If a specimen appears moderately hemolyzed, which group of analytes can still be run?

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When a specimen is moderately hemolyzed, red blood cell contents spill into the plasma, introducing free hemoglobin and enzymes that can interfere with many assays. This makes results unreliable for tests that rely on colorimetric readings or are sensitive to intracellular components, such as electrolytes and liver enzymes, where potassium and RBC enzymes can skew the values.

Lipid measurements, like those in a lipid panel, are generally tolerant of this kind of interference. The enzymatic colorimetric methods used to quantify cholesterol and triglycerides in plasma rely on lipid substrates present in the circulating serum, and they’re not significantly biased by the presence of free hemoglobin from moderate hemolysis. As a result, results from a moderately hemolyzed specimen can still be reported for the lipid panel.

In contrast, electrolytes (K+, Na+, Mg2+) are specifically affected by hemolysis because potassium and other intracellular ions leak into the serum, giving falsely elevated readings. Liver enzyme panels can show artificial elevations from RBC enzymes released during hemolysis, and bilirubin measurements can be confounded by spectral interference from hemoglobin.