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CBC's on Lipemic Patients


kimg

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We prefer doing a plasma blank as opposed to saline replacement. 

A lot of times we can correct for Lipemia with a 1:5 dilution when we can't we do the following.

Plasma Blank:

  • If severe lipemia is present, spin an aliquot of the patient’s blood at 3400 rpm for 10 minutes.
  • Remove the plasma to a small glass tube and run this “plasma blank” in manual mode to obtain the Hgb value for the plasma.
  • Calculate the corrected Hgb:
    • Corrected Hgb = Whole blood Hgb - ((1-Spun Hct) X Plasma Hgb)

  • Use the corrected Hgb and original RBC result to recalculate the MCH and MCHC as required.

 

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By performing the saline replacement, there are no calculations necessary.  All parameters can be used as reported by the instrument.  The WBC, RBC, and platelet counts can be checked against the original to make sure you didn't over or under-replace too much plasma.

Our lab used to have a policy allowing for both methods.  We discovered we were getting the exact same results with the saline replacement and got rid of the messy math.

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