A survey of practice in the management of haemolysis, icterus and lipaemia in blood specimens in the United Kingdom and Republic of Ireland

Author:

Costelloe Seán J.12ORCID,Rico Rios Natividad1,Goulding Nicola1ORCID,Mistry Hema23,Stretton Adam24,De la Salle Barbara25,Hepburn Sophie26ORCID,Thomas Annette27,Atherton Jennifer28,Cornes Michael29ORCID

Affiliation:

1. Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland

2. Association for Clinical Biochemistry and Laboratory Medicine (ACB) Preanalytical Special Interest Group, London, UK

3. Serious Hazards of Transfusion Office, Manchester, UK

4. Becton, Dickinson and Company, Wokingham, UK

5. UK NEQAS Haematology, Watford, UK

6. Blood Sciences, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK

7. Cardiff and Vale University Health Board, Cardiff, UK

8. Blood Sciences Department, Liverpool Clinical Laboratories, Aintree University Hospital, Liverpool, UK

9. Biochemistry Department, Worcestershire Acute Hospitals NHS Trust, Worcester, UK

Abstract

Background Haemolysis, icterus and lipaemia (HIL) are common interferants in laboratory medicine, potentially impacting patient care. This survey investigates HIL management in medical laboratories across the UK and Republic of Ireland (ROI). Methods A survey was sent to members of key professional organisations for laboratory medicine in the UK and ROI. Questions related to the detection, monitoring, quality control, and management of HIL. Results In total, responses from 124 laboratories were analysed, predominantly from England (52%) and ROI (36%). Most responses were from public hospitals with biochemistry services (90%), serving primary care (91%), inpatients (91%), and outpatients (89%). Most laboratories monitored H (98%), I (88%), and L (96%) using automated indices (93%), alone or in combination with visual inspection. Manufacturer-stated cut-offs were used by 83% and were applied to general chemistries in 79%, and immunoassays in 50%. Where HIL cut-offs are breached, 64% withheld results, while 96% reported interference to users. HIL were defined using numeric scales (70%) and ordinal scales (26%). HIL targets exist in 35% of laboratories, and 54% have attempted to reduce HIL. Internal Quality Control for HIL was lacking in 62% of laboratories, and just 18% of respondents have participated in External Quality Assurance. Laboratories agree manufacturers should: standardise HIL reporting (94%), ensure comparability between platforms (94%), and provide information on HIL cross-reactivity (99%). Respondents (99%) showed interest in evidence-based, standardised HIL cut-offs. Conclusions Most respondents monitor HIL, although the wide variation in practice may differentially affect clinical care. Laboratories seem receptive to education and advice on HIL management.

Publisher

SAGE Publications

Subject

Clinical Biochemistry,General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Some issues to consider with the use of serum indices;Journal of Clinical Pathology;2024-07-11

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