Hemolysis of Coagulation Specimens: A Comparative Study of Intravenous Draw Methods

Stauss, Mary; Sherman, Beth; Pugh, Lorene; Parone, Dominic; Looby-Rodriguez, Karen; Bell, Annette; Reed, Carole-Rae

doi:10.1016/j.jen.2010.08.011

Cited by 15 publications

(7 citation statements)

References 8 publications

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“…The lysis mechanism of the samples was performed mechanically because it is more similar to daily practices where in vitro hemolysis is commonly caused by mechanical factors. [ 7 , 20 ] However, the mechanical lysis carried out may result in variable tissue factor release, and this has an effect on the shortening or lengthening of PPT and APTT.…”

Section: Discussionmentioning

confidence: 99%

The effects of hemolysis on plasma prothrombin time and activated partial thromboplastin time tests using photo-optical method

Hernaningsih

Akualing²

2017

Medicine

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Hemolysis is the most common reason why coagulation test samples are rejected. However, the effects of hemolysis on plasma prothrombin time (PPT) and activated partial thromboplastin time (APTT) are rarely investigated and the results are controversial. This research aims to analyze the effects of hemolysis on PPT and APPT using the photo-optical method.Nonhemolyzed citrate blood samples (n = 30) with normal PPT and APTT underwent 2-step mechanical lysis and then hemoglobin level measurement was carried out at each step. The first lysis was mild to moderate resulting in a hemoglobin level of <0.8 g/dL. These samples were labeled as group 1. The second step showed more severe lysis, which resulted in a plasma hemoglobin level of ≥0.8 g/dL. These samples were labeled as group 2. Analysis was carried out on the PPT and APTT differences between the 2 groups and baseline, as well as between group 1 and group 2 using repeated-measures analysis of variance (ANOVA). The effects of hemolysis were analyzed using linear regression. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value in PPT and APTT.Significantly shorter APTT was measured for group 1 than baseline, (P = .000), group 2 than baseline (P = .000), and group 2 than group 1 (P = .003). With regard to PPT results, those for group 1 were significant shorter than baseline (P = .002), while those for group 2 were significantly longer than group 1 (P = .000). In the correlation assay, the level of hemolysis revealed a mildly significant correlation to APTT (R = 0.245; P = .02). Cut-off value for PPT was 1.55 g/dL (100% sensitivity and 87.9% specificity), while the value for APTT was 0.95 g/dL (75% sensitivity and 62.5% specificity).Not all hemolyzed samples should be rejected for PPT and APTT tests using photo-optical methods.

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Section: Discussionmentioning

confidence: 99%

The effects of hemolysis on plasma prothrombin time and activated partial thromboplastin time tests using photo-optical method

Hernaningsih

Akualing²

2017

Medicine

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“…A number of studies have investigated the efficacy of sampling blood from PIVC's. Studies investigating the practice have focused on the prevalence of haemolysis (Grant, 2003;Lowe et al, 2008;Phelan et al, 2018;Seemann & Reinhardt, 2000;Stauss et al, 2012;Wollowitz, Bijur, Esses, & Gallagher, 2013); equivalence with laboratory values drawn from venepuncture (Corbo, Fu, Silver, Atallah, & Bijur, 2007;Hambleton, Gomez, & Andreu, 2014;Zlotowski, Kupas, & Wood, 2001); the risk of blood culture contamination (Kelly & Klim, 2013;Self et al, 2012); and device failure caused by blood sampling (Mulloy et al, 2018). As a result of differences in how studies were conducted, mixed findings on the efficacy of sampling blood from PIVCs have not produced strong evidencebased practice recommendations.…”

Section: Literature Reviewmentioning

confidence: 99%

Blood sampling through peripheral intravenous cannulas: A look at current practice in Australia

et al. 2020

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Background: Sampling blood from a peripheral intravenous cannula offers an alternative to venepuncture. This practice can reduce frequency of venepuncture and patient discomfort. Opponents argue the practice increases the chance of haemolysis, risk of infection and device failure. Aim: To describe the prevalence and practice of blood sampling from peripheral intravenous cannulas by Australian nurses. Methods: This study used a descriptive cross-sectional design and data were collected using an electronic survey. The survey examined Australian nurses' practice of sampling blood from peripheral intravenous cannulas. Quantitative descriptive data was analysed and presented as frequencies, percentages, medians and ranges. Findings: A total of 542 nurses participated in the survey. Of these, 338 (62.4%) completed the survey. The majority of responses came from the State of Victoria (n = 137, 40.5%) and one-third were emergency nurses (n = 112, 33.1%). Sampling of blood from peripheral intravenous cannulas occurred between 37.5% and 66.7% throughout the State and Territories of Australia. Peripheral intravenous cannula blood sampling was most common in the emergency department (n = 93, 53.4%). The most frequent reasons given were difficulty of access (n = 223, 66.0%) followed by patient comfort (n = 194, 57.4%). Discussion: Blood sampling is required to diagnose and monitor treatment responses. A peripheral intravenous cannula offers the opportunity to sample blood without the need for venepuncture. Practice recommendations on when to sample blood and correct sampling technique are based on limited or conflicting evidence. Conclusion: Findings from this study indicate it is common practice to draw blood samples from a peripheral intravenous cannula. Further research is required to examine the accuracy and safety of this practice to further inform policy.

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“…A considerable variation in haemolysis rates reported in the literature was identified. Seven studies reported a haemolysis rejection below 1% of all accessions [17][18][19][20][21][22][23], six between 1% and 3% [24][25][26][27][28][29], 20 between 3% and 20% [9,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and another four above 20% [49][50][51][52]. Haemolysis detection methods, and free plasma haemoglobin levels used for this detection, are likely to be partly responsible for this variation, in addition to the differences in study designs and study populations.…”

Section: Discussionmentioning

confidence: 99%

Making sense of a haemolysis monitoring and reporting system: a nationwide longitudinal multimethod study of 68 Australian laboratory participant organisations

Vecellio

Lake

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Hemolysis of Coagulation Specimens: A Comparative Study of Intravenous Draw Methods

Cited by 15 publications

References 8 publications

The effects of hemolysis on plasma prothrombin time and activated partial thromboplastin time tests using photo-optical method

The effects of hemolysis on plasma prothrombin time and activated partial thromboplastin time tests using photo-optical method

Blood sampling through peripheral intravenous cannulas: A look at current practice in Australia

Making sense of a haemolysis monitoring and reporting system: a nationwide longitudinal multimethod study of 68 Australian laboratory participant organisations

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