Studies show samples drawn during an IV start or from an existing line have the potential to be hemolyzed
up to 78 percent of the time depending on the size and composition of the cannula, the force of the withdrawal, and other factors.
Berger and Richichi (22) concentrated on a formula to exclude the hemolysis index and clinical use of NSE for hemolyzed
(4,5) Though the general incidence of hemolyzed
samples in clinical laboratories differs broadly according to the clinical setting, geographical area, and facility type, the prevalence of hemolytic specimens can be as high as 3.3% of all routine samples, thus, accounting for from 40% to 70% of all unsuitable samples identified.
Laboratory results Test Result White blood cell count (x [10.sup.9]/L) 41.8 Hemoglobin (g/dL) 10.0 Platelets (x [10.sup.9]/L) 45 Blood urea nitrogen (mg/dL) 70 Creatinine (mg/dL) 1.03 Sodium (mEq/L) 130 Potassium (mEq/L, hemolyzed
) 6.5 Carbon dioxide (mEq/L) 15 Calcium (mg/dL) 6.0 Albumin (g/dL) 1.5 Prothrombin time (s) 20.0 International normalized ratio 1.7 D-dimer 16.45 Fibrin monomer Positive Fibrin split products ([micro]g/mL) >20 Lactic acid (mmol/L) 5.6 Venous pH 7.07 Venous pC[Osub.2] (mm Hg) 64 Venous HC[O.sub.3] (mmol/L) 18 Venous BE (mmol/L) 10.7 pC[O.sub.2] indicates partial pressure of carbon dioxide; HC[O.sub.3] bicarbonate; BE, base excess.
specimens, chemistry test results might not reflect the patient's clinical condition, either because of red blood cell contents spilling into the serum or plasma (actually changing the plasma concentration of the analytes) or because of red blood cell contents interfering with the testing methodology (eg, hemoglobin can discolor a solution and impact spectrophotometric absorbance measurements at certain wavelengths).
There are also long-term sequalae from exposure to hemolyzed
blood, including impaired endothelial function, which further exacerbates the long-term cardiovascular risk for patients on hemodialysis.
Again, within this same unit, guided or open inquiry: Why did the blood sample yield its specific results (e.g., why is the liquid portion of their blood sample clear, hemolyzed
, icteric or lipemic after its centrifugation)?
(2) The CBC results revealed a packed cell volume of 53% (reference interval, 40%-52% (2)) and a refractometric total solids value of 3.5 g/dL, and the plasma appeared moderately hemolyzed
. The patient initially had a leukocytosis (33 100 cells/[micro]L; reference interval, 4300-12 500 cells/[micro][L.sup.2]) attributable to a marked mature heterophilia (31 400 cells/([micro]L) and mild monocytosis (700 cells/[micro]L).
Basic metabolic panel was significant only for potassium of 5.6 (hemolyzed
An aliquot of the total EDTA-treated blood was hemolyzed
with cold water, and the proteins were precipitated by the addition of 30% trichloroacetic acid.
After thawing the plates, we homogenized hemolyzed
cultures by vortexing the plates.
In this study, not a single blood bag was found hemolyzed
. Of these 130 blood bags, 129 were sealed properly but one bag found leakage.