Editing Hemolysis (section)

==Outside the body==
[[File:Hemolysis.jpg|thumb|Hemolysis of blood samples. Red blood cells without (left and middle) and with (right) hemolysis. If as little as 0.5% of the red blood cells are hemolyzed, the released hemoglobin will cause the [[blood serum|serum]] or [[blood plasma|plasma]] to appear pale red or cherry red in color.<ref>{{Cite web|url=http://www.cdha.nshealth.ca/default.aspx?page=SubPage&centerContent.Id.0=21648&category.Categories.1=411|title=Capital Health}}</ref> Note that the hemolyzed sample appears clearer, because there are significantly fewer cells to scatter light.]]
''[[In vitro]]'' hemolysis can be caused by improper technique during collection of blood specimens, by the effects of mechanical processing of blood, or by bacterial action in cultured blood specimens.

===From specimen collection===
Most causes of ''in vitro'' hemolysis are related to specimen collection. Difficult collections, unsecure line connections, contamination, and incorrect needle size, as well as improper tube mixing and incorrectly filled tubes are all frequent causes of hemolysis.<ref>{{Cite journal|last1=McCaughey|first1=Euan James|last2=Vecellio|first2=Elia|last3=Lake|first3=Rebecca|last4=Li|first4=Ling|last5=Burnett|first5=Leslie|last6=Chesher|first6=Douglas|last7=Braye|first7=Stephen|last8=Mackay|first8=Mark|last9=Gay|first9=Stephanie|date=2017-01-02|title=Key factors influencing the incidence of hemolysis: A critical appraisal of current evidence|journal=Critical Reviews in Clinical Laboratory Sciences|volume=54|issue=1|pages=59–72|doi=10.1080/10408363.2016.1250247|pmid=28013559|s2cid=753640|issn=1040-8363}}</ref> 

''In vitro'' hemolysis during specimen collection can cause inaccurate laboratory test results by contaminating the surrounding plasma with the contents of hemolyzed red blood cells. For example, the concentration of [[potassium]] inside red blood cells is much higher than in the plasma and so an elevated potassium level is usually found in biochemistry tests of hemolyzed blood.

After the blood collection process, ''in vitro'' hemolysis can still occur in a sample due to external factors, such as prolonged storage, incorrect storage conditions and excessive physical forces by dropping or vigorously mixing the tube.

==={{anchor|Mechanical blood processing during surgery}}From mechanical blood processing during surgery===
In some surgical procedures (especially some heart operations) where substantial blood loss is expected, machinery is used for [[intraoperative blood salvage]]. A centrifuge process takes blood from the patient, washes the red blood cells with [[normal saline]], and returns them to the patient's blood circulation. Hemolysis may occur if the centrifuge rotates too quickly (generally greater than 500 rpm)—essentially this is hemolysis occurring outside of the body. Increased hemolysis occurs with massive amounts of sudden blood loss, because the process of returning a patient's cells must be done at a correspondingly higher speed to prevent [[hypotension]], [[pH]] imbalance, and a number of other hemodynamic and blood level factors.  Modeling of fluid flows to predict the likelihood of red cell membrane rupture in response to stress is an active area of research.<ref>{{Cite journal|last1=Faghih|first1=Mohammad M.|last2=Sharp|first2=M. Keith|date=2019-03-07|title=Modeling and prediction of flow-induced hemolysis: a review|journal=Biomechanics and Modeling in Mechanobiology|volume=18|issue=4|pages=845–881|doi=10.1007/s10237-019-01137-1|issn=1617-7940|pmid=30847662|s2cid=73496695}}</ref>

==={{anchor|In microbiology}}From bacteria culture===
{{main|Hemolysis (microbiology)}}
[[File:Streptococcal hemolysis.jpg|thumb|Hemolysis from ''Streptococcus''. Examples of the blood culture patterns created by (from left) alpha-, beta- and gamma-hemolytic streptococci.]]
Visualizing the physical appearance of hemolysis in cultured blood samples may be used as a tool to determine the species of various [[Gram-positive bacteria]] infections (''e.g.'', ''[[Streptococcus]]'').