A Dark-Brown Serum Sample (original) (raw)
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Lipemia interferences in routine clinical biochemical tests
Biochemia Medica, 2011
Introduction: Lipemic specimens are a common and frequent, but yet unresolved problem in clinical chemistry, and may produce signifi cant interferences in the analytical results of diff erent biochemical parameters. Material and methods: The aim of this study was to examine the eff ect of lipid removal using ultracentrifugation of lipemic samples, on some routine biochemistry parameters. Among all the samples obtained daily in our laboratory, the ones which were visibly muddy were selected and underwent to a process of ultracentrifugation, being determined a variety of biochemical tests before and after ultracentrifugation. A total of 110 samples were studied. Results: We found signifi cant diff erences in all the parameters studied except for total bilirubin, glucose, gamma-glutamyl transferase (GGT) and aspartate aminotransferase (AST). The greatest diff erences in the parameters analyzed were found in the concentration of alanine aminotransferase (ALT) (7.36%) and the smallest ones in the concentration of glucose (0.014%). Clinically signifi cant interferences were found for phosphorus, creatinine, total protein and calcium. Conclusion: Lipemia causes clinically signifi cant interferences for phosphorus, creatinine, total protein and calcium measurement and those interferences could be eff ectively removed by ultracentrifugation.
Handling of lipemic samples in the clinical laboratory
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio
Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in a sample caused by the accumulation of lipoproteins, mainly very-low density lipoproteins (VLDL) and chylomicrons. Several methods are available for the detection of lipemic samples, including the lipemic index, or triglyceride quantification in serum or plasma samples, or mean corpuscular hemoglobin (MCHC) concentration in blood samples. According to the European Directive 98/79/CE, it is the responsibility of clinical laboratories to monitor the presence of interfering substances that may affect the measurement of an analyte. There is an urgent need to standardize interference studies and the way interferences are reported by manufacturers. Several methods are currently available to remove interference from lipemia and enable accu...
Clinical Chemistry and Laboratory Medicine, 2000
Results from hemolyzed, icteric, and lipemic samples may be inaccurate and can lead to medical errors. These preanalytical interferences may be detected using visual or automated assessment. Visual inspection is time consuming, highly subjective and not standardized. Our aim was to assess the comparability of automated spectrophotometric detection and visual inspection of lipemic, icteric and hemolyzed samples. Methods: This study was performed on 1727 routine biochemistry serum samples. Automated detection was performed using the Olympus AU2700 analyzer. We assessed: 1) comparability of visual and automated detection of lipemic, icteric and hemolyzed samples, 2) precision of automated detection, and 3) inter-observer variability for visual inspection. Results: Weighted k coefficients for comparability of visual and automated detection were: 0.555, 0.529 and 0.638, for lipemic, icteric and hemolyzed samples, respectively. The precision for automated detection was high for all interferences, with the exception of samples being only slightly lipemic. The best overall agreement between observers was present in assessing lipemia (mean weighted ks0.698), whereas the lowest degree of agreement was observed in assessing icterus (mean weighted ks0.476). Conclusions: Visual inspection of lipemic, icteric and hemolyzed samples is highly unreliable and should be replaced by automated systems that report serum indices.
Tropical Medicine and International Health, 2002
We developed a colour tint scale to use as an aid in the clinical assessment of anaemia by measuring conjunctival pallor. The objectives of this study were to evaluate the accuracy and agreement among observers in detecting anaemia in three sequential phases with incremental information using clinical pallor of different anatomical sites, subsequently adding subjects' medical history for physical symptoms and the colour scale. After training in the application of these three sequential assessments, 12 primary health workers were assigned to independently examine 198 anaemic and 254 non-anaemic pregnant women while blind to the true anaemic status. Their assessments in each phase were then compared with the anaemic status based on haemoglobin level, measured using HemoCue, taken as the gold standard, to determine sensitivity and speci®city, and agreements among observers in detecting anaemia were calculated. In the three sequential phases of assessment the sensitivities were 73.8, 78.3, 82.9% and speci®cities 76.0, 84.7 and 90.9%, respectively. In each subsequent step, the improvements in both the sensitivity and speci®city were statistically signi®cant [P(v 2 McNemar ) < 0.01]. Kappa statistics for agreement among 12 observers for assessing anaemia in the sequential phases were 0.50, 0.71 and 0.82, respectively. The Spearman rank correlation coef®cient between haemoglobin level and the colour scale reading was 0.68 (P < 0.001). Taking medical history and incorporating a simple colour tint scale with examination of pallor improved the sensitivity, speci®city and agreement for detection of anaemia by health workers.
Discolored blood and blood components: A dilemma for transfusion specialists
Transfusion and Apheresis Science, 2014
Background and objectives: It is not uncommon in transfusion practice to see blood/components with abnormal colored plasma. The present study was conducted to identify and determine the etiology of blood and/or blood components showing altered color. Material and methods: The present study was conducted in the Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh over a period of seven months. All the blood units/components having an abnormal appearance were segregated as: 1. Green discoloration. 2. Yellow discoloration. 3. Bright cherry red color. 4. Lipemic plasma. The donor's history was carefully evaluated and relevant investigations were done depending on discoloration. Results: Seventeen units out of 7370 (0.23%) donations showed discoloration. In 3 units the plasma was green, 5 units were yellow, in 3 units PRBC/WB unit was bright cherry red and in the remaining 6 units the plasma was lipemic. Total bilirubin of all the 5 donors with yellowish plasma ranged from 1.6 to 2.3 mg/dl. The hemoglobin and hematocrit of two out of three donors with cherry red discoloration of PRBC/WB was low. All the donors with lipemic plasma gave history of intake of fatty meal prior to donating blood. Conclusion: The existing rules prohibit issue of blood and blood components if the plasma is abnormal in color. Our study showed that many of the discolored units could have been safely transfused but further larger studies are required to confirm the safety of recipients receiving such units.
A Comparison of Four Bedside Methods of Hemoglobin Assessment During Cardiac Surgery
Anesthesia and Analgesia, 1995
The purpose of this study was to compare the accuracy of conductivity, adjusted conductivity, photometric, and centrifugation methods of measuring or estimating hemoglobin (I%) with Coulter measured HB as the reference. These bedside methods were studied in 25 cardiac surgery patients during euvolemia and hemodilution and after salvaged autologous red blood cell transfusion.