization of practices. Joint effort is needed to adopt the uniform error reporting schemes and harmonize the way hemolyzed samples are processed.

hemolysis; interference; preanalytical phase; quality

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