Hemolysis, Icterus & Lipemia

Hemolysis

Causes

• Intravascular
  • Hemolytic anemia
  • Transfusion reactions
• Extravascular
  • Vigorous mixing
  • Venipuncture
    • Difficult draw
    • Tourniquet left on for too long
    • Use of small needle (e.g., butterfly) - higher gauge is smaller needle (23 gauge is smaller than 21 gauge)
  • Old sample

Interferences/Issues

• Release of cellular contents can falsely affect chemistry results
• Damage to blood cells can affect hematology results
• Can affect optical measurements

Icterus

• Elevated bilirubin in blood due to disease states
• May interfere with optical measurements at 400-540 nm
• May interfere with certain test methods

Lipemia

• High levels of fats/lipids in serum or plasma portion of blood
• May be due to diet (recent fatty meal)
• Can be pathological
• Interferes with optical tests
  • Ultracentrifugation to remove lipids