Sysmex Journal International

2007Vol.17 No.1


Automated Quantification of Free Hemoglobin in Hematology Samples


Ian GILES and Krista CURCIO

Sysmex America, Inc.


Detection of cell-free, ( extra-cellular ) hemoglobin in plasma of samples submitted to core laboratories for routine cell counting has potential clinical advantages. The presence of cell-free hemoglobin can indicate significant hemolysis, which could occur either as a consequence of the blood collection process ( in vitro hemolysis ), or could represent the presence of intravascular free hemoglobin.

Intravascular free hemoglobin could be secondary to intravascular hemolysis, or could possibly be due to the administration of hemoglobin-based blood substitute.

Detection of hemoglobin-based blood substitute could soon become important, as these products are currently being used in some countries for enhancing perfusion in hypoxic tissues secondary to severe trauma. Stability and storage requirements make these products an extremely attractive alternative to blood in certain remote clinical settings, and combat zones.

As these products become available, the anti-doping agencies will need to incorporate measurement tools into their testing procedures, in order to screen for the presence of hemoglobin-based blood substitutes.

Detecting significant hemolysis in the sample sent for hematology cell counting, could further alert clinicians to exercise caution when interpreting other results from the same patient.


Extra-cellular Hemoglobin, Cell-free Hemoglobin, Hemoglobin-based Blood Substitutes, Intravascular Hemolysis