EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Judit Tóth, Anna V Oláh, Tamás Petercsák, Tamás Kovács, János Kappelmayer

{"title":"Detection of haemolysis, a frequent preanalytical problem in the serum of newborns and adults.","authors":"Judit Tóth, Anna V Oláh, Tamás Petercsák, Tamás Kovács, János Kappelmayer","doi":"","DOIUrl":"","url":null,"abstract":"Background: Preanalytical problems can be more frequent in case of preterm and term newborns as compared to the general patient population. Here we present the leading preanalytical errors in our laboratory, the prevalence of haemolysis and its impact on laboratory test results, and our efforts to improve the diagnostic workup of newborns' samples.Methods: Preanalytical quality indicators were analysed in all samples in 2018. The haemolysis index was measured spectrophotometrically in serum samples in the period of 2012-2018, and the ratio of haemolysed samples and the test rejection rates were analysed. The data of newborns and other patients were analysed separately.Results: During the tested year, the leading preanalytical errors were haemolysis in serum samples, inadequate sample identification and clotting of anticoagulated blood regarding all samples or newborns. In this seven-year period the ratio of haemolysed serum samples was 4.00% in all patients and 46.4% in newborns, while the test rejection rates due to haemolysis were 0.57% and 3.71%, respectively. Haemolysis indices were significantly higher in case of newborns than in patients with documented severe intravascular haemolysis which suggests that the major reason of elevated haemolysis indices in newborns was in vitro haemolysis. Accordingly, all C-reactive protein (CRP) results which were rejected by severe haemolysis became reliable after repeating blood sampling.Conclusion: Haemolysis is the leading preanalytical problem not only in newborns but also in the general patient population. Our study highlights the importance of automated assessment of serum indices and continuous monitoring of the preanalytical quality indicators and suggests the need for education and blood collection trainings.","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/cb/ejifcc-31-6.PMC7109500.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37807939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Methods for Hemolysis Interference Study in Laboratory Medicine - A Critical Review. 检验医学中溶血干扰研究方法综述。

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Fernando Marques-Garcia

{"title":"Methods for Hemolysis Interference Study in Laboratory Medicine - A Critical Review.","authors":"Fernando Marques-Garcia","doi":"","DOIUrl":"","url":null,"abstract":"Hemolysis represents an important source of error associated with the pre-analytical phase. Improving the protocols for detection, measurement, management of the parameters affected by the interference, and differentiation between hemolysis in vivo and in vitro, would favor a personalized management of hemolysis by increasing patient safety. For this, it is essential to agree on the definition of \"hemolysis\". From this definition, a critical point is to establish cut-offs of hemolysis management for each analyte studied in the clinical laboratory. Thus, in this review, the main methods described in the literature developed for obtaining a hemolysate are grouped, that simulate in controlled laboratory protocols what happens with a hemolyzed sample of a patient. These methods are grouped into 3 categories according to their basis of lysing cells: freezing-thawing, osmotic shock and shear stress. In addition to development and improvement of methods for the study of hemolysis, it is necessary to carry out comparative studies to determine which one offers the best capabilities. Harmonization of the methods will allow to include them in working guidelines. All these strategies will allow to move from managing hemolysis on whole-sample basis to customize it analyte by analyte.","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"85-97"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/d5/ejifcc-31-85.PMC7109502.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving the preanalytical phase in laboratory medicine. 改进检验医学的分析前阶段。

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

引用次数: 0

Rejection of hemolyzed samples can jeopardize patient safety. 排斥溶血样品可能危及患者安全。

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Lorenzo Barbato, Marise Danielle Campelo, Sara Pigozzo, Nicola Realdon, Anna Gandini, Roberto Barbazza, Mayara Ladeira Coêlho, Chiara Bovo, Paola Marini, Gabriel Lima-Oliveira

{"title":"Rejection of hemolyzed samples can jeopardize patient safety.","authors":"Lorenzo Barbato, Marise Danielle Campelo, Sara Pigozzo, Nicola Realdon, Anna Gandini, Roberto Barbazza, Mayara Ladeira Coêlho, Chiara Bovo, Paola Marini, Gabriel Lima-Oliveira","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In vitro hemolysis is the primary cause of sample/test rejection by the laboratory.Case report: A 10-year-old, admitted with an asthma attack in the emergency-room, medicated with albuterol sulphate (intravenous bronchodilator that could induce hypokalemia), needed laboratory test monitoring. The physician prescribed the technical-nurse to perform blood sampling for: complete blood count, electrolytes, glucose, and blood gas analysis-within 30min after therapy. Samples were delivered to laboratory with a note \"I had difficult to locate an appropriate access to perform the blood collection\".Laboratory results: Glucose: 4.77 mmol/L. Complete blood count revealed discreet eosinophilia 0.13x109/L, and thrombocytopenia 18x109/L. However, platelet clumps were observed in peripheral blood smear. Blood gas analysis was unreported, laboratory informed that sample had micro clots.Electrolytes: laboratory did not report the results; sample hemolyzed. 0.9 g/L of free hemoglobin is the cut-off defined by the laboratory; the sample presented 2.3 g/L of free hemoglobin. 3.9 mmol/L of potassium was the unreported result vs 2.1 mmol/L in the new sample.Briefly, the laboratory technician was trained to hide potassium results on hemolyzed sample due to the potential overestimation. Even if the hemolyzed sample presented a potassium value close to the lower reference range value (3.5-5.1 mmol/L), reporting the potassium result could allow the physician starting proper therapy to revert the hypokalemia by albuterol sulfate.Conclusion: The laboratory should be aware of the clinical patient conditions and of the related physician needs, before hiding results. Therefore, both the laboratory and the clinic personnel should communicate in order to guarantee the patient safety.","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/ed/ejifcc-31-15.PMC7109497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37807940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can chewing gum be another source of preanalytical variability in fasting outpatients? 嚼口香糖会是空腹门诊患者分析前变异的另一个来源吗?

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Ricardas Stonys, Valdas Banys, Dalius Vitkus, Gabriel Lima-Oliveira

{"title":"Can chewing gum be another source of preanalytical variability in fasting outpatients?","authors":"Ricardas Stonys, Valdas Banys, Dalius Vitkus, Gabriel Lima-Oliveira","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In the daily laboratory practice, there are patients coming to blood collection sites chewing sugar-free gum, considering it irrelevant to laboratory tests. The aim of this study was to evaluate whether a sugar-free chewing gum can interfere with laboratory tests.Methods: We studied 22 healthy volunteers. After a 12-hour overnight fasting, the first blood sample was collected between 8:00 and 8:30 a.m. Then, immediately after the first venous blood collection, the subjects started chewing the gum (declared sugar-free) for 20 min. Subsequent venous blood samples were collected at 1, 2, and 4 hours after chewing the gum. Significant differences between samples were assessed by the Wilcoxon ranked-pairs test.Results: Among all the results, statistically significant differences (p < 0.05) between basal and × hours after chewing sugar-free gum were observed for the following parameters: cortisol, insulin, C-peptide, triglycerides, uric acid, urea, amylase, alanine aminotransferase, lipase, creatine kinase, total bilirubin, direct bilirubin, phosphate, iron, potassium, thyroid stimulating hormone, red blood cell count, hematocrit, hemoglobin, mean cell volume, red cell distribution width, white blood cell count, lymphocytes, neutrophils, and eosinophils; whereas, coagulation tests were not impacted by chewing sugar-free gum.Conclusions: We recommend instructing the patients to avoid the use of chewing gum before blood collection for laboratory tests.","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"28-45"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/0f/ejifcc-31-28.PMC7109498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges in Preanalytical Phase of Laboratory Medicine: Rate of Blood Sample Nonconformity in a Tertiary Care Hospital. 检验医学分析前阶段的挑战:某三级医院血液样本不合格率。

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Nusrat Alavi, Sana Haseeb Khan, Asma Saadia, Tahir Naeem

{"title":"Challenges in Preanalytical Phase of Laboratory Medicine: Rate of Blood Sample Nonconformity in a Tertiary Care Hospital.","authors":"Nusrat Alavi, Sana Haseeb Khan, Asma Saadia, Tahir Naeem","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To evaluate the major causes of preanalytical errors in medical laboratory of a tertiary care hospital.Methods: It was a retrospective study in which we analyzed the sample rejection data of hematology and chemical pathology sections from January to December 2018. Number of rejected samples, reason for rejection and type of test ordered on monthly basis were recorded on a platform.Results: A total of 113,817 samples were received during the study period. Preanalytical errors were found in 1,688 samples, which constitute approximately 1.48% of the total number of samples received.Conclusion: Our study highlights the magnitude of preanalytical errors in our setup. Preanalytical errors can lead to loss of patient trust in diagnostic services, can dent the laboratory's reputation, and lead to an increase in the overall operating expenses, both for laboratories as well as the hospitals. Compliance with good laboratory practices can significantly reduce the frequency of pre analytical errors.","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/13/ejifcc-31-21.PMC7109505.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pseudothrombocytopenia by ethylenediaminetetraacetic acid can jeopardize patient safety - report. 乙二胺四乙酸引起的假性血小板减少症可能危及患者的安全。

EJIFCC Pub Date : 2020-03-20 eCollection Date: 2020-03-01

Cristina Collazo Abal, Leticia Rodríguez Calviño, Laura Rollán Manso, M C Ferreirós Domínguez, M J Lorenzo Lorenzo, Cristina Regojo Balboa, Arturo Fernández Nogueira

{"title":"Pseudothrombocytopenia by ethylenediaminetetraacetic acid can jeopardize patient safety - report.","authors":"Cristina Collazo Abal, Leticia Rodríguez Calviño, Laura Rollán Manso, M C Ferreirós Domínguez, M J Lorenzo Lorenzo, Cristina Regojo Balboa, Arturo Fernández Nogueira","doi":"","DOIUrl":"","url":null,"abstract":"Pseudothrombocytopenia by ethylenediaminetetraacetic acid (EDTA) is an infrequent phenomenon of in vitro platelet agglutination due to the presence of antiplatelet autoantibodies. It has no clinical significance, but misdiagnosis may lead to clinical or therapeutic decision-making. In this study we report a case of an 8-year-old boy with no history of platelet disorder presenting a low platelet count and a peripheral blood smear showing clumping of platelets by EDTA. The initial diagnosis hypothesis was of an idiopathic thrombocytopenic purpura, and an unnecessary bone marrow aspirate was made even though he did not have personal or family history of bleeding. A second sample collected in sodium citrate confirmed the pseudothrombocytopenia by EDTA. In conclusion, the laboratory should enhance a strong relationship with clinicians trying to avoid misunderstandings as that reflected in this case report. It should be reminded that, in those cases where a pseudothrombocytopenia by EDTA is suspected, a blood smear is mandatory to confirm platelet clumps and blood must be tested anticoagulated with another anticoagulant (i.e., sodium citrate or heparin).","PeriodicalId":193105,"journal":{"name":"EJIFCC","volume":"31 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/f3/ejifcc-31-65.PMC7109506.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immune Cellular Evaluation Following Newborn Screening For Severe T and B Cell Lymphopenia. 新生儿严重T细胞和B细胞淋巴细胞减少症筛查后的免疫细胞评估。

EJIFCC Pub Date : 2019-11-25 eCollection Date: 2019-11-01

Johannes Wolf, Karolin Dahlenburg, Stephan Borte

引用次数: 0

Summer School in Flow Cytometry for Immunology: Report From a Successful ESCCA Experience. 免疫学流式细胞术暑期学校:来自ESCCA成功经验的报告。

EJIFCC Pub Date : 2019-11-25 eCollection Date: 2019-11-01

Katherina Psarra, Genny Del Zotto, Alexandra Fleva, Areti Strati, Marianna Tzanoudaki, Silvia Della Bella

引用次数: 0

Foreword: non-coding RNAs as potential laboratory biomarkers. 前言:非编码rna作为潜在的实验室生物标志物。

EJIFCC Pub Date : 2019-06-24 eCollection Date: 2019-06-01

Béla Nagy

引用次数: 0

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