Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

Du, Zhenhua; Liu, JiQin; Zhang, Hua; Bao, BuHe; Zhao, Ruiqi; Jin, Ying

doi:10.1002/jcla.22856

Cited by 13 publications

(18 citation statements)

References 21 publications

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“…It is well known that the hemolysis index is an extremely useful indicator that quantitatively evaluates the hemolysis of blood cells 16‐18 . The hemolytic interference revealed markedly significant regression and very high correlation coefficients with the measured hemolysis indices.…”

Section: Resultsmentioning

confidence: 94%

“…For hemolysis interference, the results of quantitative analysis are largely consistent with previous reports, including changes in LDH, potassium, CK, CK-MB, and some other analytes. 12,18,19 However, several previous studies used freeze-and-thaw or mechanical trauma without assessing the achievement of cell lysis. 12,16,20,21 In these studies, the extent of hemolysis was solely determined from the hemolytic index measured by the machine.…”

Section: Discussionmentioning

confidence: 99%

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A Reference chart for clinical biochemical tests of hemolyzed serum samples

Zhu

Wang

et al. 2020

Clinical Laboratory Analysis

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Background Although the effect of hemolysis has been extensively evaluated on clinical biochemical tests, a practical guidance for laboratory staff to rapidly determine whether a hemolyzed blood sample is acceptable and how to interpret the results is lacking. Here, we introduce a chart as a convenient reference for dealing with such samples. Methods Serum samples with 0.1%, 0.3%, 1%, 3%, and 10% hemolysis were prepared from sonicated endogenous red blood cells and received 35 wet and 22 dry clinical biochemical tests, respectively. The contributing part in the biochemical test result at each hemolysis condition was derived by subtracting the original test result of this sample with no hemolysis. The net results were used for analyses and preparation of the reference chart. Results The reference chart displayed the analytically calculated hemolysis interference and related statistical analyses. The chart also provided the color appearance of serum samples at each hemolysis condition for clinical staffs to determine whether a hemolyzed sample could be accepted. Conclusion In clinical laboratories, preparation of such a reference chart is extremely useful in dealing with hemolyzed blood samples for clinical biochemical tests.

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Section: Resultsmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

A Reference chart for clinical biochemical tests of hemolyzed serum samples

Zhu

Wang

et al. 2020

Clinical Laboratory Analysis

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“…However, our findings were incompatible with this information. In other studies, it has been reported that the values given by the manufacturer are not compatible with their results (27,28). On the other hand, interferograms are recommended in clinical chemistry tests for managing haemolysed specimens (11,21).…”

Section: Discussionmentioning

confidence: 96%

Effect of haemolysis on an enzymatic measurement of ethanol

Çat

Uçar

Gümüş

2021

Biochem. med. (Online)

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Introduction We investigated the interference of haemolysis on ethanol testing carried out with the Synchron assay kit using an AU680 autoanalyser (Beckman Coulter, Brea, USA). Materials and methods Two tubes of plasma samples were collected from 20 volunteers. Mechanical haemolysis was performed in one tube, and no other intervention was performed in the other tube. After centrifugation, haemolysed and non-haemolysed samples were diluted to obtain samples with the desired free haemoglobin (Hb) values (0, 1, 2, 5, 10 g/L). A portion of these samples was then separated, and ethanol was added to the separated sample to obtain a concentration of 86.8 mmol/L ethanol. After that, these samples were diluted with ethanol-free samples with the same Hb concentration to obtain samples containing 43.4, 21.7, and 10.9 mmol/L. Each group was divided into 20 equal parts, and an ethanol test was carried out. The coefficient of variation (CV), bias, and total error (TE) values were calculated. Results The TE values of haemolysis-free samples were approximately 2-5%, and the TE values of haemolysed samples were approximately 10-18%. The bias values of haemolysed samples ranged from nearly - 6.2 to - 15.7%. Conclusions Haemolysis led to negative interference in all samples. However, based on the 25% allowable total error value specified for ethanol in the Clinical Laboratory Improvement Amendments (CLIA 88) criteria, the TE values did not exceed 25%. Consequently, ethanol concentration can be measured in samples containing free Hb up to 10 g/L.

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“…It was observed that the findings within the reference range obtained in this study were consistent with our findings, and in the same study, it was stated that the manufacturer's statements were insufficient for ALT tests, among the tests evaluated. Studies on other devices and reagents have also obtained results that do not comply with the manufacturer's declarations (21)(22)(23)(24). On the other hand, the general approach assumes the significant change affecting the result as ± 10% and presents the cut-off values accordingly.…”

Section: Discussionmentioning

confidence: 99%

Interferograms plotted with reference change value (RCV) may facilitate the management of hemolyzed samples

Uçar¹,

Çat²,

Gümüş³

et al. 2022

J Med Biochemistry

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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.

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Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

Cited by 13 publications

References 21 publications

A Reference chart for clinical biochemical tests of hemolyzed serum samples

A Reference chart for clinical biochemical tests of hemolyzed serum samples

Effect of haemolysis on an enzymatic measurement of ethanol

Interferograms plotted with reference change value (RCV) may facilitate the management of hemolyzed samples

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