By Amitava Dasgupta
This functional, easy-to-use consultant, named to Doody’s center Titles 2013, addresses interference concerns in all laboratory exams, together with sufferer epigenetics, technique of specimen assortment, enzymes, biomarkers. Clinicians and laboratory scientists can hence depend on one reference which speaks to either their wishes of exact specimen research and optimum sufferer care.
Erroneous medical institution and pathology laboratory effects could be complicated and challenging, in particular in acute care occasions. whereas a few elements developing interference, will be pointed out within the laboratory, detecting many others is usually depending on scientific info unavailable to the laboratory scientists or pathologists. accordingly, clinicians needs to develop into expert in opting for such faulty studies, and dealing with pathologists and laboratory scientists to be able to comprehend the resource of such interferences, right the implications, after which make a decision what plan of action has to be for correct sufferer management.
- Named to Doody’s center Titles 2013, a suite improvement instrument for healthiness sciences libraries of all sizes, through Doody Enterprises
- Practical info for either clinicians and laboratory scientists, awarded within the type of tables and charts for simple reference
- Focus on variety and resources of interferences instead of info of toxicologic mechanisms that are good lined in toxicology textbooks
- Covers interferences throughout endocrine, oncology, hematology, immunohistochemistry, immunology, serology, microbiology, and molecular testing
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Additional info for Accurate Results in the Clinical Laboratory. A Guide to Error Detection and Correction
Anticoagulants For coagulation assays, the proper ratio of blood to citrate is critical. For this reason, the tube must be filled to the required volume. Excess air allowed to enter the tube will limit the quantity of blood, thereby perturbing this ratio . Tourniquet Effect Application of a tourniquet to approximately 60 mmHg pressure causes anaerobic metabolism and thus may elevate the lactate and ammonia and lower the pH . Tissue destruction may cause the release of intracellular components such as potassium and enzymes.
Furthermore, coagulation may still occur postcentrifugation in serum samples. Therefore, another advantage of plasma is that analyte determinations can be achieved in whole blood prior to plasma separation provided that a suitable anticoagulant has been used. For example, an anticoagulated whole blood specimen may be used for point-of-care measurements followed by plasma separation, which would avoid the delay associated with obtaining an additional specimen for laboratory analysis. Reduction of in Vitro Hemolysis In addition to the time delay associated with blood clotting, there is an increased risk of lysis and consequent false increases in many intracellular analytes such as potassium, iron, and hemoglobin released from erythrocytes in serum specimens.
Green D, McMahon B, Foiles N, Tian L. Measurement of hemostatic factors in EDTA plasma. Am J Clin Pathol 2008;130:811À15. Chuang J, Sadler MA, Witt DM. 5-ml (pediatric) tubes. Chest 2004;126:1262À6. O’Keane MP, Cunningham SK. Evaluation of three different specimen types (serum, plasma lithium heparin and serum gel separator) for analysis of certain analytes: clinical significance of differences in results and efficiency in use. Clin Chem Lab Med 2006;44:662À8. NCCLS: procedures for the collection of Arterial Blood Specimens; approved standard, Fourth Edition H11-A4.
Accurate Results in the Clinical Laboratory. A Guide to Error Detection and Correction by Amitava Dasgupta