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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2017: 3.556

CiteScore 2017: 2.34

SCImago Journal Rank (SJR) 2017: 1.114
Source Normalized Impact per Paper (SNIP) 2017: 1.188

Online
ISSN
1437-4331
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Volume 55, Issue 8

Issues

Reporting altered test results in hemolyzed samples: is the cure worse than the disease?

Giuseppe LippiORCID iD: http://orcid.org/0000-0001-9523-9054 / Gianfranco Cervellin / Mario PlebaniORCID iD: http://orcid.org/0000-0002-0270-1711
Published Online: 2017-02-16 | DOI: https://doi.org/10.1515/cclm-2017-0011

Abstract

The management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement. This approach carries some advantages, namely the timely communication of potentially life-threatening laboratory values, but also some drawbacks. These especially include the challenging definition of validated performance specifications for hemolyzed samples, the need to producing reliable data with the lowest possible uncertainty, the short turnaround time for repeating most laboratory tests, the risk that the comments may be overlooked in short-stay and frequently overcrowded units (e.g. the emergency department), as well as the many clinical advantages of a direct communication with the physician in charge of the patient. Despite the debate remains open, we continue supporting the suggestion that suppressing data in unsuitable (hemolyzed) samples and promptly notifying the clinicians about the need to recollect the samples remains the most (clinically and analytically) safe practice.

Keywords: blood samples; hemolysis; quality; safety

References

  • 1.

    Cadamuro J, Mrazek C, Haschke-Becher E, Sandberg S. To report or not to report: a proposal on how to deal with altered test results in haemolytic samples. Clin Chem Lab Med 2017;55:1109–11.Google Scholar

  • 2.

    Simundic AM, Topic E, Nikolac N, Lippi G. Hemolysis detection and management of hemolysed specimens. Biochem Med 2010;20:154–9.Google Scholar

  • 3.

    Lippi G, Mattiuzzi C. Critical laboratory values communication: summary recommendations from available guidelines. Ann Transl Med 2016;4:400.Web of SciencePubMedCrossrefGoogle Scholar

  • 4.

    Lippi G, Avanzini P, Pavesi F, Bardi M, Ippolito L, Aloe R, et al. Studies on in vitro hemolysis and utility of corrective formulas for reporting results on hemolyzed specimens. Biochem Med (Zagreb) 2011;21:297–305.PubMedGoogle Scholar

  • 5.

    Lippi G, Salvagno GL, Guidi GC. Adjustment of serum potassium for age and platelet count. A simple step forward towards personalized medicine. Clin Chem Lab Med 2015;53:e325–7.PubMedWeb of ScienceGoogle Scholar

  • 6.

    Lippi G, Salvagno GL, Guidi GC. Mean corpuscular volume and red blood cell distribution width are independent predictors of serum potassium concentration in healthy individuals. Clin Chim Acta 2015;446:117–8.Web of SciencePubMedCrossrefGoogle Scholar

  • 7.

    Brown PJ, Marquard JL, Amster B, Romoser M, Friderici J, Goff S, et al. What do physicians read (and ignore) in electronic progress notes? Appl Clin Inform 2014;5:430–44.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 8.

    Keller H. Help with decisions on the assessment of clinical chemistry results. Z Med Lab Diagn 1989;30:416–24.PubMedGoogle Scholar

  • 9.

    Horowitz GL. The power of asterisks. Clin Chem 2015;61:1009–11.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 10.

    Cervellin G, Lippi G. Repeated potassium testing in hemolyzed specimens collected in the emergency department: more pros than cons. J Emerg Med 2017;52:105–6.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 11.

    Panteghini M, Sandberg S. Defining analytical performance specifications 15 years after the Stockholm conference. Clin Chem Lab Med 2015;53:829–32.Web of SciencePubMedGoogle Scholar

  • 12.

    Plebani M. Harmonization in laboratory medicine: the complete picture. Clin Chem Lab Med 2013;51:741–51.Web of SciencePubMedGoogle Scholar

  • 13.

    Plebani M. Harmonization in laboratory medicine: requests, samples, measurements and reports. Crit Rev Clin Lab Sci 2016;53:184–96.Web of SciencePubMedCrossrefGoogle Scholar

  • 14.

    Lippi G, Banfi G, Buttarello M, Ceriotti F, Daves M, Dolci A, et al. Recommendations for detection and management of unsuitable samples in clinical laboratories. Clin Chem Lab Med 2007;45:728–36.PubMedWeb of ScienceGoogle Scholar

  • 15.

    Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, et al. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med 2015;53:357–70.Web of ScienceGoogle Scholar

  • 16.

    Lippi G, Bowen R, Adcock DM. Re-engineering laboratory diagnostics for preventing preanalytical errors. Clin Biochem 2016;49:1313–4.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 17.

    Lippi G, Plebani M, Di Somma S, Cervellin G. Hemolyzed specimens: a major challenge for emergency departments and clinical laboratories. Crit Rev Clin Lab Sci 2011;48:143–53.Web of ScienceCrossrefGoogle Scholar

About the article

Corresponding author: Prof. Giuseppe Lippi, Section of Clinical Biochemistry, University Hospital of Verona, P.le LA Scuro 10, 37134 Verona, Italy


Received: 2017-01-05

Accepted: 2017-01-06

Published Online: 2017-02-16

Published in Print: 2017-07-26


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 55, Issue 8, Pages 1112–1114, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2017-0011.

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