The effects of 0.1 and 1.0 per cent erythrocytes and hemolysis on serum chemistry values.

Changes in serum chemistry values as a result of incomplete removal of erythrocytes and in vitro hemolysis during the preparative process have been studied. Two levels of contamination, corresponding to removal of 99% and 99.9% of the erythrocytes, were used to examine the effects of both hemolyzed and intact cells. Forty chemical procedures and methods were considered. Serum LDH values were most strongly affected by hemolyzed erythrocytes. Potassium, creatine phosphokinase, aspartate aminotransferase, alanine aminotransferase, and iron showed smaller but significant effects due to the presence of 1% hemolyzed cells, with lesser effects observed at the 0.1% level. The presence of non-hemolyzed cells at either level did not significantly alter chemistry results.

Changes in serum chemical values as a result of prolonged contact with the clot.

Changes in serum biochemical values as a function of serum-clot contact time were investigated. Time extending to 48 hours were studied by drawing sets of six specimens from ten subjects. Glucose, lactic dehydrogenase, the transaminases, potassium, alkaline phosphatase, and iron showed significant changes. Other common tests, including electrophoretic separations, were not affected.

A proposed blind routine quality control system for multichannel analyzers.

A blind quality control system using a special type of commercial reference serum is described. As packaged, the product contains six pools of analyzed reference sera with vials identified by coded numbers. The test constituents in the pools cover the range of multichannel analyzers in a random manner, i.e., each pool contains constituents in the low, normal and elevated ranges. As specific pools are not identified, and the analyst is unaware of the expected values for each constituent, results collected for quality control purposes are unbiased, i.e., free of conscious or unconscious editing. Data analysis in the proposed system is by least-squares technics. During an eight-week period, performance was studied using the standard error of the estimate to evaluate precision and the slope of the regression line to evaluate accuracy on the SMA and Mark X instruments. As an empirical comparison, the data are expressed as relative errors and precision and accuracy of analyzer performance evaluated as mean and standard deviation. The proposed regression analysis-based technic has the advantage of simultaneously evaluating linearity, as well as checking accuracy and precision over the total dynamic range of the instrument by use of a series of related serum pools.