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The Hemolyzed Sample: To Analyse Or Not To Analyse

  • Seema BhargavaEmail author
  • Parul Singla
  • Anjali Manocha
  • Mamta Kankra
  • Anisha Sharma
  • Ashok Ahirwar
  • Rachna Ralhan
  • Udhavananda Thapliyal
  • Preet Mehra
Original Research Article
  • 15 Downloads

Abstract

Preanalytical errors constitute about 40–65% of laboratory errors, of which 60% are due to hemolysis. This leads to imprecise reporting and misinterpretation of the actual concentration of analytes. Hence the aim of this study was to estimate the extent of different degrees of interference by visible hemolysis. 25 hemolysed samples along with their fresh unhemolysed sample were studied. Hemolyzed serum was mixed with unhemolyzed serum in predefined serial ratios from 100%, 70%, 50%, 30% and 10% to achieve different grades of hemolysis. Each dilution was analysed for BUN, creatinine, uric acid, phosphorus, Na, K, total protein, amylase, lipase, LDH, tacrolimus and methotrexate. Percentage difference of each dilution of the hemolyzed sample as compared to the unhemolyzed sample was calculated and considered acceptable only if less than TEa. It was observed that Percentage difference of BUN, creatinine, amylase and lipase in all dilutions of hemolyzed samples were within TEa while phosphorus, Na, K, total protein and LDH were beyond the acceptance criteria. Hence It was concluded that it may be safe to analyse a hemolysed sample for BUN, creatinine, amylase, lipase, tacrolimus and methotrexate while uric acid may be estimated in a moderately hemolysed sample. Phosphorus, sodium, potassium, total protein and LDH must never be analyzed in any hemolysed sample.

Keywords

Hemolysis Preanalytical error Tacrolimus Methotrexate Total allowable error TEa 

Notes

Compliance with Ethical Standards

Conflict of interest

Dr.Seema Bhargava, Dr.Parul Singla, Dr.Anjali Manocha, Dr.Mamta Kankra, Dr.Anisha Sharma, Dr.Ashok Ahirwar, Ms. Rachna Ralhan, Mr. Udhavanand Thapliyal and Ms. Preet Mehra declare that they have no conflicts of interest.

Ethical Considerations

All procedures performed in this study were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed written consent was procured from all subjects.

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Copyright information

© Association of Clinical Biochemists of India 2019

Authors and Affiliations

  • Seema Bhargava
    • 1
    Email author
  • Parul Singla
    • 1
  • Anjali Manocha
    • 1
  • Mamta Kankra
    • 1
  • Anisha Sharma
    • 1
  • Ashok Ahirwar
    • 1
  • Rachna Ralhan
    • 1
  • Udhavananda Thapliyal
    • 1
  • Preet Mehra
    • 1
  1. 1.Department of BiochemistrySir Ganga Ram HospitalNew Delhi-60India

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