Reference interval for immature platelet fraction on Sysmex XN haematology analyser in adult population

Introduction: The Sysmex XN-series haematology analyser has newly adopted a fluorescent channel to measure immature platelet fraction (IPF). To promote the clinical utility of this promising parameter, establishing a reliable reference interval is mandatory. According to previous studies, IPF values may be affected by the employed analyser and the ethnic background of the individual, but no differences seem to be found between individuals’ genders. Therefore, this study aimed to define the reference interval for IPF in a Spanish population following Clinical and Laboratory Standard Institute (CLSI) guidelines. Materials and methods: A total of 153 healthy Caucasian adults from Spain met the inclusion criteria. IPF measurement was performed by means of a Sysmex XN-2000 haematology analyser. A non-parametric percentile method was used to calculate the reference intervals in accordance with CLSI guidelines. Results: The obtained reference interval for IPF on the Sysmex XN-2000 was 1.6–9.6% (90% confidence intervals (CIs) were 1.5–1.8 and 9.3–11.5, respectively). No significant gender difference in IPF reference intervals was observed (P = 0.101). Conclusions: This study provides, for the first time, a reference interval for IPF using a Sysmex XN-2000 in a Spanish population, ranging from 1.6 to 9.6%. These data are needed to evaluate platelet production in several conditions such as thrombocytopenia, inflammatory states and cardiovascular diseases, as well as for future research

Analysis of laboratory critical values at a referral Spanish tertiary university hospital

The aim of this study was to analyse critical value data from our laboratory and compare our critical value reporting policy with others in the literature. Analysis of critical values was performed on data obtained over a 6-month period in a tertiary university hospital. We identified 5723 critical values, of which approximately 80% came from STAT testing (4577), 15% from routine inpatients testing (884) and 5% from routine outpatients testing (262). The highest proportion of critical values corresponded to oxygen partial pressure (17.7%), followed by potassium ion (17.6%) concentrations. The parameters associated with the highest critical value notification percentage in emergency patients were pH, haematocrit, glucose, potassium ion and haemoglobin concentrations. In inpatients, these parameters were glucose, phosphate, haemoglobin, sodium ion and potassium ion concentrations. In outpatients, they were calcium and potassium concentrations. The analysis of critical values in our hospital is in accordance with that reported in the literature. Our findings demonstrate the importance of incorporating improvement actions not only in critical value notification, but especially in the registration of this activity

Reference values assessment in a Mediterranean population for small dense low-density lipoprotein concentration isolated by an optimized precipitation method

Background: High serum concentrations of small dense low-density lipoprotein cholesterol (sd-LDL-c) particles are associated with risk of cardiovascular disease (CVD). Their clinical application has been hindered as a consequence of the laborious current method used for their quantification. Objective: Optimize a simple and fast precipitation method to isolate sd-LDL particles and establish a reference interval in a Mediterranean population. Materials and methods: Forty-five serum samples were collected, and sd-LDL particles were isolated using a modified heparin-Mg2+ precipitation method. sd-LDL-c concentration was calculated by subtracting high-density lipoprotein cholesterol (HDL-c) from the total cholesterol measured in the supernatant. This method was compared with the reference method (ultracentrifugation). Reference values were estimated according to the Clinical and Laboratory Standards Institute and The International Federation of Clinical Chemistry and Laboratory Medicine recommendations. sd-LDL-c concentration was measured in serums from 79 subjects with no lipid metabolism abnormalities. Results: The Passing-Bablok regression equation is y = 1.52 (0.72 to 1.73) + 0.07x (−0.1 to 0.13), demonstrating no significant statistical differences between the modified precipitation method and the ultracentrifugation reference method. Similarly, no differences were detected when considering only sd-LDL-c from dyslipidemic patients, since the modifications added to the precipitation method facilitated the proper sedimentation of triglycerides and other lipoproteins. The reference interval for sd-LDL-c concentration estimated in a Mediterranean population was 0.04-0.47 mmol/L. Conclusion: An optimization of the heparin-Mg2+ precipitation method for sd-LDL particle isolation was performed, and reference intervals were established in a Spanish Mediterranean population. Measured values were equivalent to those obtained with the reference method, assuring its clinical application when tested in both normolipidemic and dyslipidemic subjects

Anàlisis prop del pacient

Anàlisis prop; Proves clíniques; Salut públicaAnálisis prop; Pruebas clínicas; Salud públicaPatient-focused testing; Clinical trials; Public healthInforme que ens ofereix la definició de les anàlisis prop, un estat de la qüestió, els punts forts i els punts febles i propostes de millora.Informe que nos ofrece la definición de las análisis prop, un estado de la cuestión, los puntos fuertes y los puntos débiles y propuestas de mejora

Dynamic profiles and predictive values of some biochemical and haematological quantities in COVID-19 inpatients

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in some hospitalized patients has shown some important alterations in laboratory tests. The aim of this study was to establish the most relevant quantities associated with the worst prognosis related to COVID-19. Materials and methods: This was a descriptive, longitudinal, observational and retrospective study, in a cohort of 845 adult inpatients from Bellvitge University Hospital (L'Hospitalet de Llobregat, Barcelona, Spain). A multivariate regression analysis was carried out in demographic, clinical and laboratory data, comparing survivors (SURV) and non-survivors (no-SURV). A receiver operating characteristic analysis was also carried out to establish the cut-off point for poor prognostic with better specificity and sensibility. Dynamic changes in clinical laboratory measurements were tracked from day 1 to day 28 after the onset of symptoms. Results: During their hospital stay, 18% of the patients died. Age, kidney disease, creatinine (CREA), lactate-dehydrogenase (LD), C-reactive-protein (CRP) and lymphocyte (LYM) concentration showed the strongest independent associations with the risk of death in the multivariate regression analysis. Established cut-off values for poor prognosis for CREA, LD, CRP and LYM concentrations were 75.0 mu mol/L, 320 U/L, 80.9 mg/L and 0.69 x10(9)/L. Dynamic profile of laboratory findings, were in agreement with the consequences of organ damage and tissue destruction. Conclusions: Age, kidney disease, CREA, LD, CRP and LYM concentrations in COVID-19 patients from the southern region of Catalonia provide important information for their prognosis. Measurement of LD has demonstrated to be very good indicator of poor prognosis at initial evaluation because of its stability over time

Stability of pH, Blood Gas Partial Pressure, Hemoglobin Oxygen Saturation Fraction, and Lactate Concentration

Background: The storage temperature and time of blood gas samples collected in syringes constitute preanalytical variables that could affect blood gas or lactate concentration measurement results. We analyzed the effect of storage temperature and time delay on arterial or venous blood gas stability related to pH, partial pressure of carbon dioxide (pCO(2)) and oxygen (pO(2)), hemoglobin oxygen saturation (sO(2)), and lactate concentration. Methods: In total, 1,200 arterial and venous blood sample syringes were analyzed within 10 minutes of collection. The samples were divided into different groups to determine parameter stability at 25, 4-8, and 0-3.9 degrees C and at different storage times, 60, 45, 30, and 15 minutes. Independent sample groups were used for each analysis. Percentage deviations were calculated and compared with acceptance stability limits (1.65x coefficient of variation). Additionally, sample group sub analysis was performed to determine whether stability was concentration-dependent for each parameter. Results: The pH was stable over all storage times at 4-8 and 0-3.9 degrees C and up to 30 minutes at 25 degrees C. pCO(2) was stable at <= 60 minutes at all temperatures. pO(2) was stable for 45 minutes at 0-3.9 degrees C, and sO(2) was stable for 15 minutes at 25 degrees C and for <= 60 minutes at 0-3.9 degrees C. Lactate concentration was stable for 45 minutes at 0-3.9 degrees C. Sub-analysis showed that stability was concentration-dependent. Conclusions: The strictest storage temperature and time criteria (0-3.9 degrees C, 45 minutes) should be adopted for measuring pH, pCO(2), pO(2), sO(2), and lactate concentration in blood gas syringes

Analysis of laboratory critical values at a referral Spanish tertiary university hospital

The aim of this study was to analyse critical value data from our laboratory and compare our critical value reporting policy with others in the literature. Analysis of critical values was performed on data obtained over a 6-month period in a tertiary university hospital. We identified 5723 critical values, of which approximately 80% came from STAT testing (4577), 15% from routine inpatients testing (884) and 5% from routine outpatients testing (262). The highest proportion of critical values corresponded to oxygen partial pressure (17.7%), followed by potassium ion (17.6%) concentrations. The parameters associated with the highest critical value notification percentage in emergency patients were pH, haematocrit, glucose, potassium ion and haemoglobin concentrations. In inpatients, these parameters were glucose, phosphate, haemoglobin, sodium ion and potassium ion concentrations. In outpatients, they were calcium and potassium concentrations. The analysis of critical values in our hospital is in accordance with that reported in the literature. Our findings demonstrate the importance of incorporating improvement actions not only in critical value notification, but especially in the registration of this activity

Reference values assessment in a Mediterranean population for small dense low-density lipoprotein concentration isolated by an optimized precipitation method

High serum concentrations of small dense low-density lipoprotein cholesterol (sd-LDL-c) particles are associated with risk of cardiovascular disease (CVD). Their clinical application has been hindered as a consequence of the laborious current method used for their quantification. Optimize a simple and fast precipitation method to isolate sd-LDL particles and establish a reference interval in a Mediterranean population. Forty-five serum samples were collected, and sd-LDL particles were isolated using a modified heparin-Mg 2+ precipitation method. sd-LDL-c concentration was calculated by subtracting high-density lipoprotein cholesterol (HDL-c) from the total cholesterol measured in the supernatant. This method was compared with the reference method (ultracentrifugation). Reference values were estimated according to the Clinical and Laboratory Standards Institute and The International Federation of Clinical Chemistry and Laboratory Medicine recommendations. sd-LDL-c concentration was measured in serums from 79 subjects with no lipid metabolism abnormalities. The Passing-Bablok regression equation is y = 1.52 (0.72 to 1.73) + 0.07 x (−0.1 to 0.13), demonstrating no significant statistical differences between the modified precipitation method and the ultracentrifugation reference method. Similarly, no differences were detected when considering only sd-LDL-c from dyslipidemic patients, since the modifications added to the precipitation method facilitated the proper sedimentation of triglycerides and other lipoproteins. The reference interval for sd-LDL-c concentration estimated in a Mediterranean population was 0.04-0.47 mmol/L. An optimization of the heparin-Mg 2+ precipitation method for sd-LDL particle isolation was performed, and reference intervals were established in a Spanish Mediterranean population. Measured values were equivalent to those obtained with the reference method, assuring its clinical application when tested in both normolipidemic and dyslipidemic subjects

Reference values assessment in a Mediterranean population for small dense low-density lipoprotein concentration isolated by an optimized precipitation method

Background: High serum concentrations of small dense low-density lipoprotein cholesterol (sd-LDL-c) particles are associated with risk of cardiovascular disease (CVD). Their clinical application has been hindered as a consequence of the laborious current method used for their quantification. Objective: Optimize a simple and fast precipitation method to isolate sd-LDL particles and establish a reference interval in a Mediterranean population. Materials and methods: Forty-five serum samples were collected, and sd-LDL particles were isolated using a modified heparin-Mg2+ precipitation method. sd-LDL-c concentration was calculated by subtracting high-density lipoprotein cholesterol (HDL-c) from the total cholesterol measured in the supernatant. This method was compared with the reference method (ultracentrifugation). Reference values were estimated according to the Clinical and Laboratory Standards Institute and The International Federation of Clinical Chemistry and Laboratory Medicine recommendations. sd-LDL-c concentration was measured in serums from 79 subjects with no lipid metabolism abnormalities. Results: The Passing-Bablok regression equation is y = 1.52 (0.72 to 1.73) + 0.07x (−0.1 to 0.13), demonstrating no significant statistical differences between the modified precipitation method and the ultracentrifugation reference method. Similarly, no differences were detected when considering only sd-LDL-c from dyslipidemic patients, since the modifications added to the precipitation method facilitated the proper sedimentation of triglycerides and other lipoproteins. The reference interval for sd-LDL-c concentration estimated in a Mediterranean population was 0.04-0.47 mmol/L. Conclusion: An optimization of the heparin-Mg2+ precipitation method for sd-LDL particle isolation was performed, and reference intervals were established in a Spanish Mediterranean population. Measured values were equivalent to those obtained with the reference method, assuring its clinical application when tested in both normolipidemic and dyslipidemic subjects