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Hemolysis poses a risk for blood sample analysis


Uwe Hogartz
12 June 2024
Hospital
Reading Time: 3 min.
The journey a blood sample has to cover from the collection to the final analysis result is often long and risky. Lab specimens have to be handled with caution to not put the patient’s life at stake.
Illustration of hemolysis

75 % of all mistakes occur in the preanalytical phase, thus during blood collection or lab specimen transport. One single mistake costs 157€ on average, as a new sample has to be arranged and all steps need to be carried out again.

One of the main causes for defective samples is hemolysis. Red blood cells are destroyed and hemoglobin is released. The blood sample is now useless. 10 % of all blood samples are subject to haemolysis.

What are the causes of hemolysis?

Hemolysis can be caused by different diseases or mechanical processes that make the erythrocytes explode. The red blood pigment hemoglobin is released into the cell’s plasma. An orange-reddish color of the blood is a fairly reliable indication for hemolyzed blood.

Autoimmune hemolytic anemia

Autoimmune hemolytic anemia summarizes diseases that can cause hemolysis. The immune system does not work properly and produces antibodies to fight the body’s own erythrocytes, falsely identifying them as foreign bodies.

Mechanical processes

Mechanical processes, such as improper sample collection or transport can be causes of hemolysis in blood samples, where hemoglobin is released into the blood. The additional substance creates problems for analysis. Certain parameters can no longer be determined correctly:

  • Lactate dehydrogenase
  • Potassium
  • Asparate aminotransferase
  • Alanine aminotransferase

 

Diseases cannot be diagnosed reliably anymore. In the worst case, false results might lead to a wrong diagnosis and subsequently wrong treatment for the patient.

Hemolysis during blood sample transport

Hemolysis during blood transport  is often caused by

  • Temperature deviations,
  • blunt impacts and
  • improper centrifugation of the blood sample.

 

When it comes to automated transport via a pneumatic tube system, blunt impacts and shocks are especially dangerous.

According to tests, sudden changes, jerky movements and even the tiniest impact can considerably influence the quality of blood samples. They are mainly caused by:

  • Damaged pipelines
  • Direction changes
  • Turbulent airflows

 

Likewise, interior processes of the sample tube are decisive: During transport with a standard pneumatic tube carrier, the tube moves in relation to the carrier and the blood in relation to the tube. This results in relative movements, damaging the sample.

 

How can you prevent hemolysis in blood samples?

Hemolysis is a danger for both manual and automated sample transport – there is no entirely safe method. Still, there are ways to prevent hemolysis in a blood sample.

Optimized solutions can prevent hemolysis for pneumatic tube system deliveries. Carriers with inlay fixate blood samples and reduce relative movements.

TransCheck

Our TransCheck service helps validate the quality of pneumatic tube systems. Areas that are at risk for shocks are determined by measuring parameters such as:

  • Power
  • Speed
  • Acceleration

 

Each line is assigned a corresponding risk value. The analysis results of the line with the highest risk are then compared to manual transport; if the measurement is within the acceptance range of the H-index (Hemolysis-Index: amount of hemoglobin in the cell in mg/L), the line is safe and validated.

TransCheck can also be used as a measuring device for problematic areas that can then be optimized.

There is currently no means of transport that can entirely prevent hemolysis in blood samples. If the transport systems are constantly optimized and adapted, though, the risk can be significantly reduced.

About the author

Uwe Hogartz, Product Manager, TranpoNet pneumatic tube system.


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