Visual assessment of sample quality: quo usque tandem?

Visual assessment of sample quality: quo usque tandem? Sample hemolysis is conventionally defined as the presence of a variable amount of cell-free hemoglobin in serum or plasma. The reference (i.e. “normal”) concentration of free and measurable hemoglobin conventionally ranges between 0.22 and 0.25 g/L in serum and between 0.10 and 0.13 g/L in plasma, respectively [1]. Although no definitive evidence exists about the threshold of “pathological” hemolysis in blood samples, universal consensus has been reached that clinically significant interference for the most hemolysis-vulnerable tests (i.e. potassium, lactate dehydrogenase, aspartate aminotransferase) may start with concentrations of cell-free hemoglobin ≥0.5 g/L [2], [3]. Notably, this cut-off is also conventionally used for monitoring phlebotomy practice [4].Although the very first studies about the impact of sample hemolysis on the quality of laboratory testing have been published more than 40 years ago [5], the frequency of hemolyzed samples remains high and generates remarkable challenges in clinical laboratory practice [6], [7], [8]. The first important issue is distinguishing between in vitro (i.e. spurious) and in vivo (i.e. hemolytic anemia) hemolysis. The differentiation between these conditions is not meaningless because the former case reflects a kaleidoscope of problems emerging throughout preanalytical sample management, thus including blood drawing, handling, transportation, storage and preparation for testing, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Chemistry and Laboratory Medicine (CCLM) de Gruyter

Visual assessment of sample quality: quo usque tandem?

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Publisher
De Gruyter
Copyright
©2018 Walter de Gruyter GmbH, Berlin/Boston
ISSN
1437-4331
eISSN
1437-4331
D.O.I.
10.1515/cclm-2017-0867
Publisher site
See Article on Publisher Site

Abstract

Sample hemolysis is conventionally defined as the presence of a variable amount of cell-free hemoglobin in serum or plasma. The reference (i.e. “normal”) concentration of free and measurable hemoglobin conventionally ranges between 0.22 and 0.25 g/L in serum and between 0.10 and 0.13 g/L in plasma, respectively [1]. Although no definitive evidence exists about the threshold of “pathological” hemolysis in blood samples, universal consensus has been reached that clinically significant interference for the most hemolysis-vulnerable tests (i.e. potassium, lactate dehydrogenase, aspartate aminotransferase) may start with concentrations of cell-free hemoglobin ≥0.5 g/L [2], [3]. Notably, this cut-off is also conventionally used for monitoring phlebotomy practice [4].Although the very first studies about the impact of sample hemolysis on the quality of laboratory testing have been published more than 40 years ago [5], the frequency of hemolyzed samples remains high and generates remarkable challenges in clinical laboratory practice [6], [7], [8]. The first important issue is distinguishing between in vitro (i.e. spurious) and in vivo (i.e. hemolytic anemia) hemolysis. The differentiation between these conditions is not meaningless because the former case reflects a kaleidoscope of problems emerging throughout preanalytical sample management, thus including blood drawing, handling, transportation, storage and preparation for testing,

Journal

Clinical Chemistry and Laboratory Medicine (CCLM)de Gruyter

Published: Mar 28, 2018

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