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An evaluation of the interference of hydroxycobalamin with chemistry and co-oximetry tests on nine commonly used instruments

Carlsson, Christian J.; Hansen, Heidi E.; Hilsted, Linda; Malm, Johan LU ; Odum, Lars and Szecsi, Pal B. (2011) In Scandinavian Journal of Clinical & Laboratory Investigation 71(5). p.378-386
Abstract
The administration of hydroxocobalamin (OHCob), alone or with sodium thiosulfate, is a standard therapy for cyanide poisoning. OHCob is a red chromophore, and its interference with co-oximetric and colorimetric laboratory measurements has been evaluated in a few conflicting reports. The interference of OHCob was investigated in samples spiked with 10 different concentrations of OHCob (0-1500 mg/L). The concentration of 73 different analytes was measured using nine different analysers (ABL 800 Flex, Advia 1800, Advia Centaur Xp, Architect ci8200, Immulite 2500, Konelab 30i, Modular Analytics SWA, Synchron LX 20 and Vitros 5.1). All instruments yielded some results that were affected by OHCob at concentrations equivalent to a single... (More)
The administration of hydroxocobalamin (OHCob), alone or with sodium thiosulfate, is a standard therapy for cyanide poisoning. OHCob is a red chromophore, and its interference with co-oximetric and colorimetric laboratory measurements has been evaluated in a few conflicting reports. The interference of OHCob was investigated in samples spiked with 10 different concentrations of OHCob (0-1500 mg/L). The concentration of 73 different analytes was measured using nine different analysers (ABL 800 Flex, Advia 1800, Advia Centaur Xp, Architect ci8200, Immulite 2500, Konelab 30i, Modular Analytics SWA, Synchron LX 20 and Vitros 5.1). All instruments yielded some results that were affected by OHCob at concentrations equivalent to a single therapeutic dose. Of the 73 different analytes, 64% showed interference on at least one instrument. Of all 187 tests performed, 47% were biased with more than 10%. Interference was generally limited to photometric assays, whereas immunological and ion-selective electrode measurements were unaffected. OHCob present in the blood after treatment for cyanide poisoning interfered with many laboratory assays in an unpredictable way, making some results invalid. Some affected tests are important in the treatment of cyanide poisoning. The interference is not solely due to wavelength, but also to chemical interaction. Without delaying the administration of OHCob, blood should, preferably, be drawn in advance, or, at least, the laboratory should be informed about the OHCob treatment. If the laboratory receives OHCob-containing samples, methods and instruments should be selected to minimize bias, and the manufacturer of the OHCob should recommend relevant precautions to customers in the package insert. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clinical chemistry tests, cyanide, hydroxocobalamin, interference, spectrophotometry
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
71
issue
5
pages
378 - 386
publisher
Informa Healthcare
external identifiers
  • wos:000293743200004
  • scopus:80051747344
ISSN
1502-7686
DOI
10.3109/00365513.2011.573573
language
English
LU publication?
yes
id
63efb8cd-ca7c-4543-b86f-55894e4e0f30 (old id 2162296)
date added to LUP
2011-10-03 08:41:02
date last changed
2017-10-08 04:01:29
@article{63efb8cd-ca7c-4543-b86f-55894e4e0f30,
  abstract     = {The administration of hydroxocobalamin (OHCob), alone or with sodium thiosulfate, is a standard therapy for cyanide poisoning. OHCob is a red chromophore, and its interference with co-oximetric and colorimetric laboratory measurements has been evaluated in a few conflicting reports. The interference of OHCob was investigated in samples spiked with 10 different concentrations of OHCob (0-1500 mg/L). The concentration of 73 different analytes was measured using nine different analysers (ABL 800 Flex, Advia 1800, Advia Centaur Xp, Architect ci8200, Immulite 2500, Konelab 30i, Modular Analytics SWA, Synchron LX 20 and Vitros 5.1). All instruments yielded some results that were affected by OHCob at concentrations equivalent to a single therapeutic dose. Of the 73 different analytes, 64% showed interference on at least one instrument. Of all 187 tests performed, 47% were biased with more than 10%. Interference was generally limited to photometric assays, whereas immunological and ion-selective electrode measurements were unaffected. OHCob present in the blood after treatment for cyanide poisoning interfered with many laboratory assays in an unpredictable way, making some results invalid. Some affected tests are important in the treatment of cyanide poisoning. The interference is not solely due to wavelength, but also to chemical interaction. Without delaying the administration of OHCob, blood should, preferably, be drawn in advance, or, at least, the laboratory should be informed about the OHCob treatment. If the laboratory receives OHCob-containing samples, methods and instruments should be selected to minimize bias, and the manufacturer of the OHCob should recommend relevant precautions to customers in the package insert.},
  author       = {Carlsson, Christian J. and Hansen, Heidi E. and Hilsted, Linda and Malm, Johan and Odum, Lars and Szecsi, Pal B.},
  issn         = {1502-7686},
  keyword      = {Clinical chemistry tests,cyanide,hydroxocobalamin,interference,spectrophotometry},
  language     = {eng},
  number       = {5},
  pages        = {378--386},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {An evaluation of the interference of hydroxycobalamin with chemistry and co-oximetry tests on nine commonly used instruments},
  url          = {http://dx.doi.org/10.3109/00365513.2011.573573},
  volume       = {71},
  year         = {2011},
}