Haemolysis, icterus and lipemia (HIL) are the most commonly tested interferences that affect the integrity of patient samples in the clinical laboratory. Depending on the type and the degree of interferences, it may impact patient results.
Common chemistry assays with known sensitivity to HIL interferences:
|Amylase (AMY)||Amylase (AMY)||Aspartate Aminotransferase (AST)|
|Aspartate Aminotransferase (AST)||Creatinine (SC)||Direct Bilirubin (DBI)|
|Magnesium (MG)||Digoxin||Magnesium (MG)|
|Iron (FE)||Iron (FE)||Iron (FE)|
|Lactate Dehydrogenase (LDH)||γ-Glutamyl Transferase (GGT)||Lactate Dehydrogenase (LDH)|
|Direct Bilirubin (DBI)||Triglycerides (TG)||Potassium (K)|
|Potassium (K)||Potassium/Sodium (K/Na)||Sodium (Na)|
Although most major laboratory systems include automated HIL detection features to measure common interferences, including pre-analytical checks in your QC programme can ensure that they are being accurately identified.
Join us and Dr. von Meyer, the EFLM’s pre-analytical working group chairman:
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Liquichek Serum Indices is a quality indicator intended for use as part of laboratory interference testing to monitor an instrument’s ability to detect haemolysed, icteris and or lipemic samples.
Icterus, Lipemia and Non-interfered
Resemble patient samples with human sourced material
Analysing realist concentrations of HIL interferences using human-sourced materials can increase confidence in your instruments’ performance.
Compare instrument responses among peer groups with Unity Interlaboratory Programme
An interlaboratory program can offer early awareness of shifts and trends to help avoid costly test repeats and unnecessary troubleshooting.
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Is it mandatory or necessary to do automatic HIL detection if we previously made a visual check in the pre-analytical part?
Dr von Meyer: Sometimes even very low concentrations of interferences can cause clinically relevant deviation of the “real” value. These low concentrations cannot be determined visually. Many publications show the superiority of the automated determination of HIL indices over the human eye. Such undetected interference can cause harm to the patient. Therefore, from our point of view (EFLM) visual determination of interferences is questionable concerning overall quality of lab services.
Which would be the frequency of testing HIL QC?
Dr von Meyer: In line with your routine test intervals. We (EFLM) would recommend to handle this QC comparable to other QCs. This makes it also easier to implement.
Want to learn how to ensure quality results in your laboratory? Dr Alexander von Meyer, EFLM Preanalytical Working Group Chair, answers questions on Serum Indices detection, the value on pre-analytical focus, and what to do if your HIL interference checks fail. Read the full Q&A here.
Disclaimer: The views, information, or opinions expressed in this document are obtained from and approved by Dr. Alexander von Meyer and from publications in European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) website and do not necessarily represent those of Bio-Rad Laboratories and its employees. The primary purpose of this Q&A is for information only.
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