In biochemical tests, it is often seen that the serum in the upper layer of the blood collection tube with separating gel is red after being centrifuged. Which is the rupture of blood cells in the test tube and the escape of hemoglobin. Outside the human body, if the RBC (red blood cells) are in a solution with too low osmotic pressure, water enters the red blood cells, causing swelling and rupture, resulting in hemolysis. Hemolysis in the human body is mainly due to the inherent defects of red blood cells, or due to the presence of auto antibodies, chemicals, snake venoms and other factors in plasma, causing excessive destruction of RBC. So why does hemolysis occur in a test tube containing serum separation gel?

First, let's understand the principle of separating serum and blood clot with separating gel. After the blood sample is put into the test tube, under the action of thrombin factor, fibrinogen is converted into insoluble fibrin filaments which encircled the blood cells to form blood clots and precipitate a part of serum,that is natural coagulate which is difficult to fully coagulate.With characteristic of thixotropy , the separating gel in the tube becomes liquid and flows under the action of centrifugal force. Due to the specific gravity, the blood clot with higher specific gravity settles in the bottom, the lower serum is in the upper layer, and the separating gel is in the middle. After the centrifugal force disappears, the separating gel becomes gel and completely separates the blood clot from the serum. Separating gel is inert, it does not react with anything in the chemical reaction. So it does not change the products of the reaction, nor does it destroy the hemoglobin in the cells. From this point, serum separation gel is not the cause of the destruction of blood cells.

So what are the factors that damage blood cell ?

1. Disinfect with iodine, the alcohol in the iodine is not dry and enters the blood collection tube to cause pollution and destroy red blood cells;

2. Blood collection, if the blood collection volume is insufficient and the pressure is too large, the RBC in the tube will rupture, which cause hemolysis;

3. Transfer the sample to the blood collection tube with a blood collection needle,the blood cells were damaged due to the action of pressure;

4. Invert and mix the blood collection tube about 5 times. If the force is too large, the blood cells will rupture;

5. Centrifuge the sample blood before it has fully reached the time of coagulation.

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