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This is a two-part story (#RLR)
Each stands alone but their combination is multiplicative #Synergy #Interdependence
Today’s topic: “The sample is hemolyzed” - In vitro vs In vivo
This is a two-part story (#RLR)
Each stands alone but their combination is multiplicative #Synergy #Interdependence
Today’s topic: “The sample is hemolyzed” - In vitro vs In vivo
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The lab notifies you “the sample is hemolyzed.”
First step in reasoning, did the hemolysis occur in the patient (in vivo) or during collection of the specimen (in vitro “ex vivo”), eg., prolonged application of the tourniquet
The lab notifies you “the sample is hemolyzed.”
First step in reasoning, did the hemolysis occur in the patient (in vivo) or during collection of the specimen (in vitro “ex vivo”), eg., prolonged application of the tourniquet
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In vivo hemolysis -> need to determine the cause of hemolysis (part 2 by @rabihmgeha )
In vitro hemolysis -> usually consequence of collection technique
In vivo hemolysis -> need to determine the cause of hemolysis (part 2 by @rabihmgeha )
In vitro hemolysis -> usually consequence of collection technique
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If you are a betting person, always bet in vitro hemolysis.
When should you suspect in vivo hemolysis?
If you are a betting person, always bet in vitro hemolysis.
When should you suspect in vivo hemolysis?
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Context will be your primary clue.
“Patient w/ inflammation (fever, leukocytosis)” -> in vivo hemolysis until proven otherwise
“Patient admitted with heart failure” -> in vitro hemolysis (assess the collection technique)
Context will be your primary clue.
“Patient w/ inflammation (fever, leukocytosis)” -> in vivo hemolysis until proven otherwise
“Patient admitted with heart failure” -> in vitro hemolysis (assess the collection technique)
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Which lab finding is specific for in vivo hemolysis?
Which lab finding is specific for in vivo hemolysis?
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Other clues to suggest in vivo hemolysis include reticulocytosis, positive PBS (e.g., schistocytes), indirect hyperbilirubinemia, low haptoglobin, and lactic acidosis.
Other clues to suggest in vivo hemolysis include reticulocytosis, positive PBS (e.g., schistocytes), indirect hyperbilirubinemia, low haptoglobin, and lactic acidosis.
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Conclusion:
(1) Important to know when a “hemolyzed sample” is due to in vivo pathology
(2) Once you have established in vivo hemolysis, part 2 bit.ly/2VMkoYy will guide you
Conclusion:
(1) Important to know when a “hemolyzed sample” is due to in vivo pathology
(2) Once you have established in vivo hemolysis, part 2 bit.ly/2VMkoYy will guide you
