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[Interference in blood coagulation tests on lipemic plasma. Correction using n-hexane clearing]

M Arambarri1, A Oriol, J M Sancho

  • 1Servicio de Análisis Clínicos, Hospital Universitari Germans Trias i Pujol, Universidad Autónoma de Barcelona.

Sangre
|May 13, 1998
PubMed
Summary

Adding n-hexane to lipemic blood samples effectively removes interference in coagulation tests, ensuring accurate prothrombin time (PT) and activated partial thromboplastin time (APTT) results. This method enhances diagnostic reliability for patients with high triglyceride levels.

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Area of Science:

  • Clinical Chemistry
  • Hematology
  • Laboratory Medicine

Background:

  • Lipemic samples, characterized by high triglyceride concentrations, can interfere with standard laboratory assays.
  • This interference, known as turbidity, can lead to inaccurate diagnostic results in coagulation testing.
  • Accurate coagulation testing is crucial for patient management, especially for those on anticoagulant therapy.

Purpose of the Study:

  • To investigate the efficacy of n-hexane addition in eliminating lipemia-induced bias in routine coagulation tests.
  • To validate a method for improving the reliability of coagulation assays performed on lipemic patient samples using the ACL-3000 analyzer.

Main Methods:

  • Lipemia was simulated by adding Intralipid 20% to patient plasma samples.
  • Coagulation parameters, including prothrombin time (PT) and activated partial thromboplastin time (APTT), were measured before and after n-hexane treatment.

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  • Results were compared to assess the impact of lipid removal on test accuracy.

    • Main Results:

    • The analyzer failed to provide results for samples with high triglyceride concentrations (> 9.79 mmol/L) prior to n-hexane treatment.
    • Following n-hexane addition to clear lipids, the analyzer successfully generated results for all previously unreportable samples.
    • Corrected results after n-hexane treatment showed good agreement with original samples, with applied correction factors of 1.06 for PT and 0.88 for APTT.

    Conclusions:

    • The addition of n-hexane is a validated and effective method for mitigating lipid interference in clinical coagulation testing.
    • This technique significantly improves the accuracy and reliability of PT and APTT measurements in lipemic samples.
    • Implementing n-hexane treatment can enhance diagnostic precision in hematology laboratories handling challenging sample matrices.