PB1179 - Evaluation of the point-of-care H10 Hemcheck device to detect haemolysis in whole blood.

Background: In vitro haemolysis in Coagulation samples can lead to analytical errors and inappropriate clinical decisions. It is only detectable visually or photometrically by auto analysers after sample centrifugation. A recently developed POC device (H10, Hemcheck) allows for photometric detection of haemolysis (as free haemoglobin-fHb) in whole blood. H10 use is simple enough for an operator to check a tube whilst the phlebotomy needle remains in the subjects’ vein, so that a replacement sample can be drawn if haemolysis has occurred during tube filling.

Aims: Evaluate H10 reader in detecting haemolysis in whole blood samples taken in our emergency department.

Methods: We assessed whether testing unspun Coagulation samples (Becton Dickinson, Vacutainer Plus 2.7ml) with the Hemcheck device affected results of Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, Thrombin Time and D-dimer.

We assessed concordance between H10 and the CS5100 in detecting haemolysis. A fHb =0.5 g/L cut-off is configured in and used by the H10 device. Coagulation samples from A&E patients in 3.2% sodium citrated tubes were tested by H10 before being centrifuged and analysed using CS5100 auto analysers. fHb in haemolysed samples was measured using Sysmex XN10 analyser.

Results: We detected haemolysis in 71/831 samples by both H10 and CS5100. Just 3 samples were positive by CS5100 and negative by H10. These were considered haemolysed by visual check so were considered false negatives by H10. 16 samples were negative by CS5100 and positive by H10 with Hb values ranging from < 0.1 to 0.6 g/L. All these samples were recorded by coagulation laboratory staff as having no visible haemolysis and considered false positives.

Conclusion(s): H10 device had a similar performance as CS5100 analysers to detect haemolysis. The early, rapid and easy detection of haemolysis by the H10 system prior to sample centrifugation will help avoid erroneous test results and potential for inappropriate clinical decisions.