{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:22:52Z","timestamp":1790706172852,"version":"4.1.0"},"reference-count":16,"publisher":"Walter de Gruyter GmbH","issue":"10","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,25]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n The destruction of red cells during blood collection or with the processing of the sample continues to occur at a high rate, especially among emergency department (ED) patients. This can produce pre-analytical laboratory errors, particularly for potassium. We determined the incidence of hemolyzed samples and discuss the potential medical impact for hypokalemic patients who potassium level is artificially normal (pseudoeukalemia).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Potassium results were obtained for a 6-month period. Using a measured hemolysis index (HI), hemolysis was present in 3.1\u202f% for all potassium ordered (n=94,783) and 7.5\u202f% for ED orders (n=22,770). Most of these samples were reported as having high normal result or were hyperkalemic. There were 22 hemolytic samples with a potassium of <3.5\u202fmmol\/L, and 57 hemolytic samples with a potassium in lower limit of normal (3.5\u20133.8\u202fmmol\/L). From this group, we examined the medical histories of 8 selected patients whose initially normal potassium levels were subsequently confirmed to have a potassium values that were below, at, or just above the lower limit of normal due to hemolysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The primary complaint for these patients were: necrotizing soft tissue infection, pancreatitis, volume overload from heart failure with reduced ejection fraction, hypertension treated with hydrochlorothiazide, and presence of a short bowel syndrome. A subsequent non-hemolyzed sample was collected demonstrating hypokalemia in all of these patients. Within these cases, there was a potential for harm had hemolysis detection not been performed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n We demonstrate the medical importance of detecting hemolysis for patients who have pseudoeukalemia. This is relevant because the HI cannot be obtained when electrolytes are tested using whole blood samples, and a normal potassium may lead to inappropriate patient management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/cclm-2024-0351","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T09:10:39Z","timestamp":1713172239000},"page":"1975-1979","source":"Crossref","is-referenced-by-count":6,"title":["Potential medical impact of unrecognized in\u00a0vitro<\/i> hypokalemia due to hemolysis: a case series"],"prefix":"10.1515","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5610-2036","authenticated-orcid":false,"given":"Alan H.B.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine , University of California , San Francisco , CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Franklin","family":"Peacock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"2024090411271525790_j_cclm-2024-0351_ref_001","doi-asserted-by":"crossref","unstructured":"Lippi, G, Plebani, M, Di Somma, S, Cervellin, G. Hemolyzed specimens: a major challenge for emergency departments and clinical laboratories. Crit Rev Clin Lab Sci 2021;48:143\u201353. https:\/\/doi.org\/10.3109\/10408363.2011.600228.","DOI":"10.3109\/10408363.2011.600228"},{"key":"2024090411271525790_j_cclm-2024-0351_ref_002","doi-asserted-by":"crossref","unstructured":"Calleja, R, Mielke, N, Lee, R, Johnson, S, Bahl, A. Hemolyzed laboratory specimens in the emergency department: an underappreciated, but frequent problem. J Emerg Nurs 2023;40:744\u201354. https:\/\/doi.org\/10.1016\/j.jen.2023.06.001.","DOI":"10.1016\/j.jen.2023.06.001"},{"key":"2024090411271525790_j_cclm-2024-0351_ref_003","doi-asserted-by":"crossref","unstructured":"Phelan, MP, Hustey, FM, Good, DM, Reineks, EZ. Seeing red: blood sample hemolysis is associated with prolonged emergency department throughput. J Appl Lab Med 2020;5:732\u20137. https:\/\/doi.org\/10.1093\/jalm\/jfaa073.","DOI":"10.1093\/jalm\/jfaa073"},{"key":"2024090411271525790_j_cclm-2024-0351_ref_004","doi-asserted-by":"crossref","unstructured":"Singer, AJ, Thode, HCJr, Peacock, WF. A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes. Clin Exp Emerg Med 2017;4:73\u20139. https:\/\/doi.org\/10.15441\/ceem.16.194.","DOI":"10.15441\/ceem.16.194"},{"key":"2024090411271525790_j_cclm-2024-0351_ref_005","doi-asserted-by":"crossref","unstructured":"Dietzen, DJ, Jackups, R, Zaydman, MA. 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Available from: https:\/\/med.virginia.edu\/ginutrition\/wp-content\/uploads\/sites\/199\/2014\/06\/Parrish_Feb_15.pdf."}],"container-title":["Clinical Chemistry and Laboratory Medicine (CCLM)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2024-0351\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2024-0351\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T11:34:01Z","timestamp":1725449641000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2024-0351\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,15]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,3,5]]},"published-print":{"date-parts":[[2024,9,25]]}},"alternative-id":["10.1515\/cclm-2024-0351"],"URL":"https:\/\/doi.org\/10.1515\/cclm-2024-0351","relation":{},"ISSN":["1434-6621","1437-4331"],"issn-type":[{"value":"1434-6621","type":"print"},{"value":"1437-4331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,15]]}}}