Knowledge among clinical personnel on the impact of hemolysis using blood gas analyzers

Clin Chem Lab Med. 2024 Dec 11. doi: 10.1515/cclm-2024-1018. Online ahead of print.

Abstract

Objectives: In the light of a rapidly increasing use of POCT blood gas testing, where tests and interpretation are performed by non-laboratory personnel, the objective was to investigate the knowledge among personnel in the Nordic countries using blood gas analyzers with focus on the interference from hemolysis.

Methods: Information was obtained from a self-developed, pre-tested online questionnaire. The questions covered demographic information about the respondents and specific questions on handling of and knowledge about blood gas analyses and the impact of hemolysis. The questionnaire was distributed by e-mail to relevant colleagues on behalf of the Nordic preanalytical scientific working group under the Nordic Federation of Clinical Chemistry.

Results: A total of 117 respondents completed the questionnaire. 62.7 % respondents both used the analyzer and interpreted the results. 59.6 % respondents did not know to which degree the blood gas analyzer can identify hemolysis. 4.4 % answered that all levels or high levels of hemolysis can be detected. 3.9 % considered the result valid despite hemolysis if it is released from the instrument. 73.7 % of all respondents knew that hemolysis alters potassium measurements, while knowledge about the effect on PaO2 and bicarbonate measurements were more divergent.

Conclusions: The knowledge about blood gas analyzers with focus on the interference from hemolysis is sparse among non-laboratory personnel using the blood gas analyzers. This emphasizes the need for better education and competence management, which perhaps is even more important for these analyses than for other point-of-care tests.

Keywords: POCT; blood gas analyzers; blood sample integrity; hemolysis; preanalytical.