Impact of Individualized Hemolysis Management Based on Biological Variation Cut-offs in a Clinical Laboratory
Autor: | Fernando Marques-Garcia, David Hansoe Heredero Jung, Sandra Elena Pérez |
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Rok vydání: | 2022 |
Předmět: |
Protocol (science)
medicine.medical_specialty Analyte Hematologic Tests business.industry Biochemistry (medical) Clinical Biochemistry Medical laboratory General Medicine Clinical Laboratory Services medicine.disease Hemolysis chemistry.chemical_compound Folic acid chemistry Internal medicine Biological variation Lactate dehydrogenase medicine Humans Laboratories business Retrospective Studies Whole blood |
Zdroj: | Annals of Laboratory Medicine. 42:169-177 |
ISSN: | 2234-3814 2234-3806 |
Popis: | Background Hemolysis is the most common type of preanalytical interference. Cut-offs based on the hemolysis index level can be established using different approaches. The Working Group for Preanalytical Phase of the European Federation of Laboratory Medicine has developed a protocol for hemolysis management based on cut-offs estimated from biological variation (BV) and the use of interpretative comments. We developed and assessed the implementation of the protocol in our laboratory. Methods Hemolysates from whole blood were prepared following the Meites method, and pooled serum samples with known Hb concentrations were prepared. For each analyte (42 ), interferograms were generated and used to establish cut-offs: desirable analytical quality specification and reference change value. This protocol was assessed, both pre- and post-implementation, according to expert rules in the Laboratory Information System. Results Among the analytes evaluated, we selected those that showed the highest degree of hemolysis interference: lactate dehydrogenase (LDH), aspartate aminotransferase, direct bilirubin, potassium, and folic acid. The cut-offs for LDH and direct bilirubin were the lowest. Only 28.16% of all LDH values were adequately reported in the pre-implantation retrospective study, but this percentage improved in the post-implementation stage. Conclusions The development and implementation of a harmonized protocol for hemolysis management based on BV cut-offs and result reporting significantly improve hemolysis detection and lead to a decrease in the number of hemolyzed samples over time. |
Databáze: | OpenAIRE |
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