Defined as red blood cell break down and the release of hemoglobin and intracellular contents into the plasma, hemolysis can seriously impact patient care as well as the laboratory's reputation through its affect on test results. Therefore, the European Preanalytical Scientific Committee, in collaboration with the International Federation of Clinical Chemistry Working Group on Patient Safety, have designed a questionnaire to collect data on prevalence and management of hemolytic specimens referred to the clinical laboratories for clinical chemistry testing. This book will help identify the areas where hemolysis occurs most frequently, which can, in turn, guide further analysis about why it is occurring. Once these elements are known, practices and procedures can be implemented to dramatically reduce hemolysis and avoid erroneous laboratory results affecting patient care and increasing laboratory costs.
Inhaltsverzeichnis
1;Preface;7 2;1 Structure and function of red blood cells;9 3;2 Red blood cell parameters;11 3.1;2.1 Hematocrit;11 3.2;2.2 Mean corpuscular volume;11 3.3;2.3 Mean corpuscular hemoglobin;11 3.4;2.4 Mean corpuscular hemoglobin concentration;12 3.5;2.5 Red blood cell distribution width;12 4;3 Definition of hemolysis;15 5;4 Prevalence of hemolyzed specimens in clinical laboratories;17 6;5 In vivo hemolysis;23 6.1;5.1 Causes;23 6.2;5.2 Clinical presentation;26 6.3;5.3 Diagnosis of hemolytic anemia;27 7;6 In vitro hemolysis;29 7.1;6.1 Unsuitable procedures during blood collection;29 7.2;6.2 Blood collection with various devices and needles;32 7.3;6.3 Sample transportation and storage;39 7.4;6.4 Centrifugation of the specimen;41 8;7 How to distinguish in vivo versus in vitro hemolysis;43 9;8 Effects of in vitro hemolysis on laboratory testing;47 9.1;8.1 Interference in clinical chemistry testing;47 9.2;8.2 Interference in hemostasis testing;55 9.3;8.3 Interference in immunoassays and electrophoresis;57 9.4;8.4 Interference in ABO type and antibody screen testing;60 10;9 Spurious hemolysis and veterinary medicine;63 10.1;9.1 Blood collection from small animals and pets;63 10.2;9.2 Interference of hemolysis in veterinary laboratory medicine;63 11;10 Detection of hemolyzed specimens;65 12;11 Management of hemolyzed specimens;71 12.1;11.1 Local evaluation of the bias;71 12.2;11.2 Surveys and recommendations;77 12.3;11.3 General indications for preventing hemolysis during blood collection;77 12.4;11.4 Preventing hemolysis from intravenous catheters;79 12.5;11.5 Reliable identification of hemolyzed specimens;80 12.6;11.6 Management of test results on hemolyzed specimens;81 13;12 The challenge of synthetic blood substitutes;89 13.1;12.1 Individual studies evaluating the interference of blood substitutes;89 13.2;12.2 Detection and quantification of blood substitutes;94 13.3;12.3 Final remarks on blood substitutes;96 14;References;97 15;Index;109
