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Studies on in vitro hemolysis and utility of corrective formulas for reporting results on hemolyzed specimens.

Author(s): Lippi G, Avanzini P, Pavesi F, Bardi M, Ippolito L, Aloe R, Favaloro EJ

Publication: Biochem Med (Zagreb), 2011, Vol. 21, Page 297-305

PubMed ID: 22420244 PubMed Review Paper? No

Purpose of Paper

The purpose of this paper was to determine the effects of mechanically-induced hemolysis on hematological testing, hemolysis index (HI), and levels of glucose, lactate dehydrogenase (LD), aspartate aminotransferase (AST), and potassium (K) in plasma.

Conclusion of Paper

HI and cell free hemoglobin increased with increasing numbers of aspirations through a 30-gauge needle. While increasing degrees of hemolysis did not significantly affect total hemoglobin or glucose measurements, and only marginally decreased white blood cell (WBC) counts, increasing HI resulted in significantly decreased red blood cell (RBC) counts, hematocrit, and mean corpuscular volume (MCV), as well as significantly increased mean corpuscular hemoglobin (MCH) and LD, AST, and K in plasma. Gross hemolysis (HI>100) resulted in increased platelet counts.

Studies

  1. Study Purpose

    The purpose of this study was to determine the effects of mechanically-induced hemolysis on hematological testing, HI, and levels of glucose, LD, AST, and K in plasma. Hemolysis was induced by aspiration of whole blood aliquots through a 30-gauge needle from 1 to 5 times.

    Summary of Findings:

    HI and cell free hemoglobin increased with increasing numbers of aspirations through a 30-gauge needle. While increasing degrees of hemolysis did not significantly affect total hemoglobin or glucose measurements, and only marginally decreased WBC counts, increasing HI resulted in significantly decreased RBC counts, hematocrit, and MCV, as well as significantly increased MCH and LD, AST, and K in plasma. Gross hemolysis (HI>100) resulted in increasd platelet counts. The authors conclude that use of corrective formulas for hemolyzed specimens may be unreliable due to variability between individuals and the dishomogenous nature of mechanical injury of blood.

    Biospecimens
    Preservative Types
    • None (Fresh)
    Diagnoses:
    • Normal
    Platform:
    AnalyteTechnology Platform
    Protein Clinical chemistry/auto analyzer
    Electrolyte/Metal Clinical chemistry/auto analyzer
    Carbohydrate Clinical chemistry/auto analyzer
    Cell count/volume Spectrophotometry
    Protein Spectrophotometry
    Cell count/volume Hematology/ auto analyzer
    Protein Hematology/ auto analyzer
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Biospecimen Aliquots and Components Biospecimen components <0.5 g/L free hemoglobin
    7.0 g/L free hemoglobin
    14.0 g/L free hemoglobin
    22.0 g/L free hemoglobin
    29.0 g/L free hemoglobin
    37.0 g/L free hemoglobin
    Biospecimen Aliquots and Components Blood and blood products Plasma
    Whole blood
    Biospecimen Aliquots and Components Hemolysis Fine needle aspiration-induced
    Not induced
    View more

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