LabNotes - Volume 16, No.2, 2006

Troubleshooting Hemolysis Issues in the Clinical Laboratory

Hemolysis causes a serum or plasma sample to take on a pink or red tinge, due to the presence of the heme from the red cell.

A hemolyzed sample can be a tremendous concern for the laboratory. The hemolysis can cause a false elevation in some analytes, such as potassium and lactate dehydrogenase (LD), due to their high concentration in the red cell. The red or pink color of a hemolyzed sample can also interfere with some test methodologies, such as spectrophotometric methods. The amount of analyte interference will depend on the degree of hemolysis and the methodology being used. Hemolysis can be a reason for specimen rejection, thus causing the patient sample to be redrawn.

Hemolysis can be caused by many variables, including a traumatic venipuncture, improper handling and processing of blood collection tubes, and adverse conditions when samples are being transported to a laboratory. In order to help you identify potential reasons that you may be getting hemolyzed samples, this issue of LabNotes will provide you with a Troubleshooting Hemolysis Issues wall chart.

The chart gives details on three main factors that can lead to hemolysis, along with the consequences and corrective actions for each. Keep in mind that hemolysis may be caused by more than one factor during the blood collection and handling process.

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