engleski

Practical recommendations for managing hemolyzed samples in clinical chemistry testing

We suggest here a pragmatic approach for managing results of clinical chemistry testing in hemolyzed samples collected from adults/older children, in the attempt to balance the need to produce quality laboratory data with clinical urgency of releasing test results. Automatic assessment of hemolysis index (H-index) in serum or plasma is highly advisable. Regarding the practical use of H-index, when its value does not generate analytically significant bias, results can be released, whilst when the value is associated with analyte variation in a range between analytically and clinically significant bias (i.e., variation does not exceed the reference change value), results of hemolysis- sensitive tests can be released in association with a comment describing the direction in which data are potentially altered and advising to recollect another sample. When H-index is associated with analyte variation exceeding clinically significant bias (i.e., variation exceeds the reference change value), results of hemolysissensitive tests should be suppressed and replaced with a comment that biased results cannot be released because the sample is preanalytically compromised and with the advise to recollecting another sample. If H-index values reach an even higher critical cutoff (i.e., H- index corresponding to a cell-free hemoglobin concentration ≥10 g/L), all laboratory data may be unreliable and should hence be suppressed and replaced with a comment that all data cannot be released because the sample is grossly hemolyzed and accompanied with advise to recollecting another sample. Due to high inaccuracy and imprecision, the use of corrective formulas for adjusting data of hemolysis-sensitive tests is discouraged.

hemolysis, interference, quality, safety

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