Effects of specimen haemolysis on complete blood count results by Abbott Alinity hq System.

Müjgan Ercan,Şerif Ercan,Nihayet Bayraktar,Emiş Deniz Akbulut

doi:10.11613/bm.2021.030706

Müjgan Ercan, Şerif Ercan + Show 2 more

Open Access

https://doi.org/10.11613/bm.2021.030706

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Abstract

IntroductionThe current study aimed to assess the interference of in vitro haemolysis on complete blood count (CBC) using Abbott Alinity hq system, and to determine which haemolysis levels affect the reliability of sample results.Materials and methodsBlood samples obtained from 25 volunteers in K3-EDTA tubes were divided into four aliquots. The first aliquot was not subjected to any intervention. The second, third and fourth aliquots were passed through a fine needle 2, 4 and 6 times, respectively. Complete blood count was performed by multi-angle polarized scatter separation technology and haemolysis index (HI) was assessed from the plasma samples separated by centrifugation. Five groups were formed according to the HI values. The percentage biases between the results of non-haemolysed and haemolysed groups were compared with the desirable bias limits from The European Federation of Clinical Chemistry and Laboratory Medicine database and reference change values (RCVs).ResultsIn groups 1 to 4, the effects of haemolysis on CBC parameters were acceptable comparing to the analytical bias except for lymphocytes (7.26%-7.42%), MCH (2.59%), and MCHC (0.47%-2.81%). Results of group 5 (gross haemolysis) showed decreases in HCT(- 4.56%), RBC (- 4.07%) count and increase in lymphocyte (11.60%) count higher than the analytical performance specifications. Moreover, variations in MCH (4.65%) and MCHC (5.24%) were exceeding the RCVs.ConclusionsGross haemolysis (haemoglobin concentration > 10 g/L) is likely to produce unreliable CBC results on non-pathological samples. Further studies including pathological specimens are needed.

Highlights

The current study aimed to assess the interference of in vitro haemolysis on complete blood count (CBC) using Abbott Alinity hq system, and to determine which haemolysis levels affect the reliability of sample results
In groups 1 to 4, the effects of haemolysis on CBC parameters were acceptable comparing to the analytical bias except for lymphocytes (7.26%-7.42%), mean corpuscular haemoglobin (MCH) (2.59%), and mean corpuscular haemoglobin concentration (MCHC) (0.47%-2.81%)
16 portions were excluded from the study because plasma volumes obtained after CBC testing were inadequate for the assessment of haemolysis index (HI)

Summary

Introduction

The current study aimed to assess the interference of in vitro haemolysis on complete blood count (CBC) using Abbott Alinity hq system, and to determine which haemolysis levels affect the reliability of sample results. Sample quality ensured by appropriate sampling techniques is critical in order to obtain accurate results. Errors occurring in the preanalytical phase are accepted as the main source leading to erroneous results [1]. In vitro haemolysis is one of the most common preanalytical error affecting many test results. Release of haemoglobin (Hb) and the other intracellular contents secondary to impaired membrane integrity of red blood cells (RBC) may cause artifactually increase or decrease results. Inappropriate techniques for collection, transport and processing of samples are the major causes of in vitro haemolysis. Automated analysers can quantify cell-free Hb by photometric measurement at different wavelengths following centrifugation [2,3,4,5,6,7,8,9]

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