Abstract：
UNASSIGNED: Intravenous lipid emulsion is used in the rescue treatment of certain poisonings. A complication is interference with laboratory analyses. The aim of this study was to determine the impact of intravenous lipid emulsion on routine laboratory analysis of coagulation parameters ex vivo and determine if any of the analytical techniques remain reliable.
UNASSIGNED: Samples were obtained from 19 healthy volunteers and divided in triplicate. One sample served as a control, and the other two were diluted to simulate the treatment of an average adult with Intralipid® 20 per cent Fresenius Kabi 100 mL (dilution-1) or 500 mL (dilution-2). Coagulation tests performed were prothrombin time, activated prothrombin time, D-dimer concentration and fibrinogen. Coagulation testing was performed by three techniques. Test-1 was performed on a Sysmex CN6000 analyzer. Test-2 was performed with a manual mechanical endpoint method using the semi-automated Stago KC4 Delta. Test-3 involved high-speed centrifugation before repeat testing on the Sysmex CN6000 analyzer.
UNASSIGNED: For test-1, only nine (47 per cent) samples in dilution-1 could be analyzed for coagulation tests, and no coagulation tests could be analyzed for dilution-2 because of lipaemia. For test-2 and test-3, all samples could be analyzed, and all results of both testing methods fell within the limits of the laboratory reference range.
UNASSIGNED: Difficulties in laboratory analysis of patients having received intravenous lipid emulsion are due to multiple factors. Most automated coagulation analyzers use optical measurements, which can be unreliable in the presence of a high intravenous lipid concentration. By altering the lipaemia in the testing solution using high-speed centrifugation or by using manual mechanical endpoint detection, we were able to obtain reliable results. These findings are limited by the use of an ex vivo method and healthy volunteers.
UNASSIGNED: This ex vivo model confirms that Intralipid® interferes with routine coagulation studies. It is important that clinicians are aware and inform their laboratories of its administration.
UNASSIGNED: Samples were obtained from 19 healthy volunteers and divided in triplicate. One sample served as a control, and the other two were diluted to simulate the treatment of an average adult with Intralipid® 20 per cent Fresenius Kabi 100 mL (dilution-1) or 500 mL (dilution-2). Coagulation tests performed were prothrombin time, activated prothrombin time, D-dimer concentration and fibrinogen. Coagulation testing was performed by three techniques. Test-1 was performed on a Sysmex CN6000 analyzer. Test-2 was performed with a manual mechanical endpoint method using the semi-automated Stago KC4 Delta. Test-3 involved high-speed centrifugation before repeat testing on the Sysmex CN6000 analyzer.
UNASSIGNED: For test-1, only nine (47 per cent) samples in dilution-1 could be analyzed for coagulation tests, and no coagulation tests could be analyzed for dilution-2 because of lipaemia. For test-2 and test-3, all samples could be analyzed, and all results of both testing methods fell within the limits of the laboratory reference range.
UNASSIGNED: Difficulties in laboratory analysis of patients having received intravenous lipid emulsion are due to multiple factors. Most automated coagulation analyzers use optical measurements, which can be unreliable in the presence of a high intravenous lipid concentration. By altering the lipaemia in the testing solution using high-speed centrifugation or by using manual mechanical endpoint detection, we were able to obtain reliable results. These findings are limited by the use of an ex vivo method and healthy volunteers.
UNASSIGNED: This ex vivo model confirms that Intralipid® interferes with routine coagulation studies. It is important that clinicians are aware and inform their laboratories of its administration.
摘要：
■静脉内脂肪乳剂用于某些中毒的抢救治疗。一个并发症是干扰实验室分析。这项研究的目的是确定静脉内脂肪乳剂对体外凝血参数的常规实验室分析的影响，并确定是否有任何分析技术仍然可靠。
■从19名健康志愿者获得样品并一式三份。一个样本作为对照,和其他两个被稀释以模拟用Intralipid®20％FreseniusKabi100mL（稀释-1）或500mL（稀释-2）治疗普通成人。凝血试验进行凝血酶原时间，活化凝血酶原时间，D-二聚体浓度和纤维蛋白原。通过三种技术进行凝血测试。测试-1在SysmexCN6000分析仪上进行。使用半自动StagoKC4Delta的手动机械终点方法进行测试-2。测试-3涉及在SysmexCN6000分析仪上重复测试之前的高速离心。
对于测试-1，只有9个（47％）稀释样品可以进行凝血测试，并且由于血脂血症，无法分析稀释-2的凝血测试。对于测试2和测试3，可以分析所有样品，两种测试方法的所有结果均在实验室参考范围内。
■对接受静脉内脂肪乳剂的患者进行实验室分析的困难是由于多种因素造成的。大多数自动凝血分析仪使用光学测量，在静脉内脂质浓度高的情况下，这可能是不可靠的。通过使用高速离心或使用手动机械终点检测来改变测试溶液中的血脂，我们能够获得可靠的结果。这些发现受到使用离体方法和健康志愿者的限制。
■该离体模型证实Intralipid®干扰常规凝血研究。重要的是，临床医生要了解并告知其实验室其管理。
■从19名健康志愿者获得样品并一式三份。一个样本作为对照,和其他两个被稀释以模拟用Intralipid®20％FreseniusKabi100mL（稀释-1）或500mL（稀释-2）治疗普通成人。凝血试验进行凝血酶原时间，活化凝血酶原时间，D-二聚体浓度和纤维蛋白原。通过三种技术进行凝血测试。测试-1在SysmexCN6000分析仪上进行。使用半自动StagoKC4Delta的手动机械终点方法进行测试-2。测试-3涉及在SysmexCN6000分析仪上重复测试之前的高速离心。
对于测试-1，只有9个（47％）稀释样品可以进行凝血测试，并且由于血脂血症，无法分析稀释-2的凝血测试。对于测试2和测试3，可以分析所有样品，两种测试方法的所有结果均在实验室参考范围内。
■对接受静脉内脂肪乳剂的患者进行实验室分析的困难是由于多种因素造成的。大多数自动凝血分析仪使用光学测量，在静脉内脂质浓度高的情况下，这可能是不可靠的。通过使用高速离心或使用手动机械终点检测来改变测试溶液中的血脂，我们能够获得可靠的结果。这些发现受到使用离体方法和健康志愿者的限制。
■该离体模型证实Intralipid®干扰常规凝血研究。重要的是，临床医生要了解并告知其实验室其管理。
