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The Hemolyzed Sample: To Analyse Or Not To Analyse.

Seema Bhargava¹, Parul Singla¹, Anjali Manocha¹

¹Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi-60, India.

Indian Journal of Clinical Biochemistry : IJCB

|April 1, 2020

Summary

This summary is machine-generated.

Hemolysis significantly impacts laboratory results, causing up to 60% of preanalytical errors. This study found that BUN, creatinine, amylase, and lipase can be reliably measured in hemolyzed samples, unlike phosphorus, sodium, potassium, total protein, and LDH.

Keywords:

Hemolysis Methotrexate Preanalytical error Tacrolimus Total allowable error TEa

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Area of Science:

Clinical Chemistry
Laboratory Medicine
Analytical Toxicology

Background:

Preanalytical errors are a major source of laboratory inaccuracies, with hemolysis accounting for a substantial portion.
Hemolysis can lead to the misinterpretation of analyte concentrations, affecting patient diagnosis and treatment.

Purpose of the Study:

To quantify the interference of visible hemolysis on various laboratory analytes.
To determine acceptable limits for analyzing samples with different degrees of hemolysis.

Main Methods:

Prepared serial dilutions of hemolyzed serum with unhemolyzed serum (10%-100% hemolysis).
Analyzed multiple analytes including BUN, creatinine, uric acid, phosphorus, electrolytes (Na, K), total protein, enzymes (amylase, lipase, LDH), and therapeutic drugs (tacrolimus, methotrexate).
Calculated percentage difference against unhemolyzed samples and compared with total error acceptable criteria (TEa).

Main Results:

BUN, creatinine, amylase, lipase, tacrolimus, and methotrexate showed results within TEa across all tested hemolysis levels.
Phosphorus, sodium, potassium, total protein, and LDH exceeded TEa even at low hemolysis levels.
Uric acid demonstrated acceptable results only in moderately hemolyzed samples.

Conclusions:

Analysis of BUN, creatinine, amylase, lipase, tacrolimus, and methotrexate is generally safe in hemolyzed samples.
Phosphorus, sodium, potassium, total protein, and LDH should not be analyzed in hemolyzed samples.
Uric acid analysis may be feasible with moderate hemolysis, requiring careful consideration.