Review · Volume 12, Issue 2 · pp. 230-236

A Narrative Review on the Preanalytical Sample Errors in the Hematology Section of Clinical Laboratory

Lissa Lourein Villanueva Lorque¹, Kristel Aryanna Mendiola Bonifacio¹, Irish Gonzales Padilla¹, Marie Isabelle Sandoval Panganiban¹, Asela Gabrielle Arcangel Persia¹, Rochel Diaz Tsai¹, Reymund Miguel Mabbagu¹

¹School of Medical Laboratory Science, Far Eastern University – Dr. Nicanor Reyes Medical Foundation, PHILIPPINES.

Abstract

Background: Various errors may occur during the preanalytical phase of laboratory testing and can introduce inaccuracies that can compromise test findings, which creates a significant concern for both clinicians and patients. This narrative review aims to: (1) Determine the sources of the preanalytical error in the hematology section, (2) Identify the impact of these errors, and (3) Enumerate the strategies to minimize these errors.Materials and Methods: The search for articles and journals was conducted between March 10, 2023, to March 12, 2023, using Google Scholar and PubMed as the database and the SANRA method as the instrumental tool for inclusion and exclusion criteria. Among the 161 total journal studies, 8 journals were considered and analyzed in depth.Results: The most common preanalytical errors determined in this review are: insufficient blood samples, clotted blood samples, hemolyzed samples, and other errors such as transportation delays and wrong patient information. Insufficient samples may prolong the clotting time, a low reading of hematocrit and MCV, and a high MCHC. Whereas, overfilled samples may produce false positive results for polycythemia, thrombocytopenia, and leukopenia. A clotted sample causes damage to the cell and consumption of the coagulation factor, which can affect readings on Complete Blood Count, Blood gases, Coagulation, and the Erythrocyte Sedimentation Rate. A hemolyzed sample affects tests for hemostasis considerably, affecting the results of the Prothrombin Time, activated Prothrombin Time, D-dimer tests, and the levels of antithrombin and fibrinogen.Conclusion: Insufficient phlebotomy skills and specimen preparation contribute to the different preanalytical errors that may cause erroneous results in hematology testing. These errors can result in patient misdiagnosis, incorrect treatment plans, and poor patient outcomes. Proper specimen collection, handling, and transportation should be done to minimize these preanalytic errors.

Keywords: Blood collection; Clotted samples; Hemolyzed samples; Insufficient samples; Phlebotomy

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