In-vitro hemolysis in laboratory medicine
Prof. Gian Luca Salvagno presents:
- Release Date: 06.10.2025
- Duration: 34 minutes
- Guest: Prof. Gian Luca Salvagno, MD
- Host: Director Global Medical & Clinical Affairs Ana-Maria Šimundić
- Introduction: Listen to practical insights from Professor Gian Luca Salvagno on hemolysis of blood samples.This theme is of particular interest to Prof. Salvagno, who has published many papers on it.
Timestamps for Episode 7
- 1:28 – What is hemolysis?
- 2:57 – Why are hemolyzed samples a problem?
- 4:35 – How to detect and deal with hemolysis
- 8:35 – Instruments do not have standardized methods for detection
- 11:13 – Decision limits for hemolyzed samples
- 14:12 – Why providing scaled results is to be preferred
- 15:45 – ISO requirements regarding hemolysis
- 16:50 – Understanding the causes and preventing hemolysis
- 21:25 – Physics supporting cell integrity: needle diameter, vein, pressure, etc.
- 27:48 – What is the way forward in the quest to reduce hemolysis – for each stakeholder?
- 31:36 – What's your most memorable preanalytical moment?
What You Can't Miss – In a Nutshell
Hemolysis is one of the main errors in laboratory medicine
- Less than 10% of hemolysis cases are in-vivo and due to diseases. Most causes for broken erythrocytes (=red blood cells) happen ex-vivo during blood collection.
Hemolysis is the primary cause for recollection of samples
- Recollection leads to delay in the diagnosis and treatment, challenges the organization and is to be avoided from an economic perspective.
Understanding the effect of physics during blood collection:
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wherever possible, prefer the arm vein over the thinner, more fragile hand vein
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only use tourniquet to check for veins and never apply for more than one minute
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choice of most suitable needle product for individual patient
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vacuum tube pressure might have an impact; in a lower volume tube, the reduced stress on blood dropping into tube can minimize hemolysis
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invert tube gently and consider stress of pneumatic tube transport
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sample should arrive in lab within 1-2 hours and within good temperature condition
“In-vivo hemolysis is limited to very few cases. More than 90% of the causes are due to the preanalytical phase. ”
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Practical recommendations for managing hemolyzed samples in clinical chemistry
testing; Giuseppe Lippi, Janne Cadamuro, Alexander von Meyer, Ana-Maria Simundic and on behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE); January 26, 2018; doi.org/10.1515/cclm-2017-1104
https://www.eflm.eu/upload/docs/2.%20CCLM%202018%20WG-PRE.pdf
ISO requirements for quality and competence in medical laboratories
