Utility of hemolysis rate monitoring in clinical blood samples and efforts to reduce hemolysis rates and their effects

Abstract

Ensuring the quality of clinical laboratory testing requires effective management and maintenance of processes from blood collection to laboratory analysis. This study aimed to validate the utility of hemolysis monitoring by focusing on factors contributing to hemolysis in the pre-examination process and providing concrete examples. Based on measured serum data, hemolysis was categorized into four levels, namely, 0, 1+, 2+, and > 2+, and corresponding counts and hemolysis rates were calculated. Cases with high hemolysis rates because of centrifuge damage enabled the early detection of centrifuge malfunctions through a comparison of hemolysis rates between two centrifuges and daily monitoring. In another case where a change in the manufacturer of butterfly needles led to reduced hemolysis rates, the potential to observe the effect of alterations on pre-examination processes, such as modifications in blood collection tools and techniques, was emphasized. Another case had high hemolysis rates caused by an elevated silicone coating on needles during butterfly needle manufacturing, highlighting the effectiveness of monitoring as an objective indicator for early anomaly detection. Additional cases revealed low hemolysis rates through adjustments in the blood collection volume concerning vacuum blood collection tube capacity. Collecting more than half of the tube’s capacity resulted in a significant reduction in hemolysis rates, a reduction that was further decreased using smaller vacuum collection tubes. These examples underscore the value of monitoring hemolysis rates in the test samples for the early detection of anomalies in pre-examination processes.