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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

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Chiara Riva
Biomedia srl
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Tel. 0245498282


ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da LM. Cruz Carlos

Hematocrit interference in coagulation tests: what else can we do?
Hematocrit interference in coagulation tests: what else can we do?
<p>The required blood to anti-coagulant ratio in the tubes for coagulation tests, is 9:1; any deviation from this ratio should be avoided as it may lead to erroneous analytical results. One of the variables influencing the ratio is an elevated hematocrit (&gt;55%), because the elevated concentration of citrate in the plasma specimen can cause clotting times falsely increased. These erroneous results can lead to possible misdiagnosis, incorrect patient treatment and/or the performance of additional unnecessary investigations. We present the case of a 46-year-old man referred to the laboratory for a pre-surgery check. The presence of elevated values in his coagulation tests led to delayed surgery and to additional tests. Once the error was detected, a root cause analysis was performed. The main contributing factors to the pre-analytical error were identified using Ishikawa method; factors related to the organization, staff and environment were identified and analyzed. Preventive actions (safety barriers) were designed to prevent the error from recurring. The safety barriers implemented were: an automatic flag displayed in the information laboratory system (LIS) in cases of elevated hematocrit (&gt;55%), to enhancement of the possible error detection plus additional laboratory staff training. At the best of our knowledge, since these safety barriers were applied three years ago, no coagulation test results interfered by high hematocrit have been released from our laboratory. This case demonstrates the importance of implementing safety barriers to prevent errors arising from situations that, although already described and well known, may go unnoticed by the laboratory staff</p>
Biochimica Clinica ; 17(1)
Casi Clinici - Case Report