Hemolysis: Wikis

  

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Hemolysis. Red blood cells without (left and middle) and with (right) hemolysis. Note that the hemolyzed sample is transparent, because there are no cells to scatter light.

Haemolysis (or hemolysis)—from the Greek Hemo-, Greek Αἷμα meaning blood, -lysis, meaning to break open—is the breaking open of red blood cells and the release of hemoglobin into the surrounding fluid (plasma, in vivo).

Contents

In vivo

In vivo (inside the body) hemolysis, which can be caused by a large number of conditions, can lead to anemia.

Anemias caused by in vivo hemolysis are collectively called hemolytic anemias.

In vitro

In vitro (outside the body) hemolysis can be an important unwanted effect in medical tests and can cause inaccurate results, because the contents of hemolysed red blood cells are included with the plasma. The concentration of potassium inside red blood cells is much higher than in the plasma and so an elevated potassium is usually found in biochemistry tests of hemolysed blood. If as little as 0.5% of the red blood cells are hemolysed the serum will have a visually obvious pinkish colour, due to hemoglobin.

Most causes of In vitro hemolysis are related to specimen collection. Difficult collections, unsecure line connections, contamination, and incorrect needle size, as well as improper tube mixing and incorrectly filled tubes are all frequent causes of hemolysis. Excessive suction can cause the red blood cells to be literally smashed on their way through the hypodermic needle owing to turbulence and physical forces. Such hemolysis is more likely to occur when a patient's veins are difficult to find or when they collapse when blood is removed by a syringe or a modern vacuum tube. Experience and proper technique are key for any phlebotomist or nurse to prevent hemolysis. In vitro hemolysis can also occur in a blood sample owing to prolonged storage or storage in incorrect conditions (ie too hot, too cold).

Mechanical blood processing during surgery

In some surgical procedures (especially some heart operations) where substantial blood loss is expected, machinery is used for intraoperative blood salvage. A centrifuge process takes blood from the patient, washes the red blood cells with normal saline, and returns them to the patient's blood circulation. Hemolysis may occur if the centrifuge rotates too quickly (generally greater than 500 rpm)—essentially this is hemolysis occurring outside of the body. Unfortunately, increased hemolysis occurs with massive amounts of sudden blood loss, because the process of returning a patient's cells must be done at a correspondingly higher speed to prevent hypotension, pH imbalance, and a number of other hemodynamic and blood level factors.

In microbiology

Hemolyses of streptococci. (from left) Alpha, beta and gamma.

Hemolytic patterns of the various Gram positive cocci; Streptococci are differentiated by hemolysis of red blood cells on blood agar (BA) plates.

  • Alpha hemolysis is shown by a greenish halo around the colony and is the result of hemoglobin oxidation to methemoglobin in red blood cells.
  • Beta hemolysis is shown by a clear halo around the colony and is produced by complete hemolysis of the red blood cells.
  • Gamma hemolysis is shown as no hemolysis or discoloration of the blood.

See also

External links








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