No guideline currently exists on how to detect or document haemolysis, icterus or lipemia (HIL) in blood samples, nor on subsequent use of this information. The EFLM WG-PRE has performed a survey for assessing current practices of European laboratories in HIL monitoring. This second part of two coherent articles is focused on HIL.Materials and methods: An online survey, containing 39 questions on preanalytical issues, was disseminated among EFLM member countries.Seventeen questions exclusively focused on assessment, management and follow-up actions of HIL in routine blood samples.Results: Overall, 1405 valid responses from 37 countries were received. A total of 1160 (86%) of all responders stating to analyse blood samples- monitored HIL. HIL was mostly checked in clinical chemistry samples and less frequently in those received for coagulation, therapeutic drug monitoring and serology/infectious disease testing. HIL detection by automatic HIL indices or visual inspection, along with haemolysis cut-offs definition, varied widely among responders. A quarter of responders performing automated HIL checks used internal quality controls. In haemolytic/icteric/lipemic samples, most responders (70%) only rejected HIL-sensitive parameters, whilst about 20% released all test results with general comments. Other responders did not analysed but rejected the entire sample, while some released all tests, without comments. Overall, 26% responders who monitored HIL were using this information for monitoring phlebotomy or sample transport quality.Conclusion: Strategies for monitoring and treating haemolytic, icteric or lipemic samples are quite heterogeneous in Europe. The WG-PRE will use these insights for developing and providing recommendations aimed at harmonizing strategies across Europe.
European survey on preanalytical sample handling : part 2 : practices of European laboratories on monitoring and processing haemolytic, icteric and lipemic samples : on behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE) / Janne Cadamuro, Giuseppe Lippi, Alexander von Meyer, Mercedes Ibarz, Edmee van Dongen-Lases, Michael Cornes, Mads Nybo, Pieter Vermeersch, Kjell Grankvist, Joao Tiago Guimaraes, Gunn B.B. Kristensen, Barbara de la Salle, Ana-Maria Simundic.
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