Blood sample contamination happens easily, for example when red blood cells burst due to improper handling. Opinions on how to deal with test results obtained from these unsuitable samples differ.
Hemolysis describes the rupture of red blood cells (erythrocytes) and release of their contents such as haemoglobin or potassium into the surrounding plasma. In a clinical environment this type of blood sample contamination frequently happens because of improper specimen collection or poor sample handling techniques. Since subsequent laboratory tests can be adversely affected by this, a recollection of blood will usually be initiated.
But what if a patient’s test results are immediately needed or another blood sample is difficult to obtain?
A recent opinion paper by Giuseppe Lippi from the University of Verona and colleagues has picked up upon the controversial question if data originating from hemolyzed samples should (as proposed in another paper by an Austrian research group) instead of being held back, be made available to the responsible clinician together with a standardized note on the degree of hemolysis and the impact on the respective laboratory parameter. Depending on how long it would take to obtain another sample and to run another test, this might prevent potentially life-threatening delays in diagnosis and treatment.
The Italian authors yet argue that, especially in a hectic and overcrowded unit such as an Emergency Room, the risk of overlooking single notes or comments would be dramatically high. Generally there would be too many uncertainties involved when evaluating data based on hemolyzed samples and the risk of making a false clinical decision would outweigh the slight gain in time.
As long as the problem of unsuitable blood samples persists, so will the debate about how to manage the deriving data. If you would like to learn more and form your own opinion, read up on the topic in the journal Clinical Chemistry and Laboratory Medicine.
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