Analytical interferences resulting from intravenous lipid emulsion.

Area of Science:

• Clinical Chemistry
• Toxicology
• Laboratory Medicine

Background:

• Intravenous lipid emulsion (IVLE) is widely used for drug overdoses.
• Limited data exists on the adverse analytical effects of IVLE.

Purpose of the Study:

• To investigate IVLE interference with common laboratory analytes.
• To assess the impact on reliability and turnaround time in acute intoxications.
• To test methods for minimizing these interferences.

Main Methods:

• Serum pools were spiked with increasing IVLE concentrations (0-30%).
• Analyses were performed on Beckman-Coulter and Roche automated platforms.
• Interfering analytes were re-tested after low-speed centrifugation.

Main Results:

• Significant interferences were observed for magnesium, albumin, and colorimetric glucose assays.
• Amylase, lipase, creatinine, and bilirubin became unmeasurable.
• Potentiometric glucose measurement and centrifugation showed minimal interference.
• Centrifugation removed over 90% of interfering triglycerides.

Conclusions:

• IVLE causes significant analytical interferences, particularly with glucose and magnesium.
• These interferences can lead to incorrect results, delayed treatment, and potentially harmful interventions.
• Collecting samples before IVLE and using centrifugation can mitigate interferences.