What is the best course of action for a 2-hour-old citrated blood sample that is slightly hemolyzed?

When dealing with a 2-hour-old citrated blood sample that is slightly hemolyzed, the best course of action is to consider how the components of the sample might affect the test results. The concern with hemolysis is that it can release intracellular components into the serum, potentially interfering with various assays, including creatine kinase (CK).

In the case of a CK assay, hemolysis can markedly influence the measured CK levels by falsely elevating them due to the release of CK from red blood cells. Therefore, if the sample is slightly hemolyzed, it is prudent to reject it specifically because of the hemolysis effect, which poses a risk of inaccurate results.

Citrate, as an anticoagulant, does not interfere with CK assays under normal circumstances; however, the presence of hemolysis introduces potential inaccuracies that are much more significant than any concerns that might arise from citrate itself. This makes it essential to ensure that samples are not compromised.

Hence, rejecting the sample due to hemolysis is appropriate for ensuring the reliability of the test outcomes.