Is the hemolysis index always suitable for monitoring phlebotomy performance?

Lippi, Giuseppe; Mattiuzzi, Camilla; Cadamuro, Janne

doi:10.1515/labmed-2018-0028

Cited by 3 publications

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tools to document and evaluate haemolysis indices are freely available ( 37 , 38 ). However, care has to be taken as haemolysis may also originate in vivo as a severe symptom of an underlying disease of the patient ( 39 ). In our survey, only 26% (N = 303) of responders who were performing HIL checks were actually using haemolytic information to monitor phlebotomy quality.…”

Section: Discussionmentioning

confidence: 99%

European survey on preanalytical sample handling – Part 2: Practices of European laboratories on monitoring and processing haemolytic, icteric and lipemic samples. On behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EF

Cadamuro

Lippi

Meyer³

et al. 2019

Biochem. med. (Online)

Self Cite

View full text Add to dashboard Cite

Introduction: No guideline currently exists on how to detect or document haemolysis, icterus or lipemia (HIL) in blood samples, nor on subsequent use of this information. The EFLM WG-PRE has performed a survey for assessing current practices of European laboratories in HIL monitoring. This second part of two coherent articles is focused on HIL. Materials and methods: An online survey, containing 39 questions on preanalytical issues, was disseminated among EFLM member countries. Seventeen questions exclusively focused on assessment, management and follow-up actions of HIL in routine blood samples. Results: Overall, 1405 valid responses from 37 countries were received. A total of 1160 (86%) of all responders stating to analyse blood samples - monitored HIL. HIL was mostly checked in clinical chemistry samples and less frequently in those received for coagulation, therapeutic drug monitoring and serology/infectious disease testing. HIL detection by automatic HIL indices or visual inspection, along with haemolysis cut-offs definition, varied widely among responders. A quarter of responders performing automated HIL checks used internal quality controls. In haemolytic/icteric/lipemic samples, most responders (70%) only rejected HIL-sensitive parameters, whilst about 20% released all test results with general comments. Other responders did not analysed but rejected the entire sample, while some released all tests, without comments. Overall, 26% responders who monitored HIL were using this information for monitoring phlebotomy or sample transport quality. Conclusion: Strategies for monitoring and treating haemolytic, icteric or lipemic samples are quite heterogeneous in Europe. The WG-PRE will use these insights for developing and providing recommendations aimed at harmonizing strategies across Europe.

show abstract

Section: Discussionmentioning

confidence: 99%

European survey on preanalytical sample handling – Part 2: Practices of European laboratories on monitoring and processing haemolytic, icteric and lipemic samples. On behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EF

Cadamuro

Lippi

Meyer³

et al. 2019

Biochem. med. (Online)

Self Cite

View full text Add to dashboard Cite

show abstract

Are icteric and lipemic indices reliable to screen for hyperbilirubinemia and hypertriglyceridemia?

Lippi

Bovo

Salvagno

2019

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

The hemolysis index as a tool for monitoring mild hemolysis in biochemical assays at the emergency laboratory

Bouazza,

Bouarfa,

Khalfa

et al. 2024

J Biol Res

View full text Add to dashboard Cite

Hemolysis is a common pre-analytical error that can affect the accuracy of biochemical assay results. The aim of the study is to investigate the impact of hemolysis on the measurement of nine emergency biochemical parameters: glucose, creatinine, calcium, potassium, sodium, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT),total bilirubin, and direct bilirubin. The study included blood samples collected from various units of the maternity hospital, including high-risk pregnancies follow-up, postpartum care, gynecology, neonatology, and intensive care. The study employs a Hemolysis Index (HI) to monitor and assess sample quality, determining their suitability for the analysis of the nine aforementioned biochemical parameters. The results reveal that hemolysis can significantly affect the accuracy of tests results for the studied parameters, particularly for potassium (increased 4-12 times) and AST (increased 1.47-48.55 times). Three of the studied substances showed a significant, negative, and moderate correlation with HI after the osmotic shock was induced, including AST (r = -0.501, p = 0.006), ALT (r = -0.516, p = 0.004), and sodium (r = -0.598, p = 0.001). Conversely, no significant association was found for the other parameters, which are: glucose (r = 0.079, p = 0.639); creatinine (r = 0.140, p = 0.402); direct bilirubin (r = 0.292, p = 0.075); total bilirubin (r = 0.272, p = 0.114); calcium (r = 0.215, p = 0.196); and potassium (r = -0.188, p = 0.258). Our findings indicate that HI may not be helpful for calculating a predicted value for samples with HI ranging between 87.30 and 295.9. Therefore, it is crucial to establish a threshold for the degree of hemolysis beyond which releasing the result would be considered potentially harmful to the patient especially new-borns and premature infants. In conclusion, the appropriate use of HI in clinical laboratories can enhance patient care quality by minimizing the risk of misdiagnosis leading to inappropriate treatment, particularly when requesting a second sample is not feasible.

show abstract

Is the hemolysis index always suitable for monitoring phlebotomy performance?

Cited by 3 publications

References 27 publications

European survey on preanalytical sample handling – Part 2: Practices of European laboratories on monitoring and processing haemolytic, icteric and lipemic samples. On behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EF

European survey on preanalytical sample handling – Part 2: Practices of European laboratories on monitoring and processing haemolytic, icteric and lipemic samples. On behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EF

Are icteric and lipemic indices reliable to screen for hyperbilirubinemia and hypertriglyceridemia?

The hemolysis index as a tool for monitoring mild hemolysis in biochemical assays at the emergency laboratory

Contact Info

Product

Resources

About