International Journal of Clinical Biochemistry and Research
  • Year: 2018
  • Volume: 5
  • Issue: 2

Visual hemolysis Index for routine clinical chemistry laboratory parameters

1Assistant Professor Dept. of Biochemistry, Bhasker Medical College and General Hospital, Hyderabad, Telangana

2Lecturer, Dept. of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Kingdom of Saudi Arabia

3Associate Professor, Dept. of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Kingdom of Saudi Arabia

*Corresponding Author: Email: azamhyder@gmail.com

Online published on 2 January, 2019.

Abstract

Interference substances can be significance source of error in the clinical laboratory measurements. Such errors may, in some cases represents hazards in patients. Hemolysis interferes with the Clinical Chemistry Analysis, which influence results of analytes and its leads to erroneous clinical interpretations. Hemolysis of Red cells is inevitable during the collection and handling of blood samples

In usual practice it is very difficult task to perform the rigorous analysis to evaluate interference in routine laboratories. Our objective was to assess effect of Hemolysis on routine biochemistry analysis

The study followed the CLSI EP7-A2 protocol, sample were collected from 5 male subjects, aged 2535 years, [0% (normal pool serum), serial dilution of different hemolysis grades [25% (1+), 50%(2+), 75%(3+) and 100%(4+)] of sample were prepared by spiking pooled serum with red cell lysate. The interference was studied up to concentrations of 0.5gm/dl for hemoglobin. Hemolysis indices graded on the basis of the appearance of the sample qualitatively ranked from “no visible hemolysis” to “4+ hemolysis. Aliquots were analyzed in triplicates using Beckman coulter analyzer. The data was analyzed and ±5% difference from interferent free sample was taken as acceptable criteria.

The experimental design for laboratory method validation for hemolysis showed that Hemolysed samples starting from 1+ of hemolysis grade will be rejected for laboratory analysis for clinical chemistry parameters like Total bilirubin, Aspartate amino transferase, Alkaline Phosphatase, Gamaglutamyle transferase, Uric acid and serum potassium. While serum Creatinine hemolysed sample with 4+ hemolysis will not be accepted.

Study results are useful for rejecting/to comment about the potentially misleading results in clinical chemistry parameters of clinical laboratory

Keywords

Interferences, Hemolysis, Clinical laboratory analysis, Clinical chemistry