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Review
. 2019 Mar 26;6(1):25-31.
doi: 10.1515/dx-2018-0018.

Blood sample quality

Giuseppe Lippi  1 , Alexander von Meyer  2 , Janne Cadamuro  3 , Ana-Maria Simundic  4
Affiliations
Free article
Review

Blood sample quality

Giuseppe Lippi et al. Diagnosis (Berl). .
Free article

Abstract

Several lines of evidence now confirm that the vast majority of errors in laboratory medicine occur in the extra-analytical phases of the total testing processing, especially in the preanalytical phase. Most importantly, the collection of unsuitable specimens for testing (either due to inappropriate volume or quality) is by far the most frequent source of all laboratory errors, thus calling for urgent strategies for improving blood sample quality and managing data potentially generated measuring unsuitable specimens. A comprehensive overview of scientific literature leads us to conclude that hemolyzed samples are the most frequent cause of specimen non-conformity in clinical laboratories (40-70%), followed by insufficient or inappropriate sample volume (10-20%), biological samples collected in the wrong container (5-15%) and undue clotting (5-10%). Less frequent causes of impaired sample quality include contamination by infusion fluids (i.e. most often saline or glucose solutions), cross-contamination of blood tubes additives, inappropriate sample storage conditions or repeated freezing-thawing cycles. Therefore, this article is aimed to summarize the current evidence about the most frequent types of unsuitable blood samples, along with tentative recommendations on how to prevent or manage these preanalytical non-conformities.

Keywords: blood samples; errors; hemolysis; laboratory medicine; quality.

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References

    1. Plebani M, Lippi G. Closing the brain-to-brain loop in laboratory testing. Clin Chem Lab Med 2011;49:1131–3.
    1. Lippi G, Plebani M, Graber ML. Building a bridge to safe diagnosis in health care. The role of the clinical laboratory. Clin Chem Lab Med 2016;54:1–3.
    1. Lippi G, Plebani M. A Six-Sigma approach for comparing diagnostic errors in healthcare – where does laboratory medicine stand? Ann Transl Med 2018. doi: 10.21037/atm.2018.04.02.
    1. Aita A, Sciacovelli L, Plebani M. Laboratory-related errors: you cannot manage what you don’t measure. You manage what you know and measure. Diagnosis (Berl) 2017;4:193–5.
    1. Simundic AM, Lippi G. Preanalytical phase–a continuous challenge for laboratory professionals. Biochem Med (Zagreb) 2012;22:145–9.

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