Hemolysis, icterus and/or lipemia (HIL) may affect coagulation testing. However, guidelines for HIL management is still missing. To investigate practices on HIL management by clinical laboratories in the field of blood coagulation, via the framework of the Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) a questionnaire was distributed to a large numbver of European laboratories. The ECAT Foundation closely involved in this study. The results of this questionnaire has been published in Clinicsal Chemistry and Laboratory Medcine (CCLM).
Abstract:
Objectives: Coagulation test results may be affected by hemolysis, icterus and/or lipemia (HIL). Detailed guidelines for HIL-management are missing, both for manual and automatic HIL-checks. The aim of this survey was to provide an overview of the practical procedures for the detection and
handling of HIL-samples used by laboratories in Europe in the context of coagulation testing.
Methods: A SurveyMonkey questionnaire was sent from Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) to European external quality assurance organizers, who in turn forwarded the link to mtheir participating laboratories. Questions were asked regarding detection and handling of HIL-samples, commentand reject-levels, and the guidance used by the laboratories.
Results: A written procedure for HIL-management was available in 55–67% of laboratories, and each sample was checked for HIL in 73–83% (lowest percentage for icterus, highest for hemolysis). Manual visual inspection as the only method to detect HIL was used by up to 38% of laboratories, with most relying on personal experience for HIL-level classification. All other laboratories used some type of
automated HIL-detection, alone or in combination with visual check. The terms used for classification and the HIL comment- and reject-levels varied widely, even among laboratories using the same manufacturer. Most laboratories state that they use the manufacturer’s guidance.
Conclusions: There is wide heterogeneity in HIL-detection, handling and reporting among European laboratories, which calls for an urgent collaboration among laboratories and manufacturers to harmonize the HIL-management in coagulation testing.
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