In-Vitro Hemolysis and Its Effect on Peripheral Blood Counts

Abstract

Objective: To evaluate the degree of interference caused by hemolyzed samples on Complete Blood Counts (CBC) parameters analyzed by Sysmex XN-1000.

Methodology: This cross-sectional study conducted at Chughtai Institute of Pathology from August, 2023 to August, 2024 after securing approval from the Research and Ethical committee. Peripheral venous blood samples of 100 patients were collected in potassium ethylenediaminetetraacetic acid (K2-EDTA) vials and were divided into three equal aliquots. The Aliquot-1 was subjected to no interference whereas Aliquot 2 and 3 were subjected to 5 and 10 times of interference by passing through a narrow caliber needle to create mechanical hemolysis. All these aliquots were then run on Sysmex XN-1000 automated analyzer for the CBC test. Three study groups were made based on the amount of interference and Hemolysis Index (HI).

Results: As compared to non-hemolysed samples, the interference at different levels affects various haematological parameters to varying extents. Hematocrit and platelet counts demonstrate the most substantial variability, whereas WBC counts and MCHC are relatively robust against interference.

Conclusion: This study demonstrates that the in-vitro hemolysis can have direct negative impact on the results of the CBC parameters. Thus, this preanalytical error must not be overlooked in order to safeguard patient’s best interests.