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      Measurement of Plasma Free Hemoglobin Using Hemolysis Index and Bilirubin Interference

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      https://www.riss.kr/link?id=A107956690

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      다국어 초록 (Multilingual Abstract)

      Plasma hemoglobin (pHb) is measured when hemolysis is suspected as a result of biochemical, immunological, and mechanical conditions. In this study, we evaluated the clinical feasibility of the hemolysis index (H-index) for pHb measurement using autom...

      Plasma hemoglobin (pHb) is measured when hemolysis is suspected as a result of biochemical, immunological, and mechanical conditions. In this study, we evaluated the clinical feasibility of the hemolysis index (H-index) for pHb measurement using automated chemistry analyzers. A total of 176 plasma samples were analyzed for pHb in the Severance Hospital using a Lambda 365 UV/Vis spectrophotometer (PerkinElmer, USA) and Fairbanks method 2. The remnant samples after pHb measurement were then analyzed for total bilirubin, and H-indices were determined using the automated Atellica CH930 system (Siemens, Germany) and Cobas c702 system (Roche, USA). The equivalence and correlation among the methods were evaluated using Passing-Bablok regression analysis and Spearman’s correlation analysis. All the methods showed high correlations with each other. However, the H-indices showed a negative constant bias compared to the Fairbanks method 2. When a cut-off value of 33.2 mg/dL was applied for diagnosis of hemolysis, 13 samples were determined positive by Fairbanks method 2 but negative by H-indices. These discordant results occurred mostly among samples with total bilirubin levels higher than 3 mg/dL (12 out of 13 samples). The correlation between total bilirubin and pHb measured by Fairbanks method 2 showed the largest correlation coefficient (R =0.347) and slope. These results suggest that the pHb measured by Fairbanks method 2 is more prone to bilirubin interference. In summary, our results suggest that H-indices from both automated chemistry analyzers possess excellent clinical feasibility for pHb measurements and have minimum total bilirubin interference compared to traditional measurement via Fairbanks method 2.

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      참고문헌 (Reference)

      1 박경운, "고빌리루빈혈증에서의 혈장혈색소 농도 측정" 대한진단검사의학회 22 (22): 382-387, 2002

      2 Guder WG, "The haemolytic, icteric and lipemic sample recommendations regarding their recognition and prevention of clinically relevant interferences:recommendations of the Working Group on Preanalytical Variables of the German Society for Clinical Chemistry and the German Society for Laboratory Medicine" 24 : 357-364, 2000

      3 Lubnow M, "Technical complications during veno-venous extracorporeal membrane oxygenation and their relevance predicting a system-exchange: retrospective analysis of 265 cases" 9 : e112316-, 2014

      4 Wong SS, "Quantification of plasma hemoglobin in the presence of bilirubin with bilirubin oxidase" 25 : 247-251, 1995

      5 Lippi G, "Multicenter evaluation of the hemolysis index in automated clinical chemistry systems" 47 : 934-939, 2009

      6 Fairbanks VF, "Methods for measuring plasma hemoglobin in micromolar concentration compared" 38 : 132-140, 1992

      7 Carraro P, "Hemolyzed specimens: a reason for rejection or a clinical challenge?" 46 : 306-307, 2000

      8 권영일, "Hemoglobin 평가를 위한 초기 기구의 특성 및 측정법 고찰" 대한임상검사과학회 48 (48): 401-410, 2016

      9 Blank DW, "Hemoglobin interference from in vivo hemolysis" 31 : 1566-1569, 1985

      10 Dolci A, "Harmonization of automated hemolysis index assessment and use: is it possible?" 432 : 38-43, 2014

      1 박경운, "고빌리루빈혈증에서의 혈장혈색소 농도 측정" 대한진단검사의학회 22 (22): 382-387, 2002

      2 Guder WG, "The haemolytic, icteric and lipemic sample recommendations regarding their recognition and prevention of clinically relevant interferences:recommendations of the Working Group on Preanalytical Variables of the German Society for Clinical Chemistry and the German Society for Laboratory Medicine" 24 : 357-364, 2000

      3 Lubnow M, "Technical complications during veno-venous extracorporeal membrane oxygenation and their relevance predicting a system-exchange: retrospective analysis of 265 cases" 9 : e112316-, 2014

      4 Wong SS, "Quantification of plasma hemoglobin in the presence of bilirubin with bilirubin oxidase" 25 : 247-251, 1995

      5 Lippi G, "Multicenter evaluation of the hemolysis index in automated clinical chemistry systems" 47 : 934-939, 2009

      6 Fairbanks VF, "Methods for measuring plasma hemoglobin in micromolar concentration compared" 38 : 132-140, 1992

      7 Carraro P, "Hemolyzed specimens: a reason for rejection or a clinical challenge?" 46 : 306-307, 2000

      8 권영일, "Hemoglobin 평가를 위한 초기 기구의 특성 및 측정법 고찰" 대한임상검사과학회 48 (48): 401-410, 2016

      9 Blank DW, "Hemoglobin interference from in vivo hemolysis" 31 : 1566-1569, 1985

      10 Dolci A, "Harmonization of automated hemolysis index assessment and use: is it possible?" 432 : 38-43, 2014

      11 Lippi G, "Haemolysis: an overview of the leading cause of unsuitable specimens in clinical laboratories" 46 : 764-772, 2008

      12 Thomas L, "Haemolysis as influence & interference factor" 13 : 95-98, 2002

      13 Petrova DT, "Can the Roche hemolysis index be used for automated determination of cell-free hemoglobin?: a comparison to photometric assays" 46 : 1298-1301, 2013

      14 Paal M, "A second-derivate fitting algorithm for the quantification of free hemoglobin in human plasma" 56 : 62-69, 2018

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