The Quality of Diagnostic Samples
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CONTENTS
1. Background
2. How to select specimens for laboratory analyses
2.1 Plasma or serum?
2.1.1 Advantages of using plasma
2.1.2 Disadvantages of plasma over serum
2.1.3 Analytical samples in the serological diagnosis of infectious diseases
2.2. Anticoagulants
2.2.1 EDTA
2.2.2 Citrate
2.2.3. Heparinates
2.2.4. Hirudin
2.3 Recommendations
3. How to collect and transport specimens for laboratory analyses
3.1 Sample collection and transport time
4. Centrifugation
4.1.1 Background
4.1.1.1 Plasma and serum
5. Storage
6. Evaluation of new analytical procedures
7. The Optimal Sample Volume
7.1 Recommendations
7.2 Activities which can help to reduce the required blood volume
7.3 Documentation
8. Analyte Stability in Sample Matrix
8.1 Stability and Instability
8.1.1. Definition of stability
8.1.1.1. The maximum permissible instability
8.1.1.2 The maximum permissible storage time
8.2 Quality assurance of the time delay during the preanalytical phase
8.2.1. Actions to be taken when the maximum permissible pre-analytical times are exceeded
9. The Hemolytic, Icteric and Lipemic Sample
9.1 Background
9.2 Definition of a clinically relevant interference
9.3 General recommendations
9.3.1. Documentation of interferences
9.3.2 Detection of a potentially interfering property and handling of sample and request
9.3.3 Reporting results
9.4 The hemolytic sample and the effect of therapeutic hemoglobin derivates
9.4.1 Hemolysis
9.4.2. Hemoglobin based oxygen carriers used as blood substitutes
9.4.3. Detection and measurement of hemoglobin in serum or plasma
9.4.4. Distinction of in-vivo hemolysis from in-vitro hemolysis
9.4.5 Mechanisms of interference by hemolysis
9.4.6. Means to avoid hemolysis and its interferences
9.4.7 Reaction to receipt of hemolytic samples
9.5 The lipemic sample
9.5.1 Background
9.5.2. Causes of lipemia (turbidity)
9.5.3 Identification and quantification of lipemia
9.5.4 Mechanisms of the interference by lipemia on analytical methods
9.5.5 Means to avoid lipemia and interferences caused by turbidity
9.5.5.1 Centrifugation
9.5.5.2 Fluorine chlorinated hydrocarbon extraxction, Polyethylene glycol, α-Cyclodextrin
9.5.5.3 Magnetic beads, Other methods for delipidation, Optical clearing systems
9.5.6. Recommendation
9.5.7 Test of interference by lipemia
9.6 The icteric sample
9.6.1. Appearance of different bilirubin species
9.6.2 Mechanisms of bilirubin interference
9.6.3 Detection and documentation of increased bilirubin concentrations in clinical samples
9.6.4 Prevention of bilirubin interference
9.6.4.1 Method selection
9.6.4.2 Actions recommended to use in procedures sensitive to bilirubin
10. References
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