Interference of blood cell lysis on routine coagulation testing.

作者：Giuseppe Lippi, Martina Montagnana, Gian Luca Salvagno, Gian Cesare Guidi · 发表于：PubMed · 年份：2006 · DOI：10.5858/2006-130-181-iobclo · 被引用次数：70 · 研究领域：Clinical Laboratory Practices and Quality Control、Blood properties and coagulation、Blood transfusion and management

CONTEXT: Preanalytical factors influencing the reliability of laboratory testing are commonplace. It is traditionally accepted that hemolytic samples are unsuitable for coagulation assays because of the release of hemoglobin, intracellular components, and thromboplastic substances from damaged blood cells. OBJECTIVE: To evaluate the influence of blood cell lysis on routine coagulation testing. DESIGN: Twelve aliquots prepared by serial dilutions of homologous lysated samples collected from 10 different subjects, and displaying a final percentage of lysis ranging from 0% to 9.1%, were tested for prothrombin time, activated partial thromboplastin time, fibrinogen, and dimerized plasmin fragment D. Lysis was achieved by subjecting citrated whole blood to a freeze-thaw cycle. OUTCOME MEASURES: Interference from blood cell lysis on routine coagulation testing. RESULTS: Statistically significant increases in prothrombin time and dimerized plasmin fragment D were observed in samples containing final lysate concentrations of 0.5% and 2.7% respectively, whereas significant decreases were observed in activated partial thromboplastin time and fibrinogen in samples containing a final lysate concentration of 0.9%. The current analytical quality specifications for desirable bias are +/-2.0% for prothrombin time, +/-2.3% for activated partial thromboplastin time, and +/-4.8% for fibrinogen. Percent variations from the baseline values exceeding the current analytical quality specifications f...