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Hemoglobin Free, Plasma
MessageSendout, Mayo test code: PLHBB
Test Code
LAB92
Alias/See Also
Plasma Free Hemoglobin
Plasma Hemoglobin
PLHBB
Plasma Hemoglobin
PLHBB
CPT Codes
83051
Preferred Specimen
2.0 mL plasma from a lavender EDTA tube.
Minimum Volume
1.5 mL
Instructions
1. Centrifuge and transfer plasma to a plastic vial within 2 hours of collection.
2. Results could be falsely elevated due to artifactual red blood cell lysis if not centrifuged within 2 hours of collection.
2. Results could be falsely elevated due to artifactual red blood cell lysis if not centrifuged within 2 hours of collection.
Transport Container
Plastic vial
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated (preferred): 20 days
Frozen: 30 days
Ambient: 4 days
Frozen: 30 days
Ambient: 4 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis: Mild OK; Gross OK
Lipemia: Mild OK; Gross OK
Icterus: NA
Other: Serum
Lipemia: Mild OK; Gross OK
Icterus: NA
Other: Serum
Methodology
Spectrophotometry (SP)
FDA Status
Approved
Setup Schedule
Monday through Sunday
Report Available
1-3 days
Limitations
Test should not be performed on serum; hemoglobin is liberated from red blood cells during clotting and will falsely increase the result.
Drawing blood specimens for plasma hemoglobin measurement should be done with considerable care to avoid causing hemolysis.
Causes of artifactually increased plasma hemoglobin should be excluded and include: forceful aspiration in sample procurement, cannula malposition (high negative-inflow pressures, inadequate pump speed to blood flow ratio), continuous renal replacement therapy, thrombosis or large hematomas.(1)
Bilirubin is a known interference with this assay. Elevated bilirubin levels significantly interfere with the quantitation of the total plasma hemoglobin. In the presence of elevated bilirubin (>5 mg/dL), only oxyhemoglobin will be reported. Trending data should be compared within analytes (ie, total plasma hemoglobin to total plasma hemoglobin; and oxyhemoglobin to oxyhemoglobin) as these represent different components in the blood. Therefore, in the presence of bilirubin, the trend can only be compared with baseline oxyhemoglobin levels.
If bilirubin is above 5 mg/dL, this comment will be added to the report:
Total plasma hemoglobin not reported due to elevated bilirubin interference. Oxyhemoglobin levels are not affected as significantly by bilirubin levels and are more reliable in this setting. If the plasma hemoglobin test is being utilized in a serial fashion, results should be compared within analyte type (eg, oxyhemoglobin to oxyhemoglobin levels for different time points) and using general trends. Because some variability in this test exists, multiple time points should be used to monitor trends and to confirm wide swings in levels. Because pigmented substances may cause nonspecific interference, clinical correlation is required to establish significance of individual test results.
Drawing blood specimens for plasma hemoglobin measurement should be done with considerable care to avoid causing hemolysis.
Causes of artifactually increased plasma hemoglobin should be excluded and include: forceful aspiration in sample procurement, cannula malposition (high negative-inflow pressures, inadequate pump speed to blood flow ratio), continuous renal replacement therapy, thrombosis or large hematomas.(1)
Bilirubin is a known interference with this assay. Elevated bilirubin levels significantly interfere with the quantitation of the total plasma hemoglobin. In the presence of elevated bilirubin (>5 mg/dL), only oxyhemoglobin will be reported. Trending data should be compared within analytes (ie, total plasma hemoglobin to total plasma hemoglobin; and oxyhemoglobin to oxyhemoglobin) as these represent different components in the blood. Therefore, in the presence of bilirubin, the trend can only be compared with baseline oxyhemoglobin levels.
If bilirubin is above 5 mg/dL, this comment will be added to the report:
Total plasma hemoglobin not reported due to elevated bilirubin interference. Oxyhemoglobin levels are not affected as significantly by bilirubin levels and are more reliable in this setting. If the plasma hemoglobin test is being utilized in a serial fashion, results should be compared within analyte type (eg, oxyhemoglobin to oxyhemoglobin levels for different time points) and using general trends. Because some variability in this test exists, multiple time points should be used to monitor trends and to confirm wide swings in levels. Because pigmented substances may cause nonspecific interference, clinical correlation is required to establish significance of individual test results.
Reference Range
Included with report
Clinical Significance
Determining whether hemolysis is occurring such as from:
-Transfusion reaction
-Mechanical fragmentation of red blood cells
-Relative comparison to baseline levels in extracorporeal membrane oxygenation and centrifugal ventricular assist device patients to assess pump disruption
-Transfusion reaction
-Mechanical fragmentation of red blood cells
-Relative comparison to baseline levels in extracorporeal membrane oxygenation and centrifugal ventricular assist device patients to assess pump disruption
Performing Laboratory
Mayo Clinic Laboratories, Rochester, Minnesota
Additional Information
Plasma Free Hemoglobin, Plasma
