Journal: EJHaem
Article Title: Supply chain disruptions due to the SARS‐CoV‐2 pandemic lead to an unusual preanalytical error in measuring hemoglobin concentration in a large medical center
doi: 10.1002/jha2.626
Figure Lengend Snippet: (a) Number of HERO notifications in four consecutive months (Jan‐April 2022) for variable Hg shows an unprecedented increase in April. (b, c) Marked variations in Hg concentration estimated by the Sysmex XN‐9100 analyzer (arrows) in consecutive days for two different patients, respectively. (d) Correlation of variable Hg estimated by Sysmex XN‐9100 analyzer, Radiometer ABL800 Flex, and microhematocrit (spun hematocrit). On 4/23/2022, Sysmex analyzers XN‐905 and XN‐906 resulted Hb 10.4 g/dl, similar to Hb 10.8 g/dl estimated with Radiometer ABL‐927 and Hb ∼10 g/dl with the microhematocrit. The variation of Hb 5 g/dl on 4/24/2022 and Hb 6.3 g/dl on 4/25/2022 were also concordant among the three methodologies, suggesting that the changes were preanalytical. The RBC, HTC, MCV, MCH, MCHC, WBC, platelet count (Plt), plasma condition, and Delta differential are also indicated with no overt discrepancy in different days. (e) Original collection (one step): BD Vacutainers Luer‐Lok Access blood transfer device also known as “blue vacutainer barrel” (left panel) are usually employed to collect venous blood when it attaches to the IV connector (bracket) of the central lines, into Vacutainers tubes (right panel). (f) Alternative collection (two steps) or “syringe draw method”: substitute BD Vacutainer Female Luer Adapter device also known as “pink vacutainer barrel” (left panel). Initially, 10‐ml syringes (middle panel) are attached to the IV connector (bracket) of the central lines to collect blood. Then, they are attached to the pink vacutainer barrel with transfer of blood to Vacutainer tubes (right panel).
Article Snippet: In addition, all Sysmex XN‐9100 analyzers passed measurement of Hg concentration based on daily three shifts Sysmex QC, Sysmex Peer report, Sysmex XbarM report, Delta checks, Instrument correlations, and recent CAP surveys.
Techniques: Concentration Assay
