1
|
Kovačević D, Cincović M, Majkić M, Spasojević J, Djoković R, Nikolić S, Došenović Marinković M, Delić Vujanović B, Obradović N, Anđušić L, Čukić A, Petrović M, Starič J, Ježek J. Analytical and Clinical Interference of Sample Hemolysis in Evaluating Blood Biochemical and Endocrine Parameters in Cows. Animals (Basel) 2024; 14:1773. [PMID: 38929392 PMCID: PMC11200682 DOI: 10.3390/ani14121773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
Hemolysis is a common cause of errors in laboratory tests as it affects blood parameters and leads to a positive or negative bias. This study aims to examine the relationship between the level of hemolysis (expressed as cell-free hemoglobin concentration, g/L) and the variability of metabolic and endocrine parameters and to determine the threshold level of hemolysis that causes an analytically and clinically significant bias for the twenty most frequently examined blood parameters in cows. Paired blood samples of 10 mL each were obtained from 30 cows. One was subjected to mechanical trauma and plasma was extracted directly from the other. Hemolyzed and non-hemolyzed samples from the same animal were mixed to obtain final samples with cell-free hemoglobin concentrations of 0, 1, 2, 4, 6, 8, and 10 g/L. Metabolic and endocrine parameters were measured in the samples and their deviation and the linear equation between the level of hemolysis and the deviation were determined. The following threshold values of hemolysis were determined, which correspond to the acceptable analytical (lower value) and clinical (upper value) levels of parameter variability: BHB 0.96 and 4.81; NEFA 0.39 and 3.31; GLU 0.38 and 3.90; ALB 1.12 and 6.11; TPROT 1.40 and 6.80; UREA 6.62 and 20.1; TBIL 0.75 and 5.65; AST 0.11 and 2.18; GGT 1.71 and 8.90, LDH 0.01 and 0.11, ALP 0.97 and 2.95; TGC 1.56 and 15.5; CHOL 1.29 and 8.56; Ca 5.68 and 25.7; P 0.57 and 8.43; Mg 1.10 and 8.47; INS 1.15 and 3.89; T3 8.19 and 15.6; T4 8.97 and 18.5; and CORT 2.78 and 11.22 g/L cell-free hemoglobin. Three decision levels are available for each metabolic and endocrine parameter: if hemolysis is below the lower (analytical) threshold value, results can be reported without restriction; if hemolysis is between the lower and upper thresholds, the results can be issued with guidance in the form of corrective linear equations; and if hemolysis is above the upper (clinical) threshold, the results and sample must be discarded. This method contributes to an optimal approach to hemolysis interference with metabolic profile parameters in blood samples from cows.
Collapse
Affiliation(s)
- Dražen Kovačević
- Faculty of Agriculture, University of Novi Sad, Square Dositeja Obradovića 7, 21000 Novi Sad, Serbia; (D.K.); or (M.C.); (M.M.); (J.S.); (S.N.)
| | - Marko Cincović
- Faculty of Agriculture, University of Novi Sad, Square Dositeja Obradovića 7, 21000 Novi Sad, Serbia; (D.K.); or (M.C.); (M.M.); (J.S.); (S.N.)
| | - Mira Majkić
- Faculty of Agriculture, University of Novi Sad, Square Dositeja Obradovića 7, 21000 Novi Sad, Serbia; (D.K.); or (M.C.); (M.M.); (J.S.); (S.N.)
| | - Jovan Spasojević
- Faculty of Agriculture, University of Novi Sad, Square Dositeja Obradovića 7, 21000 Novi Sad, Serbia; (D.K.); or (M.C.); (M.M.); (J.S.); (S.N.)
| | - Radojica Djoković
- Faculty of Agronomy, University of Kragujevac, Cara Dušana 34, 32000 Čačak, Serbia; (R.D.); (M.P.)
| | - Sandra Nikolić
- Faculty of Agriculture, University of Novi Sad, Square Dositeja Obradovića 7, 21000 Novi Sad, Serbia; (D.K.); or (M.C.); (M.M.); (J.S.); (S.N.)
| | | | | | - Nemanja Obradović
- Pasteur Institute Novi Sad, Hajduk Veljkova 1, 21000 Novi Sad, Serbia;
| | - Ljiljana Anđušić
- Faculty of Agriculture, University of Priština, Kopaonička bb, 38219 Lešak, Serbia; (L.A.); (A.Č.)
| | - Aleksandar Čukić
- Faculty of Agriculture, University of Priština, Kopaonička bb, 38219 Lešak, Serbia; (L.A.); (A.Č.)
| | - Miloš Petrović
- Faculty of Agronomy, University of Kragujevac, Cara Dušana 34, 32000 Čačak, Serbia; (R.D.); (M.P.)
| | - Jože Starič
- Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia;
| | - Jožica Ježek
- Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia;
| |
Collapse
|
2
|
Kofanova O, Paul S, Pexaras A, Bellora C, Petersons A, Schmitt M, Baker Berjaoui M, Qaoud Y, Kenk M, Wagner H, Fleshner N, Betsou F. Biospecimen Qualification in a Clinical Biobank of Urological Diseases. Biopreserv Biobank 2024; 22:257-267. [PMID: 37878356 DOI: 10.1089/bio.2022.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Development of novel biomarkers for diagnosis of disease and assessment of treatment efficacy utilizes a wide range of biospecimens for discovery research. The fitness of biospecimens for the purpose of biomarker development depends on the clinical characteristics of the donor and on a number of critical and potentially uncontrolled pre-analytical variables. Pre-analytical factors influence the reliability of the biomarkers to be analyzed and can seriously impact analytic outcomes. Sample quality stratification assays and tools can be utilized by biorepositories to minimize bias resulting from samples' inconsistent quality. In this study, we evaluated the quality of biobanked specimens by comparing analytical outcomes at 1, 5, and 10 years after collection. Our results demonstrate that currently available assays and tools can be used by biobank laboratories to support objective biospecimen qualification. We have established a workflow to monitor the quality of different types of biospecimens and, in this study, present the results of a qualification exercise applied to fluid samples and their derivatives in the context of urological diseases.
Collapse
Affiliation(s)
- Olga Kofanova
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Sangita Paul
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Achilleas Pexaras
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Camille Bellora
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Ala Petersons
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Margaux Schmitt
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| | - Mohamad Baker Berjaoui
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Yazan Qaoud
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Miran Kenk
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Heidi Wagner
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Neil Fleshner
- McCain GU BioBank (MGB), University Health Network-Princess Margaret Cancer Centre, Toronto, Canada
| | - Fay Betsou
- Integrated Biobank of Luxembourg (IBBL), Luxembourg Institute of Health (LIH), Dudelange, Luxembourg
| |
Collapse
|
3
|
Luginbühl M, Frey K, Gawinecka J, von Eckardstein A, Saleh L. Comparison of a two-step Tempus600 hub solution single-tube vs. container-based, one-step pneumatic transport system. Clin Chem Lab Med 2024; 0:cclm-2024-0057. [PMID: 38742247 DOI: 10.1515/cclm-2024-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/04/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES Efficient and timely transportation of clinical samples is pivotal to ensure accurate diagnoses and effective patient care. During the transportation process, preservation of sample integrity is crucial to avoid pre-analytical aberrations on laboratory results. Here, we present a comparative analysis between a two-step Tempus600 hub solution single-tube and a one-step, container-based pneumatic transport system (PTS) from Airco, for the in-house transportation of blood samples. METHODS Ten blood samples from healthy volunteers were split in 10 mL collection tubes filled at full or half capacity for transportation with the two PTS (about 250 m). To compare the impact of transportation, markers of hemolysis such as lactate dehydrogenase (LDH), potassium (K+), and the hemolysis index (HI), were determined. Additionally, differences in HI in routine samples and repeated transportation was investigated. To assess and compare the mechanistic impact profiles, we recorded the acceleration profiles of the two PTS using a shock data logger. RESULTS Transportation using the Tempus600 hub solution resulted in 49 and 46 % higher HI with samples filled to total or half capacity, respectively. Routine samples transported with the Tempus600 hub solution showed a higher median HI by 23 and 33 %. Additionally, shock logger analysis showed an elevated amount of shocks (6.5 fold) and shock intensities (1.8 fold). CONCLUSIONS The Tempus600 hub solution caused an increased number of unreportable LDH or K+ results based on the hemolysis index. However, it was only statistically significant for LDH (p<0.01 and p<0.08) - while the comparisons for K+ were not statistically significant (p<0.28 and p<0.56).
Collapse
Affiliation(s)
- Marc Luginbühl
- Institute for Clinical Chemistry, 229148 University Hospital and University Zurich , Zurich, Switzerland
| | - Kathrin Frey
- Institute for Clinical Chemistry, 229148 University Hospital and University Zurich , Zurich, Switzerland
| | - Joanna Gawinecka
- Institute for Clinical Chemistry, 229148 University Hospital and University Zurich , Zurich, Switzerland
| | - Arnold von Eckardstein
- Institute for Clinical Chemistry, 229148 University Hospital and University Zurich , Zurich, Switzerland
| | - Lanja Saleh
- Institute for Laboratory Medicine, Triemli Hospital, Zurich, Switzerland
| |
Collapse
|
4
|
Larrán B, López-Alonso M, Miranda M, Graña A, Rigueira L, Orjales I. Influence of haemolysis on blood biochemistry profiles in cattle. Res Vet Sci 2024; 171:105203. [PMID: 38432158 DOI: 10.1016/j.rvsc.2024.105203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/13/2024] [Accepted: 01/23/2024] [Indexed: 03/05/2024]
Abstract
Although haemolysis is the most common source of preanalytical error in clinical laboratories, its influence on cattle biochemistry remains poorly understood. The effect of haemolysis and its clinical relevance were investigated in 70 samples in which haemolysis was artificially induced (by spiking with increasing amounts of haemolysate, yielding 0.0%, 0.2%, 0.5%, 1.0%, 2.5%, 5.0% and 10% haemolysis degree (HD)), focusing on key parameters for bovine metabolic health assessment, including albumin, alkaline phosphatase (ALP), aspartate aminotransferase (AST), blood urea nitrogen (BUN), calcium (Ca), cholesterol, creatinine, creatine kinase (CK), gamma-glutamyl transferase (GGT), globulins, magnesium (Mg), phosphorus (P), total bilirubin (TBIL) and total proteins (TP). Preanalytical haemolysis significantly affected most (8 of 14) of the biochemical parameters analysed, leading to significant increases in concentrations of albumin (starting at 5% HD), cholesterol (at 5% HD) and P (at 10% HD) and to significant decreases in Ca (at 2.5% HD), creatinine (at 5% HD), globulins (at 10% HD), TBIL (at 2.5% HD) and TP (at 10% HD). Comparison of the present and previous data indicated that, for each parameter, the HD required to produce significant bias and the clinical relevance of over- and underestimation are variable and appear to depend on the analytical technique used. Therefore, different laboratories should evaluate the influence of haemolysis in their analytical results and provide advice to clinicians accordingly. Affected parameters should be interpreted together with clinical signs and other analytical data to minimize misinterpretations (false or masked variations). Finally, due to the significant impact on numerous parameters and the limited potential for correction, we recommend rejection of samples with >10% HD.
Collapse
Affiliation(s)
- Belén Larrán
- Department of Animal Pathology, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Marta López-Alonso
- Department of Animal Pathology, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain.
| | - Marta Miranda
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Almudena Graña
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Lucas Rigueira
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Inmaculada Orjales
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| |
Collapse
|
5
|
Mielke N, Lee R, Bahl A. Pediatric hemolysis in emergency departments: Prevalence, risk factors, and clinical implications. PLoS One 2024; 19:e0299692. [PMID: 38512885 PMCID: PMC10956767 DOI: 10.1371/journal.pone.0299692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce. METHODS We conducted a multi-site observational cohort analysis of pediatric ED encounters in Metro Detroit, Michigan, United States. The study included participants below 18 years of age who had undergone peripheral intravenous catheter (PIVC) placement and laboratory testing. The primary outcome was the presence of hemolysis, and secondary outcomes included identifying risk factors for hemolysis and assessing the impact of hemolysis on PIVC failure. RESULTS Between January 2021 and May 2022, 10,462 ED encounters met inclusion criteria, of which 14.0% showed laboratory evidence of hemolysis. The highest proportion of hemolysis occurred in the infant (age 0-1) population (20.1%). Multivariable regression analysis indicated higher odds of hemolysis for PIVCs placed in the hand/wrist in the toddler (age 2-5) and child (age 6-11) subgroups. PIVCs placed in the hand/wrist also demonstrated higher odds of failure in infants. CONCLUSIONS Hemolysis in the pediatric ED population is a frequent complication that occurs at similar rates as in adults. PIVCs placed in the hand/wrist were associated with higher odds of hemolysis compared to those placed in the antecubital fossa. Clinicians should consider alternative locations for PIVC placement if clinically appropriate. Further research is needed to better understand the clinical implications of pediatric hemolysis.
Collapse
Affiliation(s)
- Nicholas Mielke
- Creighton University School of Medicine, Omaha, Nebraska, United States of America
| | - Ray Lee
- Corewell Health Research Institute, Royal Oak, Michigan, United States of America
| | - Amit Bahl
- Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, United States of America
| |
Collapse
|
6
|
Dibbasey M, Umukoro S, Bojang A. Comparative and stability study of glucose concentrations measured in both sodium fluoride and serum separator tubes. Pract Lab Med 2024; 39:e00360. [PMID: 38313813 PMCID: PMC10832486 DOI: 10.1016/j.plabm.2024.e00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Introduction Sodium fluoride/potassium oxalate (NaF/KOx) tubes has been regarded as the gold-standard tubes for glucose analysis. Even though their ineffectiveness in immediately inhibiting glycolysis has been reported in several studies especially in the first 1-4h, they are still used in our clinical biochemistry laboratory for glucose measurement. However, in its absence, only serum separator tubes are employed for glucose measurement. We aim to determine whether serum separator tubes (SSTs) can replace NaF/KOx tubes for laboratory measurement of blood glucose and to assess the stability of glucose concentrations for 3 days period. Methods and findings NaF/KOx tube type was the reference method while SSTs type was the candidate method for glucose measurement. A total of 50 paired samples collected separately in NaF/KOx tubes and SSTs from healthy adult participants in the Gambia Adults Reference Intervals Study (GARIS) project were used as the project sample size. Following blood collection and separation, the glucose concentration was measured within 2 h, and at 24h, 42h and 72h time-points. Our data analysis showed no significant difference in the mean glucose concentrations between the reference tube and candidate tube types (Mean difference = 0.06 mmol/L; P = 0.38) recorded in the different timepoints. Using growth trajectory and mixed effects model, the study data further showed no significant change in the glucose concentrations (p = 0.25) for three days period. Conclusions The study confirms that SSTs can produce similar glucose results when employed in the absence of NaF/KOx tubes. Besides, the glucose concentrations were stable in both tubes for three days when the samples were separated within 2 h and refrigerated in 2-8°C.
Collapse
Affiliation(s)
- Mustapha Dibbasey
- Medical Research Council Unit the Gambia at London School of Hygiene and Tropical Medicine, United Kingdom
| | - Solomon Umukoro
- Medical Research Council Unit the Gambia at London School of Hygiene and Tropical Medicine, United Kingdom
| | - Abdoulie Bojang
- Medical Research Council Unit the Gambia at London School of Hygiene and Tropical Medicine, United Kingdom
| |
Collapse
|
7
|
Ríos NR, Bransfield A, Joyce CM, Cahill MR, O’Shaughnessy M, Costelloe SJ. Challenges of providing biochemistry results in a patient with Evans syndrome. Biochem Med (Zagreb) 2024; 34:011001. [PMID: 38125617 PMCID: PMC10731728 DOI: 10.11613/bm.2024.011001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/09/2023] [Indexed: 12/23/2023] Open
Abstract
A case report of in vivo hemolysis in a female patient with Evans syndrome is described. The patient was admitted with anemia and jaundice and, during her 26-day hospital admission, had 83 samples taken for biochemistry analyses. The laboratory hemolytic index (HI) was frequently elevated due to persistent complement-mediated in vivo hemolysis despite multiple lines of therapy. Initially, the release of many biochemical parameters was blocked per the manufacturer´s recommendations and reported as "sample hemolyzed". The patient developed severe acute kidney injury, ultimately requiring dialysis. Automated and timely reporting of indicative creatinine and other biochemical results in the context of ongoing hemolysis, therefore, became essential to patient care. Following a review of literature from various sources, a laboratory algorithm was designed to ensure the timely release of numerical biochemical values, where possible, with appropriate interpretative comments appended. Biochemistry, hematology, and nephrology teams were in regular communication to ensure patient samples were rapidly identified, analyzed and validated according to the algorithm, informing timely, safe and appropriate patient care. Ultimately, the patient died due to multiple disease- and treatment-related complications. In conjunction with clinical users, laboratories should plan for situations, such as in vivo hemolysis, where significant unavoidable interferences in biochemistry methodologies may occur in an ongoing manner for certain patients. Reporting categorical or best-estimate biochemistry results in such cases can be safer for patients than failing to report any results. Interpretation of these results by clinical teams requires input from appropriately trained and qualified laboratory personnel.
Collapse
Affiliation(s)
- Natividad Rico Ríos
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| | - Alison Bransfield
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| | - Caroline M Joyce
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| | - Mary R Cahill
- Department of Clinical Haematology, Cork University Hospital, Cork, Republic of Ireland
| | | | - Seán J. Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| |
Collapse
|
8
|
Edwina AE, Dreesen E, Hias J, Koch BCP, Van den Eede N, Pauwels S, Allegaert K, Van der Linden L, Spriet I, Tournoy J. Agreement Between a Colorimetric Assay and Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry for Quantifying Paracetamol Plasma Concentrations. AAPS J 2024; 26:23. [PMID: 38302833 DOI: 10.1208/s12248-024-00890-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
Special populations, like geriatric patients, experience altered paracetamol pharmacokinetics (PK), complicating pain management. More PK research is essential to optimize paracetamol (acetaminophen) dosing. Yet, the reference method ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) is not readily available. Therefore, we aimed to evaluate the agreement between UPLC-MS/MS and the more accessible colorimetric Roche acetaminophen (ACETA) assay in quantifying paracetamol plasma concentrations, to facilitate PK studies and therapeutic drug monitoring for pain management. Patient data and plasma samples were obtained from a prospective study including geriatric patients admitted to the geriatric wards. ACETA and UPLC-MS/MS assays were performed in two separate laboratories. Bland-Altman plot and Passing-Bablok regression were used to assess agreement. Accuracy was evaluated using the McNemar test for a threshold value of 10 mg/L. Population PK modeling was employed to bridge PK data obtained from both methods (NONMEM 7.5). A total of 242 plasma sample pairs were available from 40 geriatric patients (age range, 80-95 years). Paracetamol plasma concentrations from ACETA (median 9.8 [interquartile range 6.1-14.4] mg/L) and UPLC-MS/MS (9.5 [6.2-14.8] mg/L) did not differ significantly (P > 0.05). No significant proportional nor additive bias was observed between both assay methods. The classification accuracy (at threshold 10 mg/L) was 85% (P = 0.414). The conversion factor between ACETA and UPLC-MS/MS was estimated at 1.06 (relative standard error 5%), yet with a 13.4% (relative standard error 23%) interindividual variability. ACETA assay showed no systematic bias in comparison with the UPLC-MS/MS assay in determining paracetamol exposure in geriatric blood samples despite the imprecision.
Collapse
Affiliation(s)
- Angela Elma Edwina
- Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven - University of Leuven, UZ Herestraat 49, Box 7003, 3000, Leuven, Belgium
| | - Erwin Dreesen
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Julie Hias
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Birgit C P Koch
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Lorenz Van der Linden
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Isabel Spriet
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Jos Tournoy
- Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven - University of Leuven, UZ Herestraat 49, Box 7003, 3000, Leuven, Belgium.
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
| |
Collapse
|
9
|
Lehner AF, Rebolloso S, Calle PP, Ingerman K, Lewbart GA, Muñoz-Pérez JP, Valle CA, Buchweitz JP. Dried blood spot analysis for elements of nutritional concern as demonstrated in studies of Galápagos land iguanas (Conolophus species). J Trace Elem Med Biol 2024; 81:127322. [PMID: 37890447 DOI: 10.1016/j.jtemb.2023.127322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Dried blood spot (DBS) technology is valuable in providing simple means of storing blood samples from wildlife with small blood volumes. Methods designed for heavy metal analysis on DBS become more useful if extended to elements of nutritional significance. PURPOSE (1) Development of procedures for measuring Mn, Fe, Co, Cu, Zn, Se and Mo in DBS; (2) use the designed methods in health assessments of Galápagos land iguanas (Conolophus species). PROCEDURES Elements were measured by inductively coupled plasma/mass spectrometry (ICP-MS) following acid digestion of whole blood or DBS from the same animal for direct comparison. Study animals comprised free-ranging iguanas from separate islands in the Galápagos archipelago. MAIN FINDINGS DBS spikes (Mn, Fe, Co, Cu, Zn, Se and Mo) demonstrated accuracy to ∼100 ppb; reporting limits were set there except for Fe and Zn which were set at 1000 ppb. Plasma samples - generally preferable for nutritional element diagnostics - were submitted from Galápagos land iguanas along with DBS as part of a large-scale health assessment. In plasma versus DBS concentration comparisons, Fe, Cu, Se and Mn correlated well with R^2 values of 0.799, 0.818, 0.896 and 0.899, respectively, and slopes ranging 0.88 - 1.3. Co and Zn showed greater scatter. Mo had insufficient points above its reporting limit and offered advantages for toxicity assessments. Bland-Altman diagrams showed flat scatter between 2x standard deviation boundaries with no undue trends except for Mn which had few points above its reporting limit. Bias, defined as the average difference [DBS - plasma] divided by the average value, was relatively low throughout, with values of - 19.3 % (Fe), - 48.7 % (Co), - 19.6 % (Cu), - 6.9 % (Zn), - 21.4 % (Se) and + 40.7 % (Mn). Normal distribution assessment of iguana Cu, Zn, Se and Fe plasma values showed unanticipated divergences between two species. CONCLUSIONS The DBS approach for nutritional element analysis offers a suitable methodology for determining crucial elements Mn, Fe, Co, Cu, Zn, Se, and Mo in veterinary samples. Analyses of samples from Conolophus species revealed interesting divergences particularly for Cu, Zn, Se and Fe, elements generally associated with defense against oxidative stress.
Collapse
Affiliation(s)
- Andreas F Lehner
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910.
| | - Sarah Rebolloso
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910
| | - Paul P Calle
- Wildlife Conservation Society, Zoological Health Program, Bronx, NY 10460
| | - Karen Ingerman
- Wildlife Conservation Society, Zoological Health Program, Bronx, NY 10460
| | - Gregory A Lewbart
- North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607; Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador
| | - Juan Pablo Muñoz-Pérez
- Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador; Faculty of Science and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Carlos A Valle
- Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito, Quito, Ecuador
| | - John P Buchweitz
- Michigan State University Veterinary Diagnostic Laboratory, Toxicology Section, Michigan State University, East Lansing, MI, 48910; Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824
| |
Collapse
|
10
|
Kopanke JH, Chen AV, Brune JE, Brenna AC, Thomovsky SA. Creatine kinase and its isoenzymes in the serum and cerebrospinal fluid of healthy canines. Vet Clin Pathol 2023; 52:654-660. [PMID: 37985467 DOI: 10.1111/vcp.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/12/2023] [Accepted: 04/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Creatine kinase (CK) exists as three isoenzymes (CK-MM, CK-MB, and CK-BB) that are predominantly expressed in specific tissues and can be detected in both the serum and cerebrospinal fluid (CSF). CSF CK has been relatively unstudied in veterinary medicine, although studies in human medicine have demonstrated that changes in total CSF CK activity can indicate neurologic abnormalities. OBJECTIVES The purpose of this study was to establish reference intervals for CK and its three major isoenzymes in the serum and CSF of clinically healthy dogs. By establishing a definitive reference interval for this enzyme in healthy canines, the diagnostic use and possible significance of CK in clinical disease can be studied. METHODS Serum and/or CSF were collected from healthy dogs. Total CK activity was measured spectrophotometrically, and isoenzyme distributions were determined using the QuickGel CK Vis Isoenzyme Kit and a densitometric scanner. Total CK and CK isoenzyme activities were determined within 8 h of collection. RESULTS The median serum total CK in healthy canines was 159.0 U/L (range: 53.0-539.0 U/L), while the median CSF total CK was 3.7 U/L (range: 2.0-84.0 U/L). CK-BB and CK-MM were approximately equal in the serum, while CK-MM was the predominant isoenzyme in the CSF. CONCLUSIONS Knowledge of the normal distribution and concentration of CK in canine serum and CSF will set the foundation for future studies of canine CK as a potentially clinically useful biomarker.
Collapse
Affiliation(s)
- Jennifer H Kopanke
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Annie V Chen
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Jourdan E Brune
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Amanda C Brenna
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Stephanie A Thomovsky
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| |
Collapse
|
11
|
Corewyn LC, Kelaita MA, Nollman J, Hagnauer I, Blanco-Peña K, Lessnau RG, Clayton JB, Shields-Cutler R, Stoos KB. Hematology and blood biochemistry in a declining population of mantled howler monkeys (Alouatta palliata palliata) at La Pacifica, Costa Rica. J Med Primatol 2023; 52:353-360. [PMID: 37655719 PMCID: PMC10841258 DOI: 10.1111/jmp.12669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Alouatta palliata palliata are an ecologically flexible howler monkey subspecies that has recently been relisted as Endangered. Populations are declining through much of the subspecies' range, including at our study site at La Pacifica, Costa Rica. Our objectives were to screen blood hematology and biochemistry samples collected from this wild population to elucidate their baseline health. METHODS We collected blood samples from 38 adult individuals from across the study site and analyzed 13 hematology and 14 biochemistry parameters. RESULTS Most hematology and blood biochemistry parameter values were similar between males and females. However, mean hemoglobin was significantly lower, and mean white blood cell count was significantly higher in females; and mean calcium and mean creatinine were significantly lower in females compared to males. CONCLUSIONS Overall, the La Pacifica population appeared healthy based on the blood parameters analyzed from sampled individuals. Our results were also largely consistent with published data available from other populations of A. p. palliata, and with reference values for captive Alouatta caraya.
Collapse
Affiliation(s)
- Lisa C Corewyn
- Department of Biology, Ithaca College, Ithaca, New York, USA
| | - Mary A Kelaita
- Department of Natural Sciences, St. Philip's College, San Antonio, Texas, USA
| | - Jenny Nollman
- The Cincinnati Zoo & Botanical Garden, Cincinnati, Ohio, USA
| | | | - Kinndle Blanco-Peña
- Instituto Regional de Estudios en Sustancias Tóxicas (IRET), Universidad Nacional, Costa Rica, Heredia, Costa Rica
| | | | - Jonathan B Clayton
- Department of Biology, University of Nebraska Omaha, Nebraska, Omaha, USA
- Nebraska Food for Health Center, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
- Primate Microbiome Project, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | | | - Kari Brossard Stoos
- Department of Health Sciences & Public Health, Ithaca College, Ithaca, New York, USA
| |
Collapse
|
12
|
Collier BB, Brandon WC, Chappell MR, Kovach PM, Grant RP. Maximizing Microsampling: Measurement of Comprehensive Metabolic and Lipid Panels Using a Novel Capillary Blood Collection Device. J Appl Lab Med 2023; 8:1115-1126. [PMID: 37748757 DOI: 10.1093/jalm/jfad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/08/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Demand continues to grow for patient-centric sampling solutions that enable collection of small volumes of blood outside of healthcare facilities. Various technologies have been developed to facilitate sample collection but gaps in knowledge remain, preventing these technologies from replacing standard venipuncture. METHODS A novel blood collection device, Touch Activated Phlebotomy (TAP) II® from YourBio Health, and standard fingerstick collection using a BD Microtainer® were utilized to collect capillary serum samples. Measurements of a comprehensive metabolic and lipid panels were measured on these samples and compared to results from venous serum samples that were collected in parallel. Hemolysis was used to assess sample quality. Sample volumes obtained from self-collected TAP II samples were also determined. RESULTS Correlation of capillary serum with respect to venous serum was demonstrated (R > 0.9) for professionally collected TAP II samples, self-collected TAP II samples, and professionally collected fingerstick samples for alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, cholesterol, high-density lipoprotein, total bilirubin, and triglycerides. Results for creatinine demonstrated acceptable correlation, however, a consistent negative bias was observed. Biases (with unacceptable correlations) were also observed for measurements of carbon dioxide and potassium. Correlative results for albumin were not consistently acceptable across the collection techniques utilized while the remaining analytes tested did not demonstrate acceptable correlations under any condition. Correlation results, however, would improve with a wider distribution of analyte concentrations. CONCLUSIONS Collections of small volumes of liquid blood continue to show potential as a patient-centric solution.
Collapse
Affiliation(s)
| | | | | | - Peyton M Kovach
- Center for Esoteric Testing, Labcorp, Burlington, NC, United States
| | - Russell P Grant
- Center for Esoteric Testing, Labcorp, Burlington, NC, United States
| |
Collapse
|
13
|
Iacovetti G, Collier B, Setzer S, Peevler M, Ragar J, Hong K, Pan T, Brandon W, Chappell M, Grant RP, Sommer GJ, Schaff UY. Evaluation of a Compact, Portable Centrifuge for Separating Microvolume Blood Samples at the Point of Collection. J Appl Lab Med 2023; 8:1042-1053. [PMID: 37748720 DOI: 10.1093/jalm/jfad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/31/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND The increased demand for decentralized blood sample collection presents numerous operational challenges for diagnostics providers. Sample degradation including sample hemolysis due to time, temperature, and handling between collection and laboratory analysis leads to limited test menus and unreliable results. Here we introduce the lightweight, portable Labcorp TrueSpin™ for rapid point-of-care blood separation using commercially available microvolume blood collection tubes. The TrueSpin is a class I FDA-registered device designed for untrained users. The centrifuge runs on AA batteries and separates a blood sample in 5 minutes. METHODS Here we describe a series of studies evaluating sample quality and analyte stability in serum samples collected into gel microtubes and processed using the TrueSpin. Hemolysis, residual red blood cell concentration, sample volume, and serum-based chemistry analyte stability were evaluated. RESULTS No significant difference was seen in hemolysis or residual red blood cell concentration in serum samples prepared by TrueSpin compared to the reference method. Additionally, capillary and venous blood samples separated using the TrueSpin and exposed to International Safe Transit Association 3A-simulated shipping conditions were shown to yield acceptable sample volume and quality for laboratory analysis. Finally, we show that many common serum-based chemistry analytes have limited (< 1 day) stability if uncentrifuged but improve to ≥ 3-day stability following TrueSpin separation and refrigerated or room temperature storage. CONCLUSIONS These findings suggest that the TrueSpin is a simple and effective solution for remote sample separation and may enable broader test menus and increased test result reliability for decentralized sample collection pursuits.
Collapse
Affiliation(s)
- Gabriella Iacovetti
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Brad Collier
- Center for Esoteric Testing, Laboratory Corporation of America Holdings, Burlington, NC, United States
| | - Shannon Setzer
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Mitchell Peevler
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Jason Ragar
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Kyungjin Hong
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Tifany Pan
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Whitney Brandon
- Center for Esoteric Testing, Laboratory Corporation of America Holdings, Burlington, NC, United States
| | - Mathew Chappell
- Center for Esoteric Testing, Laboratory Corporation of America Holdings, Burlington, NC, United States
| | - Russell P Grant
- Center for Esoteric Testing, Laboratory Corporation of America Holdings, Burlington, NC, United States
| | - Greg J Sommer
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| | - Ulrich Y Schaff
- Diagnostic Devices Research and Development, Laboratory Corporation of America Holdings, Pleasanton, CA, United States
| |
Collapse
|
14
|
Lee D, Rapp V CG, Loureiro J, Patel MT, Mikhailov D, Gusev AI. Decentralized clinical trial design using blood microsampling technology for serum bioanalysis. Bioanalysis 2023; 15:1287-1303. [PMID: 37855231 DOI: 10.4155/bio-2023-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: Alternatives to phlebotomy in clinical trials increase options for patients and clinicians by simplifying and increasing accessibility to clinical trials. The authors investigated the technical and logistical considerations of one technology compared with phlebotomy. Methodology: Paired samples were collected from 16 donors via a second-generation serum gel microsampling device and conventional phlebotomy. Microsamples were subject to alternative sample handling conditions and were evaluated for quality, clinical testing and proteome profiling. Results: Timely centrifugation of blood serum microsamples largely preserved analyte stability. Conclusion: Centrifugation timing of serum microsamples impacts the quality of specific clinical chemistry and protein biomarkers. Microsampling devices with remote centrifugation and refrigerated shipping can decrease patient burden, expand clinical trial populations and aid clinical decisions.
Collapse
Affiliation(s)
- Dana Lee
- Biomarker Development, Novartis Institutes for BioMedical Research, 220 Massachusetts Ave., Cambridge, MA 02139, USA
| | - Charles G Rapp V
- Biomarker & Bioanalytical Science & Technology, Takeda Pharmaceutical Company, 40 Landsdowne St., Cambridge, MA 02139, USA
| | - Joseph Loureiro
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 250 Massachusetts Ave., Cambridge, MA 02139, USA
| | - Michael T Patel
- Biomarker Development, Novartis Institutes for BioMedical Research, 220 Massachusetts Ave., Cambridge, MA 02139, USA
| | - Dmitri Mikhailov
- Biomarker Development, Novartis Institutes for BioMedical Research, 220 Massachusetts Ave., Cambridge, MA 02139, USA
| | - Arkady I Gusev
- Biomarker Development, Novartis Institutes for BioMedical Research, 220 Massachusetts Ave., Cambridge, MA 02139, USA
| |
Collapse
|
15
|
Ishiguro A, Nishioka M, Morishige A, Yoneshiro M, Shinkawa K, Fujinaga A, Kobayashi T, Suehiro Y, Yamasaki T. Determination of the Optimal Wavelength of the Hemolysis Index Measurement. J Clin Med 2023; 12:5864. [PMID: 37762805 PMCID: PMC10531830 DOI: 10.3390/jcm12185864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Many biochemical auto-analyzers have methods that measure the hemolysis index (HI) to quantitatively assess the degree of hemolysis. Past reports on HI are mostly in vitro studies. Therefore, we evaluated the optimal wavelength of HI measurement ex vivo using clinical samples. Four different wavelengths (410/451 nm: HI-1, 451/478 nm: HI-2, 545/596 nm: HI-3 and 571/596 nm: HI-4) were selected for HI measurement, and correlations were examined from the measurement results of 3890 clinical samples. Another set of 9446 clinical samples was used to examine the correlation of HI with lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and potassium (K). Strong correlations were found between HI-4 and HI-1 and between HI-4 and HI-3. HI-1 and HI-2 cannot correctly assess hemolysis for high bilirubin samples, and HI-3 cannot correctly assess hemolysis for high triglyceride samples. LDH, AST and K correlated positively with HI-4 in clinical samples. For every 1-unit increase in HI-4, LDH increased by 19.51 U/L, AST by 1.03 U/L and K by 0.061 mmol/L, comparable to reports of other studies. In clinical samples, HI-4 was less susceptible to bilirubin and chyle and reflected well the changes in LDH, AST and K caused by hemolysis. This suggested that the optimal wavelength for HI measurement is 571 nm.
Collapse
Affiliation(s)
- Akiyo Ishiguro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (A.I.); (Y.S.)
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Mitsuaki Nishioka
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Akihiro Morishige
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Mai Yoneshiro
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Kanae Shinkawa
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Aki Fujinaga
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Toshihiko Kobayashi
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (A.I.); (Y.S.)
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| | - Takahiro Yamasaki
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (A.I.); (Y.S.)
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (M.N.); (A.M.); (M.Y.); (K.S.); (A.F.); (T.K.)
| |
Collapse
|
16
|
Lee LM, Bhatt KH, Haithcock DW, Prabhakarpandian B. Blood component separation in straight microfluidic channels. BIOMICROFLUIDICS 2023; 17:054106. [PMID: 37854890 PMCID: PMC10581738 DOI: 10.1063/5.0176457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
Separation of blood components is required in many diagnostic applications and blood processes. In laboratories, blood is usually fractionated by manual operation involving a bulk centrifugation equipment, which significantly increases logistic burden. Blood sample processing in the field and resource-limited settings cannot be readily implemented without the use of microfluidic technology. In this study, we developed a small footprint, rapid, and passive microfluidic channel device that relied on margination and inertial focusing effects for blood component separation. No blood dilution, lysis, or labeling step was needed as to preserve sample integrity. One main innovation of this work was the insertion of fluidic restrictors at outlet ports to divert the separation interface into designated outlet channels. Thus, separation efficiency was significantly improved in comparison to previous works. We demonstrated different operation modes ranging from platelet or plasma extraction from human whole blood to platelet concentration from platelet-rich plasma through the manipulation of outlet port fluidic resistance. Using straight microfluidic channels with a high aspect ratio rectangular cross section, we demonstrated 95.4% platelet purity extracted from human whole blood. In plasma extraction, 99.9% RBC removal rate was achieved. We also demonstrated 2.6× concentration of platelet-rich plasma solution to produce platelet concentrate. The extraction efficiency and throughput rate are scalable with continuous and clog-free recirculation operation, in contrast to other blood fractionation approaches using filtration membranes or affinity-based purification methods. Our microfluidic blood separation method is highly tunable and versatile, and easy to be integrated into multi-step blood processing and advanced sample preparation workflows.
Collapse
Affiliation(s)
- Lap Man Lee
- CFD Research Corporation, Huntsville, Alabama 35806, USA
| | - Ketan H. Bhatt
- CFD Research Corporation, Huntsville, Alabama 35806, USA
| | | | | |
Collapse
|
17
|
Tang NY, Mitchell KR, Groboske SE, Baldwin AD, Lenza M, Yeo KTJ, van Wijk XMR. Reducing Specimen Rejection Rates Using Concentration-Dependent Hemolysis Rejection Thresholds. J Appl Lab Med 2023; 8:285-295. [PMID: 36592084 DOI: 10.1093/jalm/jfac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/22/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Using middleware solutions, it is possible to implement concentration-dependent analyte-specific hemolysis rejection limits. This makes day-to-day reporting of clinical specimens more efficient and potentially lowers sample rejection rates compared to a "one-size-fits-all" approach (i.e., solely based on a single cutoff provided in the package insert). METHODS Hemolysis interference studies were performed at multiple analyte concentrations for three frequently ordered tests. For each assay, concentration-dependent hemolysis rejection limits were designed based on the total allowable error (TAE) for the analyte as well as the clinical significance of such incurred inaccuracy at the respective concentrations. In general, the following rationale was used: if the interference exceeds 10% (or package insert cutoffs), a comment is placed on the result. If the interference exceeds the TAE, the result will not be reported. Reduction in specimen rejection rates were estimated by comparing the incurred specimen rejection rates when package inserts' vs concentration-dependent hemolysis interference limits were applied to a data set in our institute during a three-month period. RESULTS Concentration-dependent analyte-specific hemolysis rejection thresholds were designed for three commonly ordered assays that are especially susceptible to hemolysis interference. It is estimated that these novel thresholds for aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and direct bilirubin (DBIL) reduced specimen rejection rates from 9.3% to 1.3%, 31.4% to 4.8%, and 19.9% to 7.1%, respectively. CONCLUSIONS Concentration-dependent analyte-specific hemolysis rejection thresholds for three commonly ordered assays can reduce rejection rates without significantly compromising the quality of test results.
Collapse
Affiliation(s)
- Nga Yeung Tang
- Department of Pathology, The University of Chicago, Chicago, IL.,Department of Pathology and Laboratory Medicine, Beaumont Health, Royal Oak, MI.,Department of Pathology and Laboratory Medicine, Oakland University William Beaumont School of Medicine, Auburn Hills, MI
| | - Kelly R Mitchell
- Section of Clinical Chemistry, The University of Chicago Medicine, Chicago, IL
| | - Sarah E Groboske
- Section of Clinical Chemistry, The University of Chicago Medicine, Chicago, IL
| | - Angel D Baldwin
- Section of Clinical Chemistry, The University of Chicago Medicine, Chicago, IL
| | - Michael Lenza
- Section of Clinical Chemistry, The University of Chicago Medicine, Chicago, IL
| | | | - Xander M R van Wijk
- Department of Pathology, The University of Chicago, Chicago, IL.,Medical and Scientific Affairs, Beckman Coulter, Brea, CA
| |
Collapse
|
18
|
Brune JE, Chen AV, Coffey T. Determination of the effect of iatrogenic blood contamination on lactate dehydrogenase and creatine kinase activity in canine cerebrospinal fluid. Vet Clin Pathol 2023; 52:64-70. [PMID: 36336843 DOI: 10.1111/vcp.13184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Lactate dehydrogenase (LDH) and creatine kinase (CK) have differential tissue activity and isoenzyme profiles. LDH and CK exist as 5 and 3 isoenzymes, respectively, in both serum and cerebrospinal fluid (CSF). Studies have demonstrated that measuring LDH, CK, and their isoenzymes in CSF has diagnostic and prognostic values for dogs and people with neurologic disorders. OBJECTIVES Iatrogenic blood contamination can distort the results of CSF analysis. The purpose of this study was to determine allowable thresholds of blood contamination (RBC/μL) for accurate measurement of LDH, CK, and their isoenzymes in canine CSF. METHODS Venous blood and CSF were collected from healthy dogs. Total LDH and CK activity were measured spectrophotometrically. Isoenzyme profiles were determined using gel electrophoresis and densitometric scanning. All samples were analyzed within 6 hours of collection. A nonlinear mixed effects regression model was used to estimate the allowable thresholds of blood contamination for accurate measurement of LDH, CK, and their isoenzymes in canine CSF. RESULTS The threshold of iatrogenic blood contamination for total LDH and total CK in healthy dogs are 6696 RBC/μL (95% CI 3879-11 187) and 5961 RBC/μL (95% CI 2939-12 085), respectively. LDH-1 is the most sensitive isoenzyme to iatrogenic blood contamination, while LDH-4 is the least sensitive. CONCLUSIONS These results are important for the interpretation of LDH, CK, and their isoenzymes in canine CSF. Additionally, our methodology is translatable for determining thresholds of acceptable iatrogenic blood contamination in CSF for other diagnostic and prognostic biomarkers of neurologic disease.
Collapse
Affiliation(s)
- Jourdan E Brune
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Annie V Chen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Todd Coffey
- Department of Mathematics and Statistics, Washington State University, Pullman, WA, USA
| |
Collapse
|
19
|
Olofsson P. Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. Am J Obstet Gynecol 2023; 228:S1222-S1240. [PMID: 37164495 DOI: 10.1016/j.ajog.2022.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 03/21/2023]
Abstract
Normal birth is a eustress reaction, a beneficial hedonic stress with extremely high catecholamines that protects us from intrauterine hypoxia and assists in the rapid shift to extrauterine life. Occasionally the cellular O2 requirement becomes critical and an O2 deficit in blood (hypoxemia) may evolve to a tissue deficit (hypoxia) and finally a risk of organ damage (asphyxia). An increase in H+ concentration is reflected in a decrease in pH, which together with increased base deficit is a proxy for the level of fetal O2 deficit. Base deficit (or its negative value, base excess) was introduced to reflect the metabolic component of a low pH and to distinguish from the respiratory cause of a low pH, which is a high CO2 concentration. Base deficit is a theoretical estimate and not a measured parameter, calculated by the blood gas analyzer from values of pH, the partial pressure of CO2, and hemoglobin. Different brands of analyzers use different calculation equations, and base deficit values can thus differ by multiples. This could influence the diagnosis of metabolic acidosis, which is commonly defined as a pH <7.00 combined with a base deficit ≥12.0 mmol/L in umbilical cord arterial blood. Base deficit can be calculated as base deficit in blood (or actual base deficit) or base deficit in extracellular fluid (or standard base deficit). The extracellular fluid compartment represents the blood volume diluted with the interstitial fluid. Base deficit in extracellular fluid is advocated for fetal blood because a high partial pressure of CO2 (hypercapnia) is common in newborns without concomitant hypoxia, and hypercapnia has a strong influence on the pH value, then termed respiratory acidosis. An increase in partial pressure of CO2 causes less increase in base deficit in extracellular fluid than in base deficit in blood, thus base deficit in extracellular fluid better represents the metabolic component of acidosis. The different types of base deficit for defining metabolic acidosis in cord blood have unfortunately not been noticed by many obstetrical experts and organizations. In addition to an increase in H+ concentration, the lactate production is accelerated during hypoxia and anaerobic metabolism. There is no global consensus on definitions of normal cord blood gases and lactate, and different cutoff values for abnormality are used. At a pH <7.20, 7% to 9% of newborns are deemed academic; at <7.10, 1% to 3%; and at <7.00, 0.26% to 1.3%. From numerous studies of different eras and sizes, it can firmly be concluded that in the cord artery, the statistically defined lower pH limit (mean -2 standard deviations) is 7.10. Given that the pH for optimal enzyme activity differs between different cell types and organs, it seems difficult to establish a general biologically critical pH limit. The blood gases and lactate in cord blood change with the progression of pregnancy toward a mixed metabolic and respiratory acidemia because of increased metabolism and CO2 production in the growing fetus. Gestational age-adjusted normal reference values have accordingly been published for pH and lactate, and they associate with Apgar score slightly better than stationary cutoffs, but they are not widely used in clinical practice. On the basis of good-quality data, it is reasonable to set a cord artery lactate cutoff (mean +2 standard deviations) at 10 mmol/L at 39 to 40 weeks' gestation. For base deficit, it is not possible to establish statistically defined reference values because base deficit is calculated with different equations, and there is no consensus on which to use. Arterial cord blood represents the fetus better than venous blood, and samples from both vessels are needed to validate the arterial origin. A venoarterial pH gradient of <0.02 is commonly used to differentiate arterial from venous samples. Reference values for pH in cord venous blood have been determined, but venous blood comes from the placenta after clearance of a surplus of arterial CO2, and base deficit in venous blood then overestimates the metabolic component of fetal acidosis. The ambition to increase neonatal hemoglobin and iron depots by delaying cord clamping after birth results in falsely acidic blood gas and lactate values if the blood sampling is also delayed. Within seconds after birth, sour metabolites accumulated in peripheral tissues and organs will flood into the central circulation and further to the cord arteries when the newborn starts to breathe, move, and cry. This influence of "hidden acidosis" can be avoided by needle puncture of unclamped cord vessels and blood collection immediately after birth. Because of a continuing anaerobic glycolysis in the collected blood, it should be analyzed within 5 minutes to not result in a falsely high lactate value. If the syringe is placed in ice slurry, the time limit is 20 minutes. For pH, it is reasonable to wait no longer than 15 minutes if not in ice. Routine analyses of cord blood gases enable perinatal audits to gain the wisdom of hindsight, to maintain quality assurance at a maternity unit over years by following the rate of neonatal acidosis, to compare results between hospitals on regional or national bases, and to obtain an objective outcome measure in clinical research. Given that the intrapartum cardiotocogram is an uncertain proxy for fetal hypoxia, and there is no strong correlation between pathologic cardiotocograms and fetal acidosis, a cord artery pH may help rather than hurt a staff person subjected to a malpractice suit based on undesirable cardiotocogram patterns. Contrary to common beliefs and assumptions, up to 90% of cases of cerebral palsy do not originate from intrapartum events. Future research will elucidate whether cell injury markers with point-of-care analysis will become valuable in improving the dating of perinatal injuries and differentiating hypoxic from nonhypoxic injuries.
Collapse
Affiliation(s)
- Per Olofsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
| |
Collapse
|
20
|
Cheng X, Zhang L, Yu H, Zhang B. Influence of hemolysis on nucleated red blood cells count. Int J Lab Hematol 2023; 45:303-309. [PMID: 36793226 DOI: 10.1111/ijlh.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/29/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Hemolysis is a common pre-analytical factor that can influence test results. Here, we explored the influence of hemolysis on nucleated red blood cells (NRBCs) count and tried to illustrate the mechanisms underlying this interference. METHODS From July 2019 to June 2021, 20 preanalytical hemolytic peripheral blood (PB) samples from inpatient at Tianjin Huanhu Hospital were evaluated using Sysmex XE-5000 automated hematology analyzer. When NRBC enumeration was positive and a flag was triggered, a 200-cell differential count was performed by experienced technologists on microscopic review. When the manual count was inconsistent with automated enumeration, samples will be re-collected. Plasma exchange test was performed to verify the influence factors of hemolyzed samples and the mechanical hemolysis experiment mimicking hemolysis that might occur during blood collection was performed to illustrate the underlying mechanisms. RESULTS Hemolysis led to false-positive NRBC count and the value of NRBC was positively correlated with the degree of hemolysis. Hemolysis specimen shared a common scatter diagram: a "beard" on WBC/ basophil (BASO) channel and a "blue scatter line" on immature myeloid information (IMI) channel. Lipid droplets were found above the hemolysis specimen after centrifugation. Plasma exchange experiment confirmed that these lipid droplets interfered with NRBCs count. Mechanical hemolysis experiment implied further that broken red blood cells (RBCs) released lipid droplets causing the false-positive NRBCs count. CONCLUSION In the present study, we firstly found that hemolysis could lead to false-positive NRBCs enumeration, which was associated with lipid droplets released from broken RBCs during hemolysis.
Collapse
Affiliation(s)
- Xiuli Cheng
- Department of Clinical Laboratory, Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Le Zhang
- Department of Clinical Laboratory, Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Haimiao Yu
- Department of Clinical Laboratory, Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Biao Zhang
- Department of Clinical Laboratory, Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| |
Collapse
|
21
|
Ye L, Ji X, Song Z, Guan L, Zhao L, Wang W, Du W. Clinical Value of Glycan Changes in Cerebrospinal Fluid for Evaluation of Post-Neurosurgical Bacterial Meningitis with Hemorrhagic Stroke Patients. Diagnostics (Basel) 2023; 13:diagnostics13020187. [PMID: 36672998 PMCID: PMC9858593 DOI: 10.3390/diagnostics13020187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Post-neurosurgical bacterial meningitis (PNBM) is one of the severe complications in patients receiving neurosurgical procedures. Recent studies have found microbe-related glycans play important roles in adhesion, invasion, and toxicity toward innate immunological reactions. In this study, we aimed to investigate the glycomic profile and its potential diagnostic efficacy in post-neurosurgical bacterial meningitis (PNBM) patients with hemorrhagic stroke. A total of 136 cerebrospinal fluid (CSF) samples were recruited and divided into a PNBM group and a non-PNBM group based on the clinical diagnostic criteria. A lectin biochip-based method was established for the detection of glycans in CSF. The clinicopathological data and biochemical parameters in CSF from all patients were analyzed. Two models for multivariate analysis investigating glycan changes in the CSF were conducted, aiming at determining the specific expression and diagnostic efficacy of lectin-probing glycans (LPGs) for PNBM. In univariate analysis, we found that 8 out of 11 LPGs were significantly correlated with PNBM. Model 1 multivariate analysis revealed that PNA (p = 0.034), Jacalin (p = 0.034) and LTL (p = 0.001) were differentially expressed in the CSF of PNBM patients compared with those of non-PNBM patients. Model 2 multivariate analysis further disclosed that LTL (p = 0.021) and CSF glucose (p < 0.001) had independent diagnostic efficacies in PNBM, with areas under the curve (AUC) of 0.703 and 0.922, respectively. In summary, this study provided a new insight into the subject of CSF glycomics concerning bacterial infection in patients with hemorrhagic stroke.
Collapse
Affiliation(s)
- Lei Ye
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China
- Correspondence: (L.Y.); (W.D.); Tel.: +86-551-6292-2114 (L.Y.); +86-551-6516-1011 (W.D.); Fax: +86-551-6363-3742 (L.Y.); +86-551-6516-5628 (W.D.)
| | - Xuefei Ji
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China
| | - Zijian Song
- Department of Orthopaedics, Xuzhou Municipal First People’s Hospital, Daxue Road 269, Xuzhou 221116, China
| | - Liao Guan
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China
| | - Liang Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China
| | - Wenwen Wang
- Department of Pathology, Anhui Medical University, Meishan Road 81, Hefei 230032, China
- School of Clinical Medicine, Anhui Medical University, Meishan Road 81, Hefei 230032, China
| | - Weidong Du
- Department of Pathology, Anhui Medical University, Meishan Road 81, Hefei 230032, China
- Correspondence: (L.Y.); (W.D.); Tel.: +86-551-6292-2114 (L.Y.); +86-551-6516-1011 (W.D.); Fax: +86-551-6363-3742 (L.Y.); +86-551-6516-5628 (W.D.)
| |
Collapse
|
22
|
Ersoy S, Ilanbey B. A Single-Center Prospective Study of the Effects of Different Methods of Phlebotomy in the Emergency Department on Blood Sample Hemolysis Rates. J Emerg Nurs 2023; 49:134-139. [PMID: 36137822 DOI: 10.1016/j.jen.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/05/2022] [Accepted: 08/14/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Hemolysis is more commonly seen in the emergency department and causes delays in diagnosis, hospitalization, discharge, and treatment of patients. The aim of this study was to determine the most appropriate phlebotomy method and device to reduce blood sample hemolysis in the emergency department. METHODS This prospective, comparative descriptive study involved patients who presented to the emergency department with any medical condition and required blood sampling. Patients were divided into 6 groups according to the method of phlebotomy and the device used for phlebotomy. Data were analyzed with logistic regression. RESULTS A total of 715 patients participated in the study. The blood sample hemolysis rate in the emergency department was 25.7%. When the hemolysis rates were compared with a steel straight needle or intravenous catheter, it was found that the use of steel straight needle significantly reduced hemolysis. Blood drawing through a 20 G intravenous catheter with Luer-Lock access device reduces the risk of hemolysis. Male sex and difficult blood collection also have been shown to increase the risk of hemolysis. DISCUSSION Blood should be drawn with a steel straight needle instead of an intravenous catheter. However, when that is not possible, we recommend the use of a 20 G intravenous catheter with Luer-Lock access device if a blood sample is to be drawn from intravenous line.
Collapse
|
23
|
Simoes FA, Joilin G, Peters O, Schneider LS, Priller J, Spruth EJ, Vogt I, Kimmich O, Spottke A, Hoffmann DC, Falkenburger B, Brandt M, Prudlo J, Brockmann K, Fries FL, Rowe JB, Church A, Respondek G, Newbury SF, Leigh PN, Morris HR, Höglinger GU, Hafezparast M. Potential of Non-Coding RNA as Biomarkers for Progressive Supranuclear Palsy. Int J Mol Sci 2022; 23:ijms232314554. [PMID: 36498882 PMCID: PMC9738832 DOI: 10.3390/ijms232314554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
Objective markers for the neurodegenerative disorder progressive supranuclear palsy (PSP) are needed to provide a timely diagnosis with greater certainty. Non-coding RNA (ncRNA), including microRNA, piwi-interacting RNA, and transfer RNA, are good candidate markers in other neurodegenerative diseases, but have not been investigated in PSP. Therefore, as proof of principle, we sought to identify whether they were dysregulated in matched serum and cerebrospinal fluid (CSF) samples of patients with PSP. Small RNA-seq was undertaken on serum and CSF samples from healthy controls (n = 20) and patients with PSP (n = 31) in two cohorts, with reverse transcription-quantitative PCR (RT-qPCR) to confirm their dysregulation. Using RT-qPCR, we found in serum significant down-regulation in hsa-miR-92a-3p, hsa-miR-626, hsa-piR-31068, and tRNA-ValCAC. In CSF, both hsa-let-7a-5p and hsa-piR-31068 showed significant up-regulation, consistent with their changes observed in the RNA-seq results. Interestingly, we saw no correlation in the expression of hsa-piR-31068 within our matched serum and CSF samples, suggesting there is no common dysregulatory mechanism between the two biofluids. While these changes were in a small cohort of samples, we have provided novel evidence that ncRNA in biofluids could be possible diagnostic biomarkers for PSP and further work will help to expand this potential.
Collapse
Affiliation(s)
- Fabio A. Simoes
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK
| | - Greig Joilin
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, 12203 Berlin, Germany
| | | | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Psychiatry and Psychotherapy, Charité, 10117 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Psychiatry and Psychotherapy, Charité, 10117 Berlin, Germany
| | - Ina Vogt
- German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Okka Kimmich
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, University of Bonn, Bonn 53127, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, University of Bonn, Bonn 53127, Germany
| | | | - Björn Falkenburger
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Moritz Brandt
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Johannes Prudlo
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, Rostock University Medical Center, 18147 Rostock, Germany
| | - Kathrin Brockmann
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Franca Laura Fries
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - James B. Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0QQ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF, UK
| | - Alistair Church
- Department of Neurology, Royal Gwent Hospital, Newport NP20 2UB, UK
| | - Gesine Respondek
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, Technische Universität München, 81377 Munich, Germany
| | | | - P. Nigel Leigh
- Brighton and Sussex Medical School, Brighton BN1 9QG, UK
| | - Huw R. Morris
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Günter U. Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Neurology, Technische Universität München, 81377 Munich, Germany
| | - Majid Hafezparast
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK
- Correspondence: ; Tel.: +44-1273-678214
| |
Collapse
|
24
|
Zheng WQ, Hu ZD. Pleural fluid biochemical analysis: the past, present and future. Clin Chem Lab Med 2022; 61:921-934. [PMID: 36383033 DOI: 10.1515/cclm-2022-0844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
Abstract
Identifying the cause of pleural effusion is challenging for pulmonologists. Imaging, biopsy, microbiology and biochemical analyses are routinely used for diagnosing pleural effusion. Among these diagnostic tools, biochemical analyses are promising because they have the advantages of low cost, minimal invasiveness, observer independence and short turn-around time. Here, we reviewed the past, present and future of pleural fluid biochemical analysis. We reviewed the history of Light’s criteria and its modifications and the current status of biomarkers for heart failure, malignant pleural effusion, tuberculosis pleural effusion and parapneumonic pleural effusion. In addition, we anticipate the future of pleural fluid biochemical analysis, including the utility of machine learning, molecular diagnosis and high-throughput technologies. Clinical Chemistry and Laboratory Medicine (CCLM) should address the topic of pleural fluid biochemical analysis in the future to promote specific knowledge in the laboratory professional community.
Collapse
Affiliation(s)
- Wen-Qi Zheng
- Department of Laboratory Medicine , The Affiliated Hospital of Inner Mongolia Medical University , Hohhot , P.R. China
| | - Zhi-De Hu
- Department of Laboratory Medicine , The Affiliated Hospital of Inner Mongolia Medical University , Hohhot , P.R. China
| |
Collapse
|
25
|
Influence of Selective Extraction/Isolation of Heme/Hemoglobin with Hydrophobic Imidazolium Ionic Liquids on the Precision and Accuracy of Cotinine ELISA Test. Int J Mol Sci 2022; 23:ijms232213692. [PMID: 36430168 PMCID: PMC9691248 DOI: 10.3390/ijms232213692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
In this study, ionic liquids were used for the selective extraction/isolation of hemoglobin from human serum for cotinine determination using the ELISA Kit. The suitability of hydrophobic imidazolium-based ionic liquids was tested, of which OMIM BF4 (1-methyl-3-octylimidazolium tetrafluoroborate) turned out to be the most suitable for direct extraction of hemoglobin into an ionic liquid without the use of any additional reagent at one extraction step. Hemoglobin was separated quantitatively (95% recovery) from the remaining types of proteins remaining in the aqueous phase. Quantum mechanical calculations showed that the interaction of the iron atom in the heme group and the nitrogen atom of the ionic liquid cation is responsible for the transfer of hemoglobin whereas molecular dynamics simulations demonstrated that the non-covalent interactions between heme and solvent are more favorable in the case of OMIM BF4 in comparison to water. The opposite trend was found for cotinine. Selective isolation of the heme/hemoglobin improved the ELISA test's accuracy, depending on the cotinine level, from 15% to 30%.
Collapse
|
26
|
Kadwa AR, Grace JF, Zeiler GE. Sources of error in acid-base analysis from a blood gas analyser result: a narrative review. J S Afr Vet Assoc 2022; 93:89-98. [DOI: 10.36303/jsava.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- AR Kadwa
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - JF Grace
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - GE Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| |
Collapse
|
27
|
Assessing the Impacts of Preanalytical Field Sampling Challenges on the Reliability of Serum Aflatoxin B1-Lysine Measurements by Use of LC-MS/MS. Toxins (Basel) 2022; 14:toxins14090612. [PMID: 36136549 PMCID: PMC9503385 DOI: 10.3390/toxins14090612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Aflatoxin exposure is endemic in developing countries with warm, humid climates that promote toxigenic mold growth on crops and foodstuffs. Estimating human aflatoxin exposure is key to identifying and abating contamination sources. Serum aflatoxin B1 bound to albumin lysine (AFB1-lys) is a preferred exposure biomarker, but field sample collection, processing, transportation, and storage logistics are challenging. We validated an improved LC-MS/MS method for serum AFB1-lys and applied it to three field sampling challenges: transportation/storage (elevated temperature); collection/processing (hemolysis); and sample type substitution (heparinized plasma). Our new LC-MS/MS method had a LOD of 0.03 ng/mL, accuracy (mean spike recovery) of 112%, total imprecision (replicate pool measurements) ≤5% at ≥0.2 ng/mL, and results that were 95.1% similar (mean percentage similarity) to an established method. AFB1-lys in human serum spiked with serum from aflatoxin-dosed rats was stable for 14 days at both ambient (22.5 °C) and elevated (38 °C) temperatures. Simulated hemolysis (adding 0.25–3 mg hemoglobin) did not affect AFB1-lys accuracy at ≥0.5 ng/mL but caused 10–25% signal suppression. Heparinized plasma AFB1-lys was 99.0% similar to serum but interfered with albumin measurements (bromocresol green) causing spurious low bias. Further investigation is warranted, but our findings suggest that AFB1-lys is pre-analytically robust.
Collapse
|
28
|
An Improved Method for Quick Quantification of Unsaturated Transferrin. BIOSENSORS 2022; 12:bios12090708. [PMID: 36140091 PMCID: PMC9496074 DOI: 10.3390/bios12090708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
Blood iron levels play a vital role in oxygen metabolism and energy generation whilst transporter protein, transferrin, binds and delivers iron to the transferrin receptor of endosomal compartments of cells. Consequently, the iron-binding capacity of transferrin is an important indicator for many diseases, and its measurements are used in the diagnosis and treatment of anaemias. Various assays, including Total Iron Binding Capacity (TIBC), Unsaturated Iron-Binding Capacity (UIBC) and Transferrin Saturation (TS), were developed to assess the iron-binding capacity of transferrin. Clinically, UIBC is measured in serum by a multi-step liquid ferrozine method and subjected to interference from conditions such as haemolysis and lipemia. Here, we report a quick method that directly measures the concentration of apotransferrin in EDTA-treated plasma, theoretically equivalent to UIBC. Importantly, this supramolecular assembly-based method is more time-efficient, cost-effective and insensitive to serum cation fluctuations. With additional colorimetric property, this method also provides a visual indicator for abnormal health conditions with extreme transferrin statuses such as those found in cancers. Its minimal requirement for equipment would be particularly useful for diagnosis in remote and under-developed regions.
Collapse
|
29
|
Wang H, Ji D, Tian H, Gao Z, Song C, Jia J, Cui X, Zhong L, Shen J, Gu J. Predictive value of proteomic markers for advanced rectal cancer with neoadjuvant chemoradiotherapy. BMC Cancer 2022; 22:868. [PMID: 35945555 PMCID: PMC9361520 DOI: 10.1186/s12885-022-09960-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Preoperative neoadjuvant chemoradiation (nCRT) has been the standard treatment for locally advanced rectal cancer. Serum biomarkers to stratify patients with respect to prognosis and response to nCRT are needed due to the diverse response to the therapy. Methods Thirteen paired pre- and post-nCRT sera from rectal cancer patients were analyzed by isobaric tags for relative and absolute quantitation (iTRAQ) method. Twenty-five proteins were selected for validation by parallel reaction monitoring (PRM) in ninety-one patients. Results Totally, 310 proteins were identified and quantified in sera samples. Reactome pathway analysis showed that the immune activation-related pathways were enriched in response to nCRT. Twenty-five proteins were selected for further validation. PRM result showed that the level of PZP was higher in pathological complete response (pCR) patients than non-pCR patients. The Random Forest algorithm identified a prediction model composed of 10 protein markers, which allowed discrimination between pCR patients and non-pCR patients (area under the curve (AUC) = 0.886 on testing set). Higher HEP2 and GELS or lower S10A8 in baseline sera were associated with better prognosis. Higher APOA1 in post nCRT sera was associated with better disease-free survival (DFS). Conclusions We identified and confirmed a 10-protein panel for nCRT response prediction and four potential biomarkers HEP2, GELS, S10A8 and APOA1 for prognosis of rectal cancer based on iTRAQ-based comparative proteomics screening and PRM-based targeted proteomic validation. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09960-z.
Collapse
Affiliation(s)
- Hanyang Wang
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China
| | - Dengbo Ji
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China
| | - Huifang Tian
- Central Laboratory, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhaoya Gao
- Peking University S.G. Hospital, Beijing, China
| | - Can Song
- School of Life Sciences, Tsinghua University, Beijing, 100084, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - Jinying Jia
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China
| | - Xinxin Cui
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China
| | - Lijun Zhong
- Medical and Health Analytical Center, Peking University Health Science Center, Beijing, 100191, China
| | - Jing Shen
- Central Laboratory, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Jin Gu
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education), Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Haidian District, Beijing, 100142, China. .,Peking University S.G. Hospital, Beijing, China. .,Peking-Tsinghua Center for Life Sciences, Beijing, China.
| |
Collapse
|
30
|
Kang L, Li D, Jiang X, Zhang Y, Pan M, Hu Y, Si L, Zhang Y, Huang J. Hepatotoxicity of the Major Anthraquinones Derived From Polygoni Multiflori Radix Based on Bile Acid Homeostasis. Front Pharmacol 2022; 13:878817. [PMID: 35662717 PMCID: PMC9157432 DOI: 10.3389/fphar.2022.878817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/15/2022] [Indexed: 01/22/2023] Open
Abstract
Polygoni Multiflori Radix (PMR), the dried root of Polygonum Multiflorum Thunb., has been widely used as traditional Chinese medicines in clinical practice for centuries. However, the frequently reported hepatotoxic adverse effects hindered its safe use in clinical practice. This study aims to explore the hepatotoxic effect of PMR extract and the major PMR derived anthraquinones including emodin, chrysophanol, and physcion in mice and the underlying mechanisms based on bile acid homeostasis. After consecutively treating the ICR mice with PMR extract or individual anthraquinones for 14 or 28 days, the liver function was evaluated by measuring serum enzymes levels and liver histological examination. The compositions of bile acids (BAs) in the bile, liver, and plasma were measured by LC-MS/MS, followed by Principal Component Analysis (PCA) and Partial Least Squares Discriminate Analysis (PLS-DA). Additionally, gene and protein expressions of BA efflux transporters, bile salt export pump (Bsep) and multidrug resistance-associated protein 2 (Mrp2), were examined to investigate the underlying mechanisms. After 14-day administration, mild inflammatory cell infiltration in the liver was observed in the physcion- and PMR-treated groups, while it was found in all the treated groups after 28-day treatment. Physcion and PMR extract induced hepatic BA accumulation after 14-day treatment, but such accumulation was attenuated after 28-day treatment. Based on the PLS-DA results, physcion- and PMR-treated groups were partially overlapping and both groups showed a clear separation with the control group in the mouse liver. The expression of Bsep and Mrp2 in the physcion- and PMR-treated mouse liver was decreased after 14-day treatment, while the downregulation was abrogated after 28-day treatment. Our study, for the first time, demonstrated that both PMR extract and tested anthraquinones could alter the disposition of either the total or individual BAs in the mouse bile, liver, and plasma via regulating the BA efflux transporters and induce liver injury, which provide a theoretical basis for the quality control and safe use of PMR in practice.
Collapse
Affiliation(s)
- Li Kang
- School of Pharmaceutical Science, South-Central MinZu University, Wuhan, China.,School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,National Demonstration Center for Experimental Ethnopharmacology Education, South-Central MinZu University, Wuhan, China
| | - Dan Li
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Pharmacy, Shenzhen University General Hospital, Shenzhen, China
| | - Xin Jiang
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Zhang
- College of Pharmacy, Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi University, Shihezi, China
| | - Minhong Pan
- Department of Pharmacy, Shenzhen University General Hospital, Shenzhen, China
| | - Yixin Hu
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Luqin Si
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongjun Zhang
- The Third Affiliated Hospital of School of Medicine, Shihezi University, Shihezi, China
| | - Jiangeng Huang
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
31
|
Nikolac Gabaj N, Miler M, Vrtaric A, Celap I, Bocan M, Filipi P, Radisic Biljak V, Simundic AM, Supak Smolcic V, Kocijancic M. Comparison of three different protocols for obtaining hemolysis. Clin Chem Lab Med 2022; 60:714-725. [PMID: 35212494 DOI: 10.1515/cclm-2021-1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hemolysis is associated with erroneous or delayed results. Objectives of the study were to compare four different methods for obtaining hemolysis in vitro on three different analyzers. METHODS Hemolysis was prepared with addition of pure hemoglobin into serum pool, osmotic shock, aspiration through blood collection needle, freezing/thawing of whole blood. Biochemistry parameters were measured in duplicate at Architect c8000 (Abbott, Abbott Park, USA), Beckman Coulter AU680 (Beckman Coulter, Brea, USA) and Cobas 6000 c501 (Roche, Mannheim, Germany), according to manufacturers' declarations. Cut-off value was defined as the highest value of H index with corresponding bias lower than acceptance criteria. RESULTS We were not able to obtain results with freezing protocol. On all three platforms, lowest number of analytes were sensitive to hemolysis at H=0.5 using method of adding free hemoglobin. When osmotic shock was used, cut-off values for the most analytes were generally met at lower values. Hemolysis significantly interfered with measurement of potassium and lactate dehydrogenase (LD) at H=0.5 on all platforms. The most of the tested analytes had the lowest acceptable H index when aspiration method was used. At the low level of hemolysis (H=0.8) glucose, sodium, potassium, chloride, phosphate, and LD were affected on all analyzers, with some additional analytes depending on the manufacturer. CONCLUSIONS Hemolysis interference differs on different analyzers and according to protocol for obtaining hemolysis. Aspiration method was generally the most sensitive to hemolysis interference, while addition of free Hb was the most resistant.
Collapse
Affiliation(s)
- Nora Nikolac Gabaj
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Marijana Miler
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Alen Vrtaric
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivana Celap
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marina Bocan
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Medical Biochemistry Laboratory, Polyclinic Salzer, Zagreb, Croatia
| | - Petra Filipi
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Medical Laboratory Diagnostics, University Hospital Centre Split, Split, Croatia
| | - Vanja Radisic Biljak
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Ana-Maria Simundic
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Vesna Supak Smolcic
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Clinical Department of Laboratory Diagnostics, Clinical Hospital Center Rijeka, Rijeka, Croatia
- Department of Medical Informatics, Rijeka University School of Medicine, Rijeka, Croatia
| | - Marija Kocijancic
- Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
- Department of Laboratory Medicine, Central Laboratory, University Clinic Halle, Halle, Germany
| |
Collapse
|
32
|
Smith JW, Ng DK, Alvarez CS, Egner PA, Burke SM, Chen JG, Kensler TW, Koshiol J, Rivera-Andrade A, Kroker-Lobos MF, Ramírez-Zea M, McGlynn KA, Groopman JD. Assessing the Validity of Normalizing Aflatoxin B1-Lysine Albumin Adduct Biomarker Measurements to Total Serum Albumin Concentration across Multiple Human Population Studies. Toxins (Basel) 2022; 14:toxins14030162. [PMID: 35324659 PMCID: PMC8954427 DOI: 10.3390/toxins14030162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/12/2023] Open
Abstract
The assessment of aflatoxin B1 (AFB1) exposure using isotope-dilution liquid chromatography-mass spectrometry (LCMS) of AFB1-lysine adducts in human serum albumin (HSA) has proven to be a highly productive strategy for the biomonitoring of AFB1 exposure. To compare samples across different individuals and settings, the conventional practice has involved the normalization of raw AFB1-lysine adduct concentrations (e.g., pg/mL serum or plasma) to the total circulating HSA concentration (e.g., pg/mg HSA). It is hypothesized that this practice corrects for technical error, between-person variance in HSA synthesis or AFB1 metabolism, and other factors. However, the validity of this hypothesis has been largely unexamined by empirical analysis. The objective of this work was to test the concept that HSA normalization of AFB1-lysine adduct concentrations effectively adjusts for biological and technical variance and improves AFB1 internal dose estimates. Using data from AFB1-lysine and HSA measurements in 763 subjects, in combination with regression and Monte Carlo simulation techniques, we found that HSA accounts for essentially none of the between-person variance in HSA-normalized (R2 = 0.04) or raw AFB1-lysine measurements (R2 = 0.0001), and that HSA normalization of AFB1-lysine levels with empirical HSA values does not reduce measurement error any better than does the use of simulated data (n = 20,000). These findings were robust across diverse populations (Guatemala, China, Chile), AFB1 exposures (105 range), HSA assays (dye-binding and immunoassay), and disease states (healthy, gallstones, and gallbladder cancer). HSA normalization results in arithmetic transformation with the addition of technical error from the measurement of HSA. Combined with the added analysis time, cost, and sample consumption, these results suggest that it may be prudent to abandon the practice of normalizing adducts to HSA concentration when measuring any HSA adducts—not only AFB1-lys adducts—when using LCMS in serum/plasma.
Collapse
Affiliation(s)
- Joshua W. Smith
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.W.S.); (P.A.E.); (S.M.B.); (T.W.K.)
| | - Derek K. Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Christian S. Alvarez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (C.S.A.); (J.K.); (K.A.M.)
| | - Patricia A. Egner
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.W.S.); (P.A.E.); (S.M.B.); (T.W.K.)
| | - Sean M. Burke
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.W.S.); (P.A.E.); (S.M.B.); (T.W.K.)
| | - Jian-Guo Chen
- Department of Epidemiology, Qidong Liver Cancer Institute, Qidong 226200, China;
| | - Thomas W. Kensler
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.W.S.); (P.A.E.); (S.M.B.); (T.W.K.)
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (C.S.A.); (J.K.); (K.A.M.)
| | - Alvaro Rivera-Andrade
- Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City 1188, Guatemala; (A.R.-A.); (M.F.K.-L.); (M.R.-Z.)
| | - María F. Kroker-Lobos
- Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City 1188, Guatemala; (A.R.-A.); (M.F.K.-L.); (M.R.-Z.)
| | - Manuel Ramírez-Zea
- Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City 1188, Guatemala; (A.R.-A.); (M.F.K.-L.); (M.R.-Z.)
| | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (C.S.A.); (J.K.); (K.A.M.)
| | - John D. Groopman
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.W.S.); (P.A.E.); (S.M.B.); (T.W.K.)
- Correspondence:
| |
Collapse
|
33
|
Trends in biomedical analysis of red blood cells – Raman spectroscopy against other spectroscopic, microscopic and classical techniques. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2021.116481] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
34
|
Naeem N, Drese KS, Paterson L, Kersaudy-Kerhoas M. Current and Emerging Microfluidic-Based Integrated Solutions for Free Hemoglobin and Hemolysis Detection and Measurement. Anal Chem 2021; 94:75-85. [PMID: 34860012 DOI: 10.1021/acs.analchem.1c04567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Noman Naeem
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K
| | - Klaus-Stefan Drese
- The Institute of Sensor and Actuator Technology (ISAT), 96450 Coburg, Germany
| | - Lynn Paterson
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K
| | - Maïwenn Kersaudy-Kerhoas
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.,Infection Medicine, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9YL, U.K
| |
Collapse
|
35
|
Larrán B, Miranda M, Herrero-Latorre C, Rigueira L, Pereira V, Suárez ML, López-Alonso M. Influence of Haemolysis on the Mineral Profile of Cattle Serum. Animals (Basel) 2021; 11:ani11123336. [PMID: 34944113 PMCID: PMC8698072 DOI: 10.3390/ani11123336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The results of blood tests routinely used in clinical chemistry can be altered by haemolysis, the disruption of red blood cells. Haemolysis of serum samples is recognized to be the leading cause of preanalytical errors in clinical laboratories. The influence of haemolysis must be specifically studied for each analyte and species of clinical interest, as it is often not known how serum samples are affected. Little is known about the potential alterations in the concentrations of mineral elements in haemolyzed serum in general and the phenomenon has not been specifically studied in bovine serum samples. We investigate how haemolysis affects the mineral content of bovine samples. Abstract Haemolysis of serum samples is the leading cause of preanalytical errors in clinical laboratories. Little is known about the potential alterations in the concentrations of mineral elements in haemolyzed serum and the phenomenon has not been specifically studied in bovine serum samples. We investigate how haemolysis affects the mineral content of bovine samples. We used ICP-MS to measure the concentrations of 12 mineral elements (Ca, Co, Cr, Cu, Fe, Mg, Mn, Mo, Ni, P, Se and Zn) in bovine whole blood, serum and gradually haemolyzed samples and observed significant differences between the different types of samples, particularly in the Fe and Zn concentrations. However, in practice, the high interindividual variability makes it difficult to establish whether a given value corresponds to normal or haemolyzed samples. In response to this problem, we propose to consider that a result is significantly biased when the haemolysis threshold (the degree of haemolysis above which the concentration of an element in serum is significantly altered) of a given element is surpassed. The haemolysis threshold values for the different elements considered were found as follows: 0.015 g Hb L−1 for Fe, 2 g for Zn, 4 g for Cr and 8 g for Ca, Se and Mo.
Collapse
Affiliation(s)
- Belén Larrán
- Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (B.L.); (L.R.); (M.L.S.)
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Marta Miranda
- Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (B.L.); (L.R.); (M.L.S.)
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
- Correspondence:
| | - Carlos Herrero-Latorre
- Research Institute on Chemical and Biological Analysis, Analytical Chemistry, Nutrition and Bromatology Department, Faculty of Sciences, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain;
| | - Lucas Rigueira
- Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (B.L.); (L.R.); (M.L.S.)
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Víctor Pereira
- Department of Animal Pathology, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (V.P.); (M.L.-A.)
| | - María Luisa Suárez
- Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (B.L.); (L.R.); (M.L.S.)
- Rof-Codina Veterinary Teaching Hospital, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain
| | - Marta López-Alonso
- Department of Animal Pathology, Faculty of Veterinary, Campus Terra, University of Santiago de Compostela, 27002 Lugo, Spain; (V.P.); (M.L.-A.)
| |
Collapse
|
36
|
Kalaria T, Gill H, Sharrod-Cole H, Ford C, Gama R. Conflicting effects of haemolysis on plasma sodium and chloride are due to different haemolysis study protocols: A case for standardisation. Ann Clin Biochem 2021; 59:101-109. [PMID: 34747198 DOI: 10.1177/00045632211040691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Haemolysis has been reported as having a positive, negative or no effect on plasma sodium (PNa) and chloride (PCl). We investigated the haemoltytic effect of different haemolysis protocols on PNa and PCl using modelling and laboratory experiments. METHODS In a modelling experiment, percentage change and recovery due to dilution in routinely (in vitro) haemolysed samples were compared against shear stress haemolysis and samples spiked with haemolysate from whole blood freeze-thaw, packed cells freeze-thaw and osmotic shock protocols. The results were compared against a control base pool. Additionally, for the osmotic shock method, results were compared against saline- and deionised water (DIW)-spiked controls. In a laboratory experiment, percentage change and recovery were similarly compared using haemolysate from whole blood freeze-thaw and osmotic shock protocols. PNa, PCl and H-index were measured on the Abbott Architect and haemoglobin on the Sysmex XN-9000. RESULTS In the modelling experiment, the percentage decrease in PNa and PCl was similar in in vitro haemolysis, shear stress haemolysis, whole blood freeze-thaw haemolysis and packed cells freeze-thaw haemolysis and this was lower compared to the osmotic shock method. In the laboratory experiment, the change in PNa compared to the base pool was less (p < 0.001) per unit increase in H-index in the freeze-thaw method (-0.33 mmol, 95% CI -0.35 to -0.31) compared to the osmotic shock method (-0.65 mmol, 95% CI -0.66 to -0.64). PCl did not change with haemolysis in the freeze-thaw method and changed by -0.21 ± 0.01 mmol per unit increase in the H-index in the osmotic shock method. Recovery of PNa and PCl increased with increasing H-index in both methods. CONCLUSION The osmotic shock protocol is inappropriate for haemolysis studies because of dilution with DIW used for cell lysis. Recovery calculations may incorrectly compensate for genuine dilution caused by haemolysis.
Collapse
Affiliation(s)
- Tejas Kalaria
- Clinical Biochemistry, Black Country Pathology Services, 8692The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Henry Gill
- Clinical Biochemistry, Black Country Pathology Services, 8692The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Hayley Sharrod-Cole
- Clinical Biochemistry, Black Country Pathology Services, 8692The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Clare Ford
- Clinical Biochemistry, Black Country Pathology Services, 8692The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Rousseau Gama
- Clinical Biochemistry, Black Country Pathology Services, 8692The Royal Wolverhampton NHS Trust, Wolverhampton, UK.,School of Medicine and Clinical Practice, 8695University of Wolverhampton, Wolverhampton, UK
| |
Collapse
|
37
|
Idalan N, Zeitz JO, Weber CN, Müller E, Giger U. Comparative study of immunohematological tests with canine blood samples submitted for a direct antiglobulin (Coombs') test. Canine Med Genet 2021; 8:10. [PMID: 34645506 PMCID: PMC8515749 DOI: 10.1186/s40575-021-00107-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A 2019 ACVIM consensus statement on diagnostics for immune-mediated hemolytic anemia (IMHA) in dogs made testing recommendations. As data on the performance of immunohematological tests was lacking, we undertook a comparative analysis. MATERIAL AND METHODS Anticoagulated blood samples from 126 dogs suspected of having IMHA submitted to a diagnostic veterinary laboratory for a routine direct antiglobulin test (DAT) and from 28 healthy control dogs were evaluated for spherocytosis and autoagglutination before and after three saline washes. Samples were also subjected to different DATs: a gel minitube and an immunochromatographic strip kit used in clinics; neutral gel column cards, microtiter plates (at 4°, 22°, and 37°C), capillary tubes, and flow cytometry used in laboratories. RESULTS Samples from healthy dogs yielded negative results with all immunodiagnostic tests. Among the 126 samples submitted for DAT 67 were positive by a DAT utilizing microtiter plates with goat anti-dog antiglobulin DAT at 22°C. Notably, DAT results were comparable and consistent across all evaluated methods regardless of antiglobulin and temperature used. DAT+ dogs were more severely anemic and more likely to have erythroid regeneration compared to DAT- dogs. Macroscopic agglutination in tubes or on slides was observed in 48 samples after 1:1 and 1:4 blood to saline dilution, but only persisted in four samples after washing. Among the DAT+ samples, 57% had agglutination, 87% had spherocytosis, and 45% had both. There was good correlation between spherocytosis and DAT results from the six DAT techniques, but the correlation with autoagglutination was only fair. Clinical follow-up was available for 42 dogs. Of the sample from 12 DAT+ dogs collected during treatment, 10 remained DAT+ when tested 1-24 weeks after initial assessment. CONCLUSIONS Based upon this comparative prospective survey, all in-clinic and laboratory DAT techniques produced similar results when performed by trained personnel and can therefore be recommended for detection of antibody-coated erythrocytes and immunohematological diagnosis. In addition, use of these tests for monitoring response of IMHA dogs to treatment might be valuable.
Collapse
Affiliation(s)
- Nadine Idalan
- Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Johanna O Zeitz
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Corinna N Weber
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Elisabeth Müller
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Urs Giger
- Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland.
- Section of Medical Genetics, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA, 19104, USA.
| |
Collapse
|
38
|
Liu S, Li J, Ning L, Wu D, Wei D. Assessing the influence of true hemolysis occurring in patient samples on emergency clinical biochemistry tests results using the VITROS ® 5600 Integrated system. Biomed Rep 2021; 15:91. [PMID: 34631046 DOI: 10.3892/br.2021.1467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022] Open
Abstract
Hemolysis is one of the most frequent causes of pre-analytical errors in the emergency department (ED), and it can lead to inaccurate blood results and often requires repeat testing. The purpose of the present study was to evaluate the effects of true hemolysis occurring in ED blood samples on routine clinical biochemistry tests using the VITROS® 5600 Integrated system. A total of 92 pairs of blood samples were collected from 92 ED patients. Each pair of samples included one hemolyzed sample and one successful (non-hemolyzed) redraw from the same patient. A total of 21 common laboratory analytes and the hemolytic index (HI) were examined. The degree of hemolysis (slight, mild, moderate and heavy) was determined based on the HI. A clinically significant difference in one analyte was defined as a difference greater than its Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) total allowable error (TAE) limits. The results demonstrated that the mean differences in 11 serum analytes (unconjugated bilirubin, Ca2+, equivalent CO2, Cl-, creatinine, glucose, Mg2+, phosphorus, Na+, urea nitrogen and uric acid) in hemolyzed and non-hemolyzed samples were within their CLIA'88 TAE limits, while the differences in the other 10 analytes [alanine aminotransferase (ALT), albumin (ALB), amylase (AMYL), aspartate aminotransferase (AST), total bilirubin (TBIL), creatine kinase (CK), CK-myocardial band isoenzyme (CK-MB), lactate dehydrogenase (LDH), K+ and total protein (TP)] in paired samples in at least one of the four groups were greater than their CLIA'88 TAE limits. These results suggest that hemolysis had a notable impact on ALT, ALB, AMYL, AST, TBIL, CK, CK-MB, LDH, K+ and TP levels. Furthermore, for ALT, AMYL, TBIL and TP, wet chemistry methods displayed superior anti-hemolytic ability compared with dry chemistry methods. Notably, a high concentration of AST was less affected by hemolysis.
Collapse
Affiliation(s)
- Shuangqing Liu
- Department of Clinical Laboratory, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Juan Li
- Department of Rheumatology, Featured Medical Center of Chinese People's Armed Police Force, Tianjin 300072, P.R. China
| | - Li Ning
- Department of Clinical Laboratory, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Dawei Wu
- Department of Clinical Laboratory, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Dianjun Wei
- Department of Clinical Laboratory, Hebei Yanda Hospital, Langfang, Hebei 065201, P.R. China
| |
Collapse
|
39
|
Merrill VD, Ward MD, Diaz-McNair J, Pickett EA, Duh SH, Christenson RH. Assessing Phlebotomy Device Preference and Specimen Quality in an Oncology Outpatient Clinic. J Appl Lab Med 2021; 7:532-540. [PMID: 34632493 DOI: 10.1093/jalm/jfab109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Oncology patients have frequent venipunctures, which causes scarring, making subsequent draws difficult and painful. Novel blood collection systems may decrease discomfort in patients experiencing repeat blood draws. METHODS Oncology outpatients (n = 101; criteria excluded 12) were recruited to determine their preference for either of two blood collection systems, the 23-gauge standard BD Vacutainer Push Button Blood Collection Set (Standard Push Button system) or the 25-gauge BD Vacutainer UltraTouch Push Button Blood Collection Set (UltraTouch Push Button system). Subjects received two blinded, randomized blood draws, one with each device and just one device for each arm. Subjects subsequently rated their blinded preference for blood collection system. Specimen quality was assessed for each device with measurements for plasma hemoglobin (Shimadzu UV-1800 spectrophotometer, Shimadzu), lactate dehydrogenase, and potassium (Vitros 4600/5600 analyzer, Ortho Diagnostics). RESULTS Preference for the 25-gauge UltraTouch Push Button system over the 23-gauge Standard Push Button system was significant (UltraTouch, n = 51; Standard n = 30; no preference, n = 8; P = 0.0196). Regarding sample quality, the 25-gauge UltraTouch Push Button system had significantly lower plasma hemoglobin (average 5.34 mg/dL) vs the 23-gauge Standard Push Button system (9.37 mg/dL; P < 0.0001); serum lactate dehydrogenase and potassium differences were not statistically significant. CONCLUSION Subjects in an oncology clinic preferred phlebotomy with the 25-gauge UltraTouch Push Button system, and samples using this device had less hemolysis as assessed by plasma hemoglobin.
Collapse
Affiliation(s)
- VeRonika D Merrill
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Matthew D Ward
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jovita Diaz-McNair
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Elizabeth A Pickett
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Show-Hong Duh
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
40
|
Clinical Risk Score and COVID-19. J Gen Intern Med 2021; 36:2151. [PMID: 33821409 PMCID: PMC8021299 DOI: 10.1007/s11606-021-06721-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/04/2020] [Accepted: 03/14/2021] [Indexed: 11/05/2022]
|
41
|
Clinical Evaluation of the Torq Zero Delay Centrifuge System for Decentralized Blood Collection and Stabilization. Diagnostics (Basel) 2021; 11:diagnostics11061019. [PMID: 34199408 PMCID: PMC8226604 DOI: 10.3390/diagnostics11061019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/22/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
Blood sample collection and rapid separation—critical preanalytical steps in clinical chemistry—can be challenging in decentralized collection settings. To address this gap, the Torq™ zero delay centrifuge system includes a lightweight, hand-portable centrifuge (ZDrive™) and a disc-shaped blood collection device (ZDisc™) enabling immediate sample centrifugation at the point of collection. Here, we report results from clinical validation studies comparing performance of the Torq System with a conventional plasma separation tube (PST). Blood specimens from 134 subjects were collected and processed across three independent sites to compare ZDisc and PST performance in the assessment of 14 analytes (K, Na, Cl, Ca, BUN, creatinine, AST, ALT, ALP, total bilirubin, albumin, total protein, cholesterol, and triglycerides). A 31-subject precision study was performed to evaluate reproducibility of plasma test results from ZDiscs, and plasma quality was assessed by measuring hemolysis and blood cells from 10 subject specimens. The ZDisc successfully collected and processed samples from 134 subjects. ZDisc results agreed with reference PSTs for all 14 analytes with mean % biases well below clinically significant levels. Results were reproducible across different operators and ZDisc production lots, and plasma blood cell counts and hemolysis levels fell well below clinical acceptance thresholds. ZDiscs produce plasma samples equivalent to reference PSTs. Results support the suitability of the Torq System for remotely collecting and processing blood samples in decentralized settings.
Collapse
|
42
|
Fu YX, Wang H, Hu T, Wang FM, Hu R. Factors affecting the accuracy and reliability of the measurement of anti-Müllerian hormone concentration in the clinic. J Int Med Res 2021; 49:3000605211016161. [PMID: 34044635 PMCID: PMC8165850 DOI: 10.1177/03000605211016161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/13/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We aimed to identify the factors that influence serum anti-Müllerian hormone (AMH) concentration measurements. METHODS We collected serum samples between May and September 2018 and compared the effect on AMH concentration measured by ELISA of conditions including venepuncture, storage time, storage temperature, locations of the reaction microplate, and the use of the oral contraceptive pill and gonadotrophin-releasing hormone (GnRH). RESULTS AMH concentration was not affected by food intake but was affected by haemolysis. It was also much higher in samples on the edge of the ELISA microtitre plate. AMH concentration increased after incubation at room temperature for 1 day, 4°C for 3 days, -20°C for 1 month and -40°C for 4 months, but no change occurred during storage at -80°C for 9 months. AMH concentration was high in patients following GnRH agonist treatment but was not affected by oral contraceptives. CONCLUSIONS No fasting is required prior to AMH measurement. Placement of serum samples on the edge of microtitre plates affects the results of the AMH ELISA. If serum samples cannot be assayed immediately, it is best to store them at -80°C. Basal AMH concentration cannot be used as a measure of ovarian reserve after GnRH agonist treatment.
Collapse
Affiliation(s)
- Yun-Xing Fu
- Ningxia Medical University, General Hospital of Ningxia Medical
University, Yinchuan, Ningxia, China
| | - Hui Wang
- Reproductive Medicine Center, Yinchuan Maternal and Child Health
Hospital, Yinchuan, Ningxia, China
| | - Ting Hu
- Gansu Province Maternity and Child-care hospital, Lan zhou,
Gansu, China
| | - Fei-Miao Wang
- Reproductive Medicine Center, Key Laboratory of Fertility
Preservation and Maintenance of Ministry of Education, Ningxia Medical
University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia,
China
| | - Rong Hu
- Reproductive Medicine Center, Key Laboratory of Fertility
Preservation and Maintenance of Ministry of Education, Ningxia Medical
University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia,
China
| |
Collapse
|
43
|
Bargnoux AS, Kuster N, Sutra T, Laroche L, Rodriguez A, Morena M, Chenine L, Chalabi L, Dupuy AM, Badiou S, Cristol JP. Evaluation of a new point-of-care testing for creatinine and urea measurement. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:290-297. [PMID: 33908840 DOI: 10.1080/00365513.2021.1914344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Point of care testing makes it possible to obtain results in an extremely short time. Recently, radiometer has expanded the panel of tests available on its ABL90 FLEX PLUS blood gas analyzer (ABL90) by adding urea and creatinine. The aim of this study was to verify the performance of these new parameters. This included assessment of imprecision, linearity, accuracy by comparison with central laboratory standard assays and interferences. In addition, clinical utility in a dialysis center was evaluated. Within-lab coefficients of variation were close to 2%. The mean and limits of agreement (mean ± 1.96 SD) of the difference between ABL90 and Roche enzymatic assays on cobas 8000 were 0.5 (from -1.4 to 2.3) mmol/L and -0.9 (from -19.5 to 17.8) µmol/L for urea and creatinine, respectively. The ABL90 enzymatic urea and creatinine assays met the acceptance criteria based on biological variation for imprecision and showed good agreement with central laboratory. The two assays were unaffected by hematocrit variation between 20 and 70%, hemolysis and icterus interferences. It should be noted that the relationship between lab methods and ABL90 was conserved even for high pre-dialysis values allowing easy access to dialysis adequacy parameters (Kt/V) and muscle mass evaluation (creatinine index). Rapid measurement of creatinine and urea using whole blood specimens on ABL90 appears as a fast and convenient method. Analytical performances were in accordance with our expectations without any significant interferences by hemolysis or icterus.
Collapse
Affiliation(s)
- Anne-Sophie Bargnoux
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Nils Kuster
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Thibault Sutra
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Laëtitia Laroche
- Département de Biochimie et Hormonologie, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Annie Rodriguez
- Département de Biochimie et Hormonologie, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Marion Morena
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Leila Chenine
- Département de Néphrologie, Dialyse et Transplantation, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | | | - Anne-Marie Dupuy
- Département de Biochimie et Hormonologie, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Stéphanie Badiou
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| |
Collapse
|
44
|
Park Y, Ryu B, Ki SJ, McCracken B, Pennington A, Ward KR, Liang X, Kurabayashi K. Few-Layer MoS 2 Photodetector Arrays for Ultrasensitive On-Chip Enzymatic Colorimetric Analysis. ACS NANO 2021; 15:7722-7734. [PMID: 33825460 DOI: 10.1021/acsnano.1c01394] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Enzymatic colorimetric analysis of metabolites provides signatures of energy conversion and biosynthesis associated with disease onsets and progressions. Miniaturized photodetectors based on emerging two-dimensional transition metal dichalcogenides (TMDCs) promise to advance point-of-care diagnosis employing highly sensitive enzymatic colorimetric detection. Reducing diagnosis costs requires a batched multisample assay. The construction of few-layer TMDC photodetector arrays with consistent performance is imperative to realize optical signal detection for a miniature batched multisample enzymatic colorimetric assay. However, few studies have promoted an optical reader with TMDC photodetector arrays for on-chip operation. Here, we constructed 4 × 4 pixel arrays of miniaturized molybdenum disulfide (MoS2) photodetectors and integrated them with microfluidic enzyme reaction chambers to create an optoelectronic biosensor chip device. The fabricated device allowed us to achieve arrayed on-chip enzymatic colorimetric detection of d-lactate, a blood biomarker signifying the bacterial translocation from the intestine, with a limit of detection that is 1000-fold smaller than the clinical baseline, a 10 min assay time, high selectivity, and reasonably small variability across the entire arrays. The enzyme (Ez)/MoS2 optoelectronic biosensor unit consistently detected d-lactate in clinically important biofluids, such as saliva, urine, plasma, and serum of swine and humans with a wide detection range (10-3-103 μg/mL). Furthermore, the biosensor enabled us to show that high serum d-lactate levels are associated with the symptoms of systemic infection and inflammation. The lensless, optical waveguide-free device architecture should readily facilitate development of a monolithically integrated hand-held module for timely, cost-effective diagnosis of metabolic disorders in near-patient settings.
Collapse
Affiliation(s)
- Younggeun Park
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Byunghoon Ryu
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Seung Jun Ki
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Brendan McCracken
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Amanda Pennington
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Kevin R Ward
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Xiaogan Liang
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Katsuo Kurabayashi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan 48109, United States
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan 48109, United States
| |
Collapse
|
45
|
Interference of hemolysis on the postmortem biochemical analysis of IgE by ECLIA. Int J Legal Med 2021; 135:1661-1668. [PMID: 33783602 PMCID: PMC8008023 DOI: 10.1007/s00414-021-02578-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/16/2021] [Indexed: 11/22/2022]
Abstract
Forensic diagnosis of anaphylactic shock is a challenging task in forensic practice due to the lack of characteristic morphological changes. Postmortem analysis of serum IgE can provide helpful information for determining anaphylaxis. However, postmortem serum always suffers from hemolysis. To investigate the interference of hemolysis on postmortem analysis of total IgE by electrochemiluminescent immunoassay (ECLIA) and verify the suitability of the commercially available ECLIA kit for postmortem hemolyzed blood with the dilution-correction method, different levels of hemolyzed serum were prepared to evaluate the interference of hemolysis. A linear regression analysis was then performed on the concentration of total IgE in the completely hemolyzed blood and the corresponding serum. Our results indicated that hemolysis negatively interfered with the total IgE analysis by ECLIA and the interference (|Bias%|) increased with increasing levels of hemolysis. After controlling for |Bias%| by dilution, the test concentration of total IgE in the completely hemolyzed blood was still significantly lower than that in the serum (P < 0.05) and resulted in eight false-negative cases. A strong correlation was observed between the test concentration of total IgE in the completely hemolyzed blood and that in the serum (r = 0.983). After correction by the regression formula, the corrected concentration revealed no significant differences and exhibited the same diagnostic ability, compared with the serum total IgE concentration. These results indicate that the completely hemolyzed blood is not recommended for postmortem analysis of total IgE directly. The dilution-correction method might have potential utility in forensic practice for evaluating serum total IgE concentrations.
Collapse
|
46
|
HEMATOLOGY, PLASMA BIOCHEMISTRY, AND PLASMA PROTEIN ELECTROPHORESIS REFERENCE INTERVALS FOR BLUE IGUANAS ( CYCLURA LEWISI) FROM GRAND CAYMAN ISLAND. J Zoo Wildl Med 2021; 51:933-947. [PMID: 33480574 DOI: 10.1638/2020-0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2020] [Indexed: 11/21/2022] Open
Abstract
The blue iguana (Cyclura lewisi) is an endangered rock iguana species native to Grand Cayman, in the Cayman Islands. Health assessments were conducted on captive and free-roaming iguanas in 2001 and 2003-2014 and were performed in the summer wet season (June-July) of 2003-2004 and 2010-2014 and in the winter dry season (November-December) of 2001 and 2005-2009. Morphometric data were recorded from iguanas when blood samples were collected: 903 samples were collected and data from 890 samples from 775 iguanas were included. Samples were analyzed for hematology, plasma biochemistry, protein electrophoresis, mineral panels, 25-hydroxyvitamin D, and testosterone. Reference intervals were created for captive subadults, captive adults, and free-roaming adults when data were sufficient. Significant differences among these groups were described, as were differences on the basis of sex, season, and origin (captive vs free-roaming). In captive iguanas, most analytes were significantly different between subadults and adults, mature heterophils and copper were significantly higher in the dry season, zinc levels were significantly higher in the wet season, and cholesterol and triglycerides were significantly higher in adult females than adult males. Testosterone in adult males was significantly higher in the dry season. These results will aid in future health assessments and disease investigations in wild and captive populations of blue iguanas and are of comparative value for other Cyclura species that are free-roaming, captive, and, especially, in similar conservation release programs.
Collapse
|
47
|
Kosecki PA, Brooke P, Abbott L, Canonico E. The effect of sample hemolysis on blood ethanol analysis using headspace gas chromatography. J Forensic Sci 2021; 66:1136-1142. [PMID: 33768533 DOI: 10.1111/1556-4029.14675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/18/2020] [Accepted: 01/07/2021] [Indexed: 12/01/2022]
Abstract
Hemolysis, a common occurrence in blood collected for chemical analysis, has been reported to affect analytical test results for some analytes depending upon the material tested and the analytical technique employed. The potential for hemolysis to impact blood ethanol determinations using headspace gas chromatography of samples diluted with an internal standard was investigated. A sample of non-hemolyzed blood and a matched sample of hemolyzed blood were both analyzed thirty times for ethanol concentration using headspace gas chromatography. The mean ethanol concentration measured for the non-hemolyzed samples was 0.0639 g/dl. The mean ethanol concentration measured for the hemolyzed samples was 0.0642 g/dl. The calculated t value, 1.897, was less than the critical t value, 2.002, at a 0.05 level of significance. There was no measured statistical difference detected between the mean blood ethanol concentration determined for a hemolyzed whole blood sample and a non-hemolyzed whole blood sample.
Collapse
Affiliation(s)
| | - Phillip Brooke
- Scottsdale Police Department Crime Laboratory, Scottsdale, AZ, USA
| | - Lori Abbott
- Scottsdale Police Department Crime Laboratory, Scottsdale, AZ, USA
| | - Erika Canonico
- Scottsdale Police Department Crime Laboratory, Scottsdale, AZ, USA
| |
Collapse
|
48
|
Cyclic Voltammetry in Biological Samples: A Systematic Review of Methods and Techniques Applicable to Clinical Settings. SIGNALS 2021. [DOI: 10.3390/signals2010012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Oxidative stress plays a pivotal role in the pathogenesis of many diseases, but there is no accurate measurement of oxidative stress or antioxidants that has utility in the clinical setting. Cyclic Voltammetry is an electrochemical technique that has been widely used for analyzing redox status in industrial and research settings. It has also recently been applied to assess the antioxidant status of in vivo biological samples. This systematic review identified 38 studies that used cyclic voltammetry to determine the change in antioxidant status in humans and animals. It focusses on the methods for sample preparation, processing and storage, experimental setup and techniques used to identify the antioxidants responsible for the voltammetric peaks. The aim is to provide key information to those intending to use cyclic voltammetry to measure antioxidants in biological samples in a clinical setting.
Collapse
|
49
|
Hyponatremia in childhood urinary tract infection. Eur J Pediatr 2021; 180:861-867. [PMID: 32949290 DOI: 10.1007/s00431-020-03808-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/06/2020] [Accepted: 09/11/2020] [Indexed: 02/08/2023]
Abstract
Acute urinary tract infection (UTI) is the most common bacterial infection in childhood. Although hyponatremia was described in ~ 2/3 of these children, its clinical significance is still unclear. Herein, we evaluated the prevalence and clinical implications of hyponatremia in children hospitalized with a UTI. Medical records of previously healthy children hospitalized between January 2011 and December 2016 with UTI were retrospectively reviewed. Patients (median age 5.5 months) were divided into two groups according to their sodium levels: normonatremia (Na ≥ 135 mEq/L) and hyponatremia (Na < 135 mEq/L). Hyponatremia diagnosed on admission was found in 114/219 children (49%). Hyponatremic patients experienced a more severe disease manifested by a longer hospital stay (3.8 vs 3.4 days, p = 0.003), a higher prevalence of abnormal findings on renal ultrasound (10 vs 2, p = 0.01), higher C-reactive protein (CRP) levels (8.6 vs 3.4 mg/dl, p = <0.001), and a negative correlation between sodium levels and CRP (r = - 0.38, p < 0.001).Conclusion:Hyponatremia occurs frequently in children hospitalized with UTI and is associated with elevated inflammatory markers and a more severe disease course. What is Known: • Hyponatremia, one of the most common electrolyte abnormalities, occurs in approximately 1/3 of hospitalized children and in 2/3 of children with pyelonephritis. • In certain cases of various medical conditions, hyponatremia has been shown to correlate with disease severity. What is New: • Hyponatremia in hospitalized children with UTI correlates with elevated inflammatory markers and a more severe disease course.
Collapse
|
50
|
Kalaria T, Gill H, Harris S, Ford C, Gama R. The effect of haemolysis on the direct and indirect ion selective electrode measurement of sodium. Ann Clin Biochem 2021; 58:190-195. [PMID: 33356447 DOI: 10.1177/0004563220987593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We compared the effect of haemolysis in sodium measurement using indirect and direct ion-selective electrodes to test the hypothesis that haemolytic effect on sodium would be greater with indirect ion-selective electrode due to electrolyte exclusion effect from released intracellular proteins. METHODS Plasma lithium heparin samples (n = 36) from four volunteers were prepared to give a range of haemolytic indices (H-indices). Samples were analysed for sodium by indirect ion-selective electrode, H-index and total protein on an Abbott Architect c16000 and sodium by direct ion-selective electrode on a Siemens RAPIDPoint 500. Percentage changes in sodium in paired direct and indirect ion-selective electrode values were compared. RESULTS Abbott H-index, which represents haemoglobin concentration in g/L, correlated with percentage negative change in sodium by direct ion-selective electrode (ρ 0.995, P < 0.001) and indirect ion-selective electrode (ρ 0.991, P < 0.001). Percentage negative change was less when sodium was measured by direct ion-selective electrode compared to indirect ion-selective electrode (Wilcoxon signed-rank Z = 3.46, P = 0.01). The difference in percentage change in sodium between direct ion-selective electrode and indirect ion-selective electrode correlated with total protein (ρ 0.751, P < 0.001). The negative bias in sodium results exceeded the reference change value of 2.2% at an H-index of 8.31 for indirect ion-selective electrode and 9.26 for direct ion-selective electrode. CONCLUSION Haemolysis causes negative influence with sodium measured by both indirect and direct ion-selective electrode due to a dilutional hyponatremia. The additional interference in indirect ion-selective electrode is due to the electrolyte exclusion effect but this is unlikely to be clinically significant as it is small in magnitude.
Collapse
Affiliation(s)
- Tejas Kalaria
- Blood Sciences, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Henry Gill
- Blood Sciences, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Steve Harris
- Blood Sciences, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Clare Ford
- Blood Sciences, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Rousseau Gama
- Blood Sciences, Royal Wolverhampton NHS Trust, Wolverhampton, UK.,School of Medicine and Clinical Practice, University of Wolverhampton, Wolverhampton, UK
| |
Collapse
|