The effect of hemolytic contamination in sample on clinical chemistry analysis

  • ปานทิพย์ รัตนศิลป์กัลชาญ Faculty of Medical Technology, Huachiewchalermprakiet University
  • วรภัทร์ บุญเยี่ยม
  • ธนวัฒน์ กษมาวุฒิ
Keywords: Clinical chemistry, Hemolysis

Abstract

This study aimed to examine the effect of hemolysis on clinical chemistry analysis. Blood samples were obtained from 30 healthy volunteers in the age range of 20-60 years. Non-hemolyzed plasma was separated from whole blood by centrifugation. Hemolysis was simulated in samples by adding their own hemolysate to their non-hemolyzed plasma to make the final concentration of hemoglobin at 0.9 mg/mL, 1.8 mg/mL, 3.5 mg/mL and 6.7 mg/mL. These samples can be classified as 1+, 2+, 3+ and 4+ hemolysis samples respectively. Subsequently, all samples were analyzed for the following 14 parameters: glucose, BUN, creatinine, uric acid, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, total protein, albumin, total bilirubin, direct bilirubin, AST and ALT using an automatic analyzer. Clinical chemistry analysis showed that different hemolysis levels appear to significantly increase the level of certain tests. Accordingly, hemolysis 1+ affected direct bilirubin level (p<0.05). Hemolysis 2+ affected total bilirubin and AST level (p<0.05). Hemolysis 4+ affected glucose, uric acid, ALT and total protein level (p<0.05). However, hemolysis did not significantly affect to the results of BUN, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, albumin and creatinine level. In conclusion, these results suggest that different levels of hemolysis may affect different chemical analytic parameters. Considering these results, hemolysis level may be an important factor to prevent unnecessary rejection.

References

1. A Wooley A., Golmard L, Kitchen S. Effects of haemolysis, icterus and lipaemia on coagulation test as performed on Stago STA-Compact-Max analyzer. Int J lab hematol 38(4):375-388, 2016.
2. Sol F.Green. “The cost of poor blood specimen quality and errors in preanalytical processes” Clin Biochem, 46;1175-1179, 2013.
3. Sysmex-europe.com [Internet]. SLS DETECTION METHOD [cited 2016 october 30]. Available from: https://www.sysmex-europe.com/academy/knowledge-centre/measurement-technologies/sls-detection-method.html
4. Joseph J Frank, Edward W Bermes, Margaret J Bickel, Bruce F Watkins. Effect of in vitro hemolysis on chemical values for serum. Clin Chem, 24(11):1966-1970, 1978
5. Mehmet Koseoglu, Aysel Hur, Aysenur Atay, Serap Cuhadar. “Effects of hemolysis interference on routine biochemistry parameters” Biochemia Medica, 21(1):79-85, 2011.
6. Dogan Yucel, Klara Dalva. “Effect of In Vitro Hemolysis on 25 Common Biochemical Tests” Clin Chem. 38(4);575-577, 1992.
Published
2019-06-26
How to Cite
1.
รัตนศิลป์กัลชาญป, บุญเยี่ยมว, กษมาวุฒิธ. The effect of hemolytic contamination in sample on clinical chemistry analysis. HCU Journal [Internet]. 26Jun.2019 [cited 21Nov.2019];23(1):47-9. Available from: https://www.tci-thaijo.org/index.php/HCUJOURNAL/article/view/146640
Section
Research article