Comparison of Red Blood Cell Hemolysis Using Plasma and Serum Separation Tubes for Outpatient Specimens
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: To rapidly obtain outpatient results, we use plasma separation tubes (PST) for chemistry analysis. If lactate dehydrogenase measurement is required, serum separation tubes (SST) are used. There has been no evaluation of hemolysis with these tubes. We compared the hemolytic index (HI) obtained by using PST and SST and applied this for choosing appropriate tubes for clinical laboratories. Methods: The HI of specimens obtained from outpatients visiting Asan Medical Center between July and December 2012 was analyzed. The HI was scored from 0 to 10 by using the Toshiba 200FR (Toshiba Medical Systems Co., Japan). HI was classified by sample tube type, and significant hemolysis was defined as a HI of 2 or more. For significant hemolysis cases, medical records were reviewed to identify the causes. Results: Among 171,519 specimens, significant hemolysis was observed in 0.66% of specimens (0.68% of PST specimens, 0.46% of SST specimens). The mean HI in PST was 0.18 (SD: 0.43) and that in SST was 0.14 (SD: 0.37). The proportion of significant hemolysis was significantly higher in PST than in SST (P=0.001). The cause of significant hemolysis was identified as chemotherapy and prosthetic valve in 48.1% of specimens. Complex sampling errors may have caused significant hemolysis in the remaining 51.9% of specimens. Conclusions: The incidence of hemolysis was slightly higher for PST than SST, although both were <1%. PST are thought to be more useful than SST in outpatient testing because of rapid turnaround time, greater sample volume, and less risk of random errors due to fibrin strands.
Abstract
Background: To rapidly obtain outpatient results, we use plasma separation tubes (PST) for chemistry analysis. If lactate dehydrogenase measurement is required, serum separation tubes (SST) are used. There has been no evaluation of hemolysis with these tubes. We compared the hemolytic index (HI) obtained by using PST and SST and applied this for choosing appropriate tubes for clinical laboratories. Methods: The HI of specimens obtained from outpatients visiting Asan Medical Center between July and December 2012 was analyzed. The HI was scored from 0 to 10 by using the Toshiba 200FR (Toshiba Medical Systems Co., Japan). HI was classified by sample tube type, and significant hemolysis was defined as a HI of 2 or more. For significant hemolysis cases, medical records were reviewed to identify the causes. Results: Among 171,519 specimens, significant hemolysis was observed in 0.66% of specimens (0.68% of PST specimens, 0.46% of SST specimens). The mean HI in PST was 0.18 (SD: 0.43) and that in SST was 0.14 (SD: 0.37). The proportion of significant hemolysis was significantly higher in PST than in SST (P=0.001). The cause of significant hemolysis was identified as chemotherapy and prosthetic valve in 48.1% of specimens. Complex sampling errors may have caused significant hemolysis in the remaining 51.9% of specimens. Conclusions: The incidence of hemolysis was slightly higher for PST than SST, although both were <1%. PST are thought to be more useful than SST in outpatient testing because of rapid turnaround time, greater sample volume, and less risk of random errors due to fibrin strands.
참고문헌 (18)
- Chung HJ, "Analysis of turnaround time by subdividing three phases for outpatient chemistry specimens", Ann Clin Lab Sci, 39, pp.144~149 (2009)
- Bais R, "IFCC methods for the measurement of catalytic concentration of enzymes. Part 8. IFCC method for lactate dehydrogenase (L-lactate: NAD oxidoreductase, EC 1.1.1.27)", J Automat Chem, 16, pp.167~182 (1994)
- Lippi G, "Influence of hemolysis on routine clinical chemistry testing", Clin Chem Lab Med, 44, pp.311~316 (2006)
- Guder WG, "Samples: From the Patient to the Laboratory: the impact of preanalytical variables on the quality of laboratory results" (2003), Wiley-VCH Verlag GmbH & Co
- Lippi G, "Multicenter evaluation of the hemolysis index in automated clinical chemistry systems", Clin Chem Lab Med, 47, pp.934~939 (2009)
- Plebani M, "Hemolysis index: quality indicator or criterion for sample rejection?", Clin Chem Lab Med, 47, pp.899~902 (2009)
- Soderberg J, "Haemolysis index--an estimate of preanalytical quality in primary health care", Clin Chem Lab Med, 47, pp.940~944 (2009)
- Babic N, "Effect of blood collection tubes on the incidence of artifactual hyperkalemia on patient samples from an outreach clinic", Clin Chim Acta, 413, pp.1454~1458 (2012)
- Boyanton BL Jr, "Stability studies of twenty-four analytes in human plasma and serum", Clin Chem, 48, pp.2242~2247 (2002)
- Dimeski G, "Evaluation of the Becton-Dickinson rapid serum tube: does it provide a suitable alternative to lithium heparin plasma tubes?", Clin Chem Lab Med, 48, pp.651~657 (2010)
- O’Keane MP, "Evaluation of three different specimen types (serum, plasma lithium heparin and serum gel separator) for analysis of certain analytes: clinical significance of differences in results and efficiency in use", Clin Chem Lab Med, 44, pp.662~668 (2006)
- Sevastos N, "Pseudohyperkalemia in serum: the phenomenon and its clinical magnitude", J Lab Clin Med, 147, pp.139~144 (2006)
- Carraro P, "Hemolyzed specimens: a reason for rejection or a clinical challenge?", Clin Chem, 46, pp.306~307 (2000)
- Tabbara IA, "Hemolytic anemias. Diagnosis and management", Med Clin North Am, 76, pp.649~668 (1992)
- Kellerman PS, "Pseudohyperkalemia due to pneumatic tube transport in a leukemic patient", Am J Kidney Dis, 46, pp.746~748 (2005)
- Groopman JE, "Chemotherapy-induced anemia in adults: incidence and treatment", J Natl Cancer Inst, 91, pp.1616~1634 (1999)
- "J Lab Clin Med", 1977, 1080~1091
- Brodeur MT, "Red blood cell survival in patients with aortic valvular disease and ball-valve prostheses", Circulation, 32, pp.570~581 (1965)