Interference of in vitro hemolysis complete blood count
Gabriela de Jonge1, Talita L Dos Santos1, Bruno R Cruz1
1Department of Clinical and Toxicological Analysis, State University of Ponta Grossa-UEPG, Ponta Grossa, Brazil.
Journal of Clinical Laboratory Analysis
|February 4, 2018
Summary
In vitro hemolysis significantly impacts blood count results, decreasing red blood cell counts and hematocrit while increasing platelet counts. This interference compromises the reliability of diagnostic evaluations.
Area of Science:
- Hematology
- Clinical Pathology
- Pre-analytical Variables
Background:
- Hemolysis, the rupture of red blood cells, can occur in vivo or in vitro due to pre-analytical errors.
- Hemolyzed samples can lead to inaccurate diagnostic and monitoring results.
- Understanding in vitro hemolysis interference is crucial for reliable hematological testing.
Purpose of the Study:
- To evaluate the interference of in vitro hemolysis on blood cell counting parameters.
- To assess the impact of varying degrees of hemolysis on impedance-based hematology analyzers.
Main Methods:
- Peripheral blood samples were collected in K2-EDTA anticoagulant.
- Scalar amounts of hemolysis were induced by passing samples through a small-gauge needle (5 and 10 times).
- Hematological tests were performed using the Hemacounter 60-RT 7600® impedance analyzer.
Main Results:
- High hemolysis decreased red blood cell count and hematocrit; increased mean corpuscular hemoglobin concentration and platelet count.
- Mild hemolysis showed slight increases in mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet count.
- Significant hemolysis exceeded desirable bias for red blood cell count, hematocrit, mean corpuscular volume, red cell distribution width, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet counts.
Conclusions:
- In vitro hemolysis significantly diminishes the clinical and analytical reliability of blood count assessments.
- Pre-analytical error management, specifically preventing hemolysis, is vital for accurate hematological diagnostics.
- The study highlights the need for careful sample handling to ensure the integrity of blood count parameters.
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