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Correction of factitious hyperkalemia in hemolyzed specimens
Heather Owens1, Georgette Siparsky, Lalit Bajaj
1Department of Pediatrics, The Children's Hospital, Denver, CO 80218, USA. owens.heather@tchden.org
The American Journal of Emergency Medicine
|November 18, 2005
Summary
A correction factor was developed to adjust potassium (K+) levels falsely elevated by in vitro hemolysis. This can prevent unnecessary repeat blood draws when hemolysis occurs in pediatric specimens.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Pediatric Hematology
Background:
- Hemolysis is common in pediatric blood samples, leading to falsely high potassium (K+) levels.
- This inaccurate elevation of K+ often necessitates repeat blood draws, increasing patient burden and healthcare costs.
Purpose of the Study:
- To establish a reliable correction factor for factitious hyperkalemia caused by in vitro hemolysis.
- To utilize free plasma hemoglobin (p-Hgb) as a quantitative measure of hemolysis for this correction.
Main Methods:
- Whole blood specimens were subjected to mechanical hemolysis and/or potassium acetate addition.
- Standard potassium (K+) and free plasma hemoglobin (p-Hgb) measurements were performed on all manipulated specimens.
Main Results:
- A linear relationship was observed between the increase in K+ and the level of p-Hgb in hemolyzed samples.
- A statistically significant correction factor (0.00319 x p-Hgb) was derived to adjust for factitious hyperkalemia.
Conclusions:
- A reliable correction factor for factitious hyperkalemia within a clinically relevant range has been established.
- This factor can help avoid unnecessary repeat blood draws by predicting corrected K+ values, particularly when results fall within the reference range after adjustment.
