Background: The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) have recommended an algorithm based on the reference change value (RCV) to evaluate hemolysis. We utilized this algorithm to analyze hemolysis-sensitive parameters. Methods: Two tubes of blood were collected from each of the 10 participants, one of which was subjected to mechanical trauma while the other was centrifuged directly. Subsequently, the samples were diluted with the participant's hemolyzed sample to obtain the desired hemoglobin concentrations (0, 1, 2, 4, 6, 8, and 10 g/L). ALT, AST, K, LDH, T.Bil tests were performed using Beckman Coulter AU680 analyzer. The analytical and clinical cut-offs were based on the biological variation for the allowable imprecision and RCV. The algorithms could report the values directly below the analytical cut-off or those between the analytical and clinical cut-offs with comments. If the change was above the clinical cut-off, the test was rejected. The linear regression was used for interferograms, and the hemoglobin concentrations corresponding to cut-offs were calculated via the interferograms. Results: The RCV was calculated as 29.6% for ALT. Therefore, ALT should be rejected in samples containing >5.9 g/L hemoglobin. The RCVs for AST, K, LDH, and T.Bil were calculated as 27.9%, 12.1%, 19.2%, and 61.2%, while the samples' hemoglobin concentrations for test rejection were 0.8, 1.6, 0.5, and 2.2 g/L, respectively. Conclusions: Algorithms prepared with RCV could provide evidence-based results and objectively manage hemolyzed samples.

Aim: The objective of this study is to evaluate blood gas analysis (BGA) sample rejection ratios (SRRs) in our laboratory and investigate the effect of various BGA syringes on SRR. Material and Method: 3 groups were formed based on the type and use period of BGA syringes. Syringes containing spray-dosed droplet liquid Lithium Heparin were used in Group 1 (November 2018–May 2019), syringes containing lyophilized dried Lithium Heparin were used in Group 2 (July 2019–January 2020), and another syringes containing spray-dosed droplet liquid Lithium Heparin were used in Group 3 (March 2020–September 2020), and the groups were determined based on such use. SRRs of these groups were calculated, causes for sample rejection were identified, and department-based investigations were conducted. Comparisons between groups were performed according to the indicated variables. Results: Mean SRRs of the groups by percentage (%) were calculated as 6.1±1.5, 10.0±0.9, and 3.8±0.9, respectively, and showed a statistically significant difference (p