Correction and reporting of potassium results in haemolysed samples
Date
2005
Authors
Dimeski, Goce
Clague, Alan E
Hickman, Peter
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Royal Society of Medicine Press Ltd
Abstract
Background: Potassium is usually the most important analyte affected by in vitro haemolysis and the result obtained may falsely indicate or disguise a life-threatening abnormality and so give rise to inappropriate treatment. The purpose of the study was to provide a solution to the problem of reporting potassium on haemolysed samples, taking into account both clinical needs and analytical concerns (inter-individual and inter-sample variability). Methods: Using a new procedure that mimics the collection process in an actual clinical setting, haemolysed samples were prepared from 41 volunteers with a range of inter-individual factors - haemoglobin 80-173g/L, red blood cells 2.42-6.77 × 1012/L, leucocytes 3.0-306 × 109/L and platelets 31-710 × 109/L - in order to develop a more accurate correction equation using a haemolytic index (HI) corresponding to g Hb/L in plasma. Results: The mean (range) potassium increase was 0.0036 mmol/L (0.0029-0.0053 mmol/L) per unit HI. The following equation was developed to estimate potassium increase per HI, in order to compensate approximately for potassium leakage in haemolysed samples: Corrected K+ = Measured K+-(HI × 0.004). Conclusion: The balanced solution is this: instead of reporting the post-haemolysis corrected potassium result a qualitative comment is given, indicating the likely range of the potassium concentration. If the potassium result is in a critically low or high range, it is communicated promptly to the requesting clinician.
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Keywords: potassium; accuracy; analytic method; article; clinical article; erythrocyte; hemolysis; human; hyperkalemia; laboratory test; observer variation; priority journal; Blood Specimen Collection; False Positive Reactions; Hemolysis; Humans; Hyperkalemia; Math
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Source
Annals Of Clinical Biochemistry
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Journal article
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2037-12-31
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