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Visible Hemolysis

This is a question from my colleague and neighbor, Vicki Cardone.

Do you feel slight hemolysis would compromise PT/PTT results?  If so would you recollect or add a comment to let physician know the results may be falsely decreased. We are a Children’s Hospital and do not want to recollect unnecessarily. Thanks. Vicki Cardone, Children’s Hospital of Alabama.

Hi, Vicki. The 2003 CLSI guideline H21-A3, Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays; Approved Guideline—Fourth Edition leaves little margin, as it states, “Samples that have visible hemolysis should not be used because of possible clotting factor activation and end point measurement interference.” Hemolysis may also indicate platelet activation.

I’d take the approach of running the PT or PTT and reporting a result with a qualifying narrative only when there is no way to re-collect the specimen. Geo.

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