A paradigmatic case of haemolysis and pseudohyperkalemia in blood gas analysis
A 51-year old male patient was admitted to the hospital with acute dyspnea and history of chronic asthma. Venous blood was drawn into a 3.0 mL heparinized syringe and delivered to the laboratory for blood gas analysis (GEM Premier 4000, Instrumentation Laboratory), which revealed high potassium value (5.2 mmol/L; reference range on whole blood, 3.5-4.5 mmol/L). This result was unexpected, so that a second venous blood sample was immediately drawn by direct venipuncture into a 3.5 mL lithium-heparin blood tube, and delivered to the laboratory for repeating potassium testing on Cobas 8000 (Roche Diagnostics). The analysis revealed normal plasma potassium (4.6 mmol/L; reference range in plasma, 3.5-5.0 mmol/L) and haemolysis index (5; 0.05 g/L). Due to suspicion of spurious haemolysis, heparinized blood was transferred from syringe into a plastic tube and centrifuged. Potassium and haemolysis index were then measured in this heparinized plasma, confirming high haemolysis index (50; 0.5 g/L) and pseudohyperkalemia (5.5 mmol/L). Investigation of this case revealed that spurious haemolysis was attributable to syringe delivery in direct ice contact for ~15 min. This case emphasizes the importance of avoiding sample transportation in ice and the need of developing point of care analysers equipped with interference indices assessment.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2019 |
---|---|
Erschienen: |
2019 |
Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
---|---|
Enthalten in: |
Biochemia medica - 29(2019), 1 vom: 15. Feb., Seite 011003 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Salvagno, Gian Luca [VerfasserIn] |
---|
Links: |
---|
Themen: |
Case Reports |
---|
Anmerkungen: |
Date Completed 13.05.2019 Date Revised 05.10.2023 published: Print Citation Status MEDLINE |
---|
doi: |
10.11613/BM.2019.011003 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM294248404 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM294248404 | ||
003 | DE-627 | ||
005 | 20231225081055.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2019 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.11613/BM.2019.011003 |2 doi | |
028 | 5 | 2 | |a pubmed24n0980.xml |
035 | |a (DE-627)NLM294248404 | ||
035 | |a (NLM)30799980 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Salvagno, Gian Luca |e verfasserin |4 aut | |
245 | 1 | 2 | |a A paradigmatic case of haemolysis and pseudohyperkalemia in blood gas analysis |
264 | 1 | |c 2019 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 13.05.2019 | ||
500 | |a Date Revised 05.10.2023 | ||
500 | |a published: Print | ||
500 | |a Citation Status MEDLINE | ||
520 | |a A 51-year old male patient was admitted to the hospital with acute dyspnea and history of chronic asthma. Venous blood was drawn into a 3.0 mL heparinized syringe and delivered to the laboratory for blood gas analysis (GEM Premier 4000, Instrumentation Laboratory), which revealed high potassium value (5.2 mmol/L; reference range on whole blood, 3.5-4.5 mmol/L). This result was unexpected, so that a second venous blood sample was immediately drawn by direct venipuncture into a 3.5 mL lithium-heparin blood tube, and delivered to the laboratory for repeating potassium testing on Cobas 8000 (Roche Diagnostics). The analysis revealed normal plasma potassium (4.6 mmol/L; reference range in plasma, 3.5-5.0 mmol/L) and haemolysis index (5; 0.05 g/L). Due to suspicion of spurious haemolysis, heparinized blood was transferred from syringe into a plastic tube and centrifuged. Potassium and haemolysis index were then measured in this heparinized plasma, confirming high haemolysis index (50; 0.5 g/L) and pseudohyperkalemia (5.5 mmol/L). Investigation of this case revealed that spurious haemolysis was attributable to syringe delivery in direct ice contact for ~15 min. This case emphasizes the importance of avoiding sample transportation in ice and the need of developing point of care analysers equipped with interference indices assessment | ||
650 | 4 | |a Case Reports | |
650 | 4 | |a diagnostic errors | |
650 | 4 | |a hyperkalemia | |
650 | 4 | |a potassium | |
650 | 4 | |a preanalytical variability | |
700 | 1 | |a Demonte, Davide |e verfasserin |4 aut | |
700 | 1 | |a Lippi, Giuseppe |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Biochemia medica |d 1997 |g 29(2019), 1 vom: 15. Feb., Seite 011003 |w (DE-627)NLM095507043 |x 1846-7482 |7 nnns |
773 | 1 | 8 | |g volume:29 |g year:2019 |g number:1 |g day:15 |g month:02 |g pages:011003 |
856 | 4 | 0 | |u http://dx.doi.org/10.11613/BM.2019.011003 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 29 |j 2019 |e 1 |b 15 |c 02 |h 011003 |