title: The degree of acceptability of swine blood values at increasing levels of hemolysis evaluated through visual inspection versus automated quantification.
abstract: The pronounced fragility that characterizes swine erythrocytes is likely to produce a variable degree of hemolysis during blood sampling, and the free hemoglobin may then unpredictably bias the quantification of several analytes. The aim of this study was to evaluate the degree of acceptability of values obtained for several biochemical parameters at different levels of hemolysis. Progressively increased degrees of physical hemolysis were induced in 3 aliquots of 30 nonhemolytic sera, and the relative effects on the test results were assessed. To define the level of hemolysis, we used both visual estimation (on a scale of 0 to 3+) and analytical assessment (hemolytic index) and identified the best analytical cutoff values for discriminating the visual levels of hemolysis. Hemolysis led to a variable and dose-dependent effect on the test results that was specific for each analyte tested. In mildly hemolyzed specimens, C-reactive protein, haptoglobin, β1-globulin, β2-globulin, α1-globulin, γ-globulin, sodium, calcium, and alkaline phosphatase were not significantly biased, whereas α2-globulin, albumin, urea, creatinine, glucose, total cholesterol, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, nonesterified fatty acids, bilirubin, phosphorus, magnesium, iron, zinc, copper, lipase, triglycerides, lactate dehydrogenase, unbound iron-binding capacity, and uric acid were significantly biased. Chloride and total protein were unbiased even in markedly hemolyzed samples. Analytical interference was hypothesized to be the main source of this bias, leading to a nonlinear trend that confirmed the difficulty in establishing reliable coefficients of correction for adjusting the test results.
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai) gdimartino@izsvenezie.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Di Martino
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Anna Lisa
authors.initials: AL
authors.lastname: Stefani
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Laura
authors.initials: L
authors.lastname: Gagliazzo
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Wanda
authors.initials: W
authors.lastname: McCormick
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gabai
authors.affiliation: Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padova, Italy (Di Martino, Stefani, Gagliazzo, Bonfanti)Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy (Lippi)Moulton College, Moulton, Northamptonshire, United Kingdom (McCormick)Dipartimento di Biomedicina Comparata e Alimentazione, University of Padova, Legnaro, Padova, Italy (Gabai).
authors.forename: Lebana
authors.initials: L
authors.lastname: Bonfanti
mesh_terms: D000818:Animals; D001663:Bilirubin / Q000097:blood; D001774:Blood Chemical Analysis / Q000662:veterinary*; D001800:Blood Specimen Collection / Q000662:veterinary*; D015986:Confounding Factors, Epidemiologic; D004912:Erythrocytes / Q000502:physiology*; D005260:Female; D006461:Hemolysis / Q000502:physiology*; D008297:Male; D015203:Reproducibility of Results; D013552:Swine; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D001663:Bilirubin
keywords: Biochemical profile; C-reactive protein; haptoglobin; hemolysis; swine