Correction of factitious hyperkalemia in hemolyzed specimens

Owens, Heather; Siparsky, Georgette L.; Bajaj, Lalit; Hampers, Louis C.

doi:10.1016/j.ajem.2005.05.011

Cited by 34 publications

(22 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The change in serum measured K + concentration was plotted versus the change in serum hemolysis index for each pair of samples [5]. The database was treated for outliers, only 2 SDs (standard deviations) where allowed in relation to the medium time (2 h) between drawn, medium Δ K + and medium hemolysis index, with a total N of 114.…”

Section: Methodsmentioning

confidence: 99%

“…Hemolysis is a major pre-analytical issue in current clinical pathology, prevalence can be as high as 3.3% of all routine samples, accounting for up to 40%-70% of all unsuitable specimens identified [1]. It may interfere in many lab tests, such as potassium, bilirubin, haptoglobin, liver enzymes, amylase, folic acid and iron [1][2][3][4][5]. Hemolysis is the main reason for the re-collection of blood samples, and so increasing TAT (turnaround time), costs on blood collection materials and other clinical products.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Correction of Factitious Hyperkalemia in Hemolysed Specimens from Adult Emergency Department Using the Beckman Coulter Unicell DxC 880i® Analyzer Derived Factor

Domingues¹,

Carneiro²,

Dias³

2017

JPP

View full text Add to dashboard Cite

Hemolysis in ED (emergency department) patients is common due to difficult blood draws. Values of serum potassium (K + ) become falsely elevated secondary to release of intracellular contents. Objective: The aim of the study was to establish a correction factor for factitious elevated K + in samples for de adult ED. Methods: We used samples from 125 adult ED patients, in which the 2nd sample was drawn due to hemolysis of the first tube. Results: Firstly, we derived a correction factor expressing an increase in potassium concentration in 0.21 mmol/L (95% confidence interval, 0.17-0.24 mmol/L with p < 0.01) for each hemolysis index increment. Conclusions: A reliable correction factor for factitious hyperkalemia in a clinical relevant range exists.

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Correction of Factitious Hyperkalemia in Hemolysed Specimens from Adult Emergency Department Using the Beckman Coulter Unicell DxC 880i® Analyzer Derived Factor

Domingues¹,

Carneiro²,

Dias³

2017

JPP

View full text Add to dashboard Cite

show abstract

“…2 This is a controversial practice with mixed views on its validity and safety. 1,[3][4][5][6][7] Some authors have suggested that correction can be done with the associated uncertainty reported in a qualitative or semi-quantatitive manner. 5,[7][8][9][10] For any response to an interferent the laboratory must determine several factors.…”

Section: Introductionmentioning

confidence: 99%

Correcting laboratory results for the effects of interferences: an approach incorporating uncertainty of measurement

Jones

Hawkins

2014

Ann Clin Biochem

View full text Add to dashboard Cite

Background: Results of numerical pathology tests may be subject to interference and many laboratories identify such interferences and withhold results or issue warnings if clinically erroneous results may be issued. Some laboratories choose to correct for the effect of interferences, with the uncertainty of the correction noted as a limitation in this process. We investigate the effect of correcting for the effect of interferences on the ability to release results within defined error goals using the effect of in-vitro haemolysis on serum potassium measurement as an example. Methods: A model was developed to determine the uncertainty of a result corrected for the effect of an interferent with a linear relationship between concentration and effect. The model was used to assess the effect of correction on the results which could be released within specified accuracy criteria. Results: Using the effects of haemolysis on potassium results as an example, the maximum amount of haemolysis in a sample that would change the result by > 0.5 mmol/L, with a frequency of 5%, was increased from approximately 1100 mg/L (no correction) to 8000 mg/L (with correction). Conclusions: With modelling of the factors related to the uncertainties of results in the presence of interferences, it is possible to release results in the presence of significantly higher concentrations of interferences after correction than without correction. Correction of a result for a known bias and allowance for the uncertainty of the correction can be considered consistent with the guide to the expression of uncertainty in measurement (GUM).

show abstract

“…Kapilarni uzorci za parametre acidobazine ravnoteže, pedijatrijske uzorke za kompletne krvne slike ili za dijagnostiku uz bolesnika u hitnoj dijagnostici predstavljaju poseban problem u smislu interferencija. 23 Interferencije u ovim uzorcima najče-šće se uočavaju zbog izrazito promijenjenih vrijednosti, a ponavljaju se kad graniče ili prelaze kritične vrijednosti.…”

unclassified

Hemolysis - a constant source of error in laboratory diagnostics // Hemoliza – stalni izvor greške u laboratorijskoj dijagnostici

Kutlija

2017

SZNJ

View full text Add to dashboard Cite

APSTRAKTCilj ovog rada je da se ukaže na značaj pravilne preanalitičke pripreme uzorka kako bi se smanjio broj grešaka u laboratoriji sa posebnim naglaskom na hemolizu. Posljednih godina laboratorija postaje efi kasnija u smislu bržih dobijanja rezultata, tačnijih, bržih i preciznijih kontrola, a sve zahvaljujući automatizaciji, ali treba biti oprezan jer greške se i dalje dešavaju. Najveći udio grešaka se dešava u preanalitičkoj i postanalitičkoj fazi. Hemoliza eritrocita in vivo ili in vitro je jedna od najznačajnijih greška preanalitičke faze Radi se o pregledu literature. Period pregleda literature je od 20-31 maj 2017. godine. Pregled literature je vršen u bazama podataka HINARI, PUB MED I GOOGLE SEARCH. Ukupno je pregledano oko 120 naučnih članaka uglavnom na engleskom jeziku, od kojih smo 20 uvrstili u rad. Pregledom sažetka svakog članka, svi članci u kojima se nije pisalo o hemolizi, kao izvoru greške su isključeni. Pregledom literature kroz istraživanja koja su rađena u svijetu i kod nas, pokazalo se da je greška u laboratorijskoj dijagnostici i dalje prisutna. Najveći broj grešaka se dešava u preanalitičkoj fazi rada. Prema podacima posljednjih istraživanja, hemoliza zauzima prvo mjesto od grešaka u preanalitičkoj fazi laboratorijskog procesa. Rezultati analitičkog rada laboratorija moraju zadovoljiti zahtjeve analitičke tačnosti i preciznosti kao i kliničke koristi analize. Osnovni uslov za postizanje najvećeg mogućeg kvantitativnog smanjenja laboratorijskih pogrešaka je timski rad i međuklinička saradnja. Laboratorijski stručnjaci moraju prednjačiti u osiguranju sigurnosti bolesnika kako unutar, tako i izvan zidova kliničkih laboratorija. KLJUČNE REČI UVODPosljednjih godina je došlo do ekspanzije poboljšanja rada kliničkih laboratorija. Klinička laboratorija je postala efi kasnija nego ikad ranije. Manuelne radnje u pripremi i analiziranju bioloških uzoraka se izuzimaju i proces rada se sve više automatizuje. 1 Automatizacija i kontrola kvaliteta, spoljašnja i unutrašnja, omogućavaju praćenje i unapređenje analitičke preciznosti i tačnosti dobijenih rezultata. Proces rada u kliničkim laboratorijama se poboljšava i preko certifi kovanih i akreditovanih programa. 2 Programi oblikuju i defi nišu proces primjenom odgovarajućih standarda rada u laboratorijama. Vrijeme analiziranja uzoraka je svedeno na najmanju moguću mjeru, omogućavajući analiziranje većeg broja uzoraka i više parametara u istom vremenskom intervalu. 3,4 U dnevnoj je praksi moguće koristiti više od 1000 pojedinačnih analiza. Broj analiza godišnje se povećava, što utiče na dinamiku organizacijskih promjena u pojedinim medicinsko-biohemijskim laboratorijama.Značajan je porast broja novih analiza unazad 15 godina kada se intenzivno uvode analize u području imunologije, molekularno-biohemijske analize ili nove tehnologije kao i analize uz bolesnika (eng. Point-of-care testing, POCT), plinsko-masene spektrometrije, protočne citometrije. Omjer imunohemijskih i standardnih klinič-ko-hemijskih analiza danas je 55% u odnosu na 45%, za razliku o...

show abstract

Correction of factitious hyperkalemia in hemolyzed specimens

Cited by 34 publications

References 5 publications

Correction of Factitious Hyperkalemia in Hemolysed Specimens from Adult Emergency Department Using the Beckman Coulter Unicell DxC 880i® Analyzer Derived Factor

Correction of Factitious Hyperkalemia in Hemolysed Specimens from Adult Emergency Department Using the Beckman Coulter Unicell DxC 880i® Analyzer Derived Factor

Correcting laboratory results for the effects of interferences: an approach incorporating uncertainty of measurement

Hemolysis - a constant source of error in laboratory diagnostics // Hemoliza – stalni izvor greške u laboratorijskoj dijagnostici

Contact Info

Product

Resources

About