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Lee HT, Lee SY, Seo JY, Ahn JY. Short-Term (6 Weeks) Experience of a Modular Workcell for Hemostasis Testing Including an Intelligent Data Manager at a Tertiary Care Hospital. Lab Med 2023; 54:495-501. [PMID: 36728171 DOI: 10.1093/labmed/lmac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Modular workcells could be a better solution than total laboratory automation (TLA) in hemostasis laboratories. Here, we evaluated the impact of implementing a modular workcell (HemoCell) with an intelligent data management facility (HemoHub). METHODS We compared the turnaround times (TATs), numbers of rerun samples, and rerun times pre- and postimplementation of the HemoCell at Gil Medical Center. Prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, and fibrinogen were evaluated. RESULTS The TAT standard deviations (SDs) and maximum TAT values decreased after HemoCell implementation, although the mean TATs for PT, aPTT, and D-dimer were increased. Numbers of rerun samples were increased (18.1/day vs 44.7/day). However, rerun times were reduced, and SDs were decreased during the post-HemoCell period compared with pre-HemoCell. Additionally, technologists needed smaller working space and less labor. CONCLUSION The modular workcell could improve quality and efficiency by providing more consistent TATs and shorter rerun times in the hemostasis laboratory.
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Affiliation(s)
- Hwan Tae Lee
- Department of Laboratory Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- Department of Laboratory Medicine, BS Hospital, Incheon, Republic of Korea
| | - So Young Lee
- Department of Laboratory Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Ja Young Seo
- Department of Laboratory Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeong-Yeal Ahn
- Department of Laboratory Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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2
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Ieko M, Komiyama Y, Yamazaki S, Katagiri H, Shimazu C, Naito S, Matsuda M, Yuki Y, Miyata K, Arai R, Kumano O, Emmi M, Yoshida T, Tanaka H, Okuhara T, Yamashita T, Sekine Y, Homma M, Kawai Y, Tohyama K, Ieko M, Komiyama Y, Yamazaki S, Katagiri H, Shimazu C, Naito S, Matsuda M, Yuki Y, Miyata K, Arai R, Kumano O, Emmi M, Yoshida T, Tanaka H, Okuhara T, Yamashita T, Sekine Y, Homma M, Kawai Y, Tohyama K. Expert consensus regarding standardization of sample preparation for clotting time assays. Int J Hematol 2020; 112:614-620. [PMID: 32929688 DOI: 10.1007/s12185-020-02983-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/31/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022]
Abstract
Accurate clotting time assay results are vital, as the test is employed to indicate the amount of oral anticoagulant to be prescribed, while it is also used for screening the hemorrhagic and thrombotic diseases. The procedure chosen for preparation of a patient blood sample including centrifugation can contribute to significant differences in the results obtained. Thus, for the purpose of proposing a standardized method to appropriately prepare blood samples prior to assay, the Japanese Society of Laboratory Hematology organized the Working Group for Standardization of Sample Preparation for Clotting Time Assays (WG). Following reviews of previously announced guidelines and original experimental results, consensus was obtained by the WG, with the main findings as follows. (1) The recommended anticoagulant in the blood collection tube is sodium citrate solution at 0.105-0.109 M (3.13-3.2%). (2) Whole blood samples should be stored at room temperature (18-25 ˚C) within 1 h of collection from the patient. (3) For plasma preparation, centrifugation at 1500 × g should be performed for at least 15 min or at 2000 × g for at least 10 min at room temperature. (4) After the plasma sample is prepared, it should be stored at room temperature and assayed within 4 h.
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Affiliation(s)
- Masahiro Ieko
- Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, 1757-Kanazawa, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan.
| | - Yutaka Komiyama
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan
| | - Satoshi Yamazaki
- Department of Clinical Laboratory, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | | | - Chisato Shimazu
- Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Sumiyoshi Naito
- Department of Clinical Laboratory, Health Sciences University of Hokkaido Hospital, Ishikari-Tobetsu, Japan
| | - Masato Matsuda
- Medical Laboratory Division, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoichi Yuki
- Faculty of Clinical Laboratory, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Rika Arai
- General Hospital Products Group, Terumo Corporation, Tokyo, Japan
| | - Osamu Kumano
- Protein Technology, Engineering 1, Sysmex Corporation, Kobe, Japan
| | - Mari Emmi
- Product Strategy Department, Diagnostics Division Business Management Unit, Sekisui Medical Co. Ltd., Tokyo, Japan
| | - Tatsuya Yoshida
- Research and Development Department, IVD Business Segment, LSI Medience Corporation, Tokyo, Japan
| | | | | | - Tetsuji Yamashita
- Business Management Division, Clinical Laboratory Business Segment, LSI Medience Corporation, Tokyo, Japan
| | - Yasuji Sekine
- Kohtohbiken Medical Laboratories Inc., Tukuba, Japan
| | - Masaru Homma
- Mitsukoshi Health and Welfare Foundation, Tokyo, Japan
| | - Yohko Kawai
- International University of Health and Welfare, Sanno-Affiliated Hospital, Tokyo, Japan
| | - Kaoru Tohyama
- Department of Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan
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Boissier E, Lakhal K, Talon L, Senage T, Rozec B, Roussel JC, Sinegre T, Lebreton A. The centrifuge brake impacts neither routine coagulation assays nor platelet count in platelet-poor plasma. Clin Chem Lab Med 2020; 58:e185-e188. [PMID: 32069229 DOI: 10.1515/cclm-2019-1273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/17/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Elodie Boissier
- Service d'Hématologie Biologique, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Karim Lakhal
- Service d'Anesthésie-réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Laurie Talon
- Service d'Hématologie Biologique, CHU Clermont-Ferrand, Hôpital Estaing, Clermont-Ferrand, France
| | - Thomas Senage
- Service de chirurgie thoracique et cardiovasculaire, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Bertrand Rozec
- Service d'Anesthésie-réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean-Christian Roussel
- Service de chirurgie thoracique et cardiovasculaire, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Thomas Sinegre
- Service d'Hématologie Biologique, CHU Clermont-Ferrand, Hôpital Estaing, Clermont-Ferrand, France
| | - Aurélien Lebreton
- Service d'Hématologie Biologique, CHU Clermont-Ferrand, Hôpital Estaing, Clermont-Ferrand, France
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Arnold JE, Camus MS, Freeman KP, Giori L, Hooijberg EH, Jeffery U, Korchia J, Meindel MJ, Moore AR, Sisson SC, Vap LM, Cook JR. ASVCP Guidelines: Principles of Quality Assurance and Standards for Veterinary Clinical Pathology (version 3.0): Developed by the American Society for Veterinary Clinical Pathology's (ASVCP) Quality Assurance and Laboratory Standards (QALS) Committee. Vet Clin Pathol 2020; 48:542-618. [PMID: 31889337 DOI: 10.1111/vcp.12810] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Melinda S Camus
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | | | - Luca Giori
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Emma H Hooijberg
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Unity Jeffery
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jérémie Korchia
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, USA
| | | | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sandra C Sisson
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Linda M Vap
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Sakurai S, Kato H, Yoshida Y, Sugawara Y, Fujisawa M, Yasumoto A, Matsumoto M, Fujimura Y, Yatomi Y, Nangaku M. Profiles of Coagulation and Fibrinolysis Activation-Associated Molecular Markers of Atypical Hemolytic Uremic Syndrome in the Acute Phase. J Atheroscler Thromb 2019; 27:353-362. [PMID: 31484852 PMCID: PMC7192816 DOI: 10.5551/jat.49494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aim: Atypical hemolytic uremic syndrome (aHUS), characterized by thrombotic microangiopathy (TMA), is a genetic, life-threatening disease which needs many differential diagnoses. This study aimed to reveal coagulation and fibrinolysis profiles in aHUS and secondary TMA patients. Furthermore, we investigated whether aHUS patients progress to, and meet, disseminated intravascular coagulation (DIC) criteria. Methods: The acute phase samples were available in 15 aHUS and 20 secondary TMA patients. We measured PT-ratio, activated partial thromboplastin time (APTT), fibrinogen, fibrin degradation product (FDP), fibrin monomer complex (FMC), antithrombin (AT), plasmin-α2 plasmin inhibitor complex (PIC), and von Willebrand factor antigen (VWF:Ag). We examined and compared these tests among aHUS, secondary TMA patients, and healthy volunteer (HV), and evaluated whether patients with aHUS and secondary TMA met DIC criteria. Results: PT-ratio, APTT, FDP, FMC and PIC in patients with aHUS and secondary TMA were higher than those in HV. Fibrinogen and AT showed no significant difference among three groups. VWF:Ag was higher in only aHUS patients. No tests showed significant difference between aHUS and secondary TMA patients. Three aHUS patients out of 15 met DIC criteria. Conclusion: We revealed the profiles and distributions of coagulation and fibrinolysis tests of aHUS and secondary TMA patients. All tests were enhanced compared to HV; however, our results showed the no specificities in distinguishing aHUS from secondary TMA patients. We also clarified that some aHUS patients fulfilled DIC diagnostic criteria, indicating that DIC itself cannot be an exclusion criterion of aHUS.
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Affiliation(s)
- Satoko Sakurai
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
| | - Hideki Kato
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
| | - Yoko Yoshida
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
| | - Yuka Sugawara
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
| | - Madoka Fujisawa
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
| | - Atsushi Yasumoto
- Department of Clinical Laboratory Medicine, the University of Tokyo Graduate School of Medicine
| | | | | | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, the University of Tokyo Graduate School of Medicine
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine
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6
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Zhang L, Du J, Zhang J, Yang J, Zhang Z. A new preanalytical factor: conveyor transport influences residual platelet concentrations. Clin Chem Lab Med 2019; 57:e162-e164. [PMID: 30485174 DOI: 10.1515/cclm-2018-1102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/25/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Litao Zhang
- Department of Pathology and Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, P.R. China
| | - Jia Du
- Department of Pathology and Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, P.R. China
| | - Jiali Zhang
- Department of Pathology and Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, P.R. China
| | - Jun Yang
- Department of Pathology and Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, P.R. China
| | - Zhenlu Zhang
- Department of Pathology and Clinical Laboratory, Wuhan Asia Heart Hospital, No. 753 Jinghan Avenue, Wuhan 430022, P.R. China, Phone: +86 27 65796739, Fax: +86 27 85854036
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7
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Lippi G, Da Rin G. Advantages and limitations of total laboratory automation: a personal overview. ACTA ACUST UNITED AC 2019; 57:802-811. [DOI: 10.1515/cclm-2018-1323] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/14/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Automation is considered one of the most important breakthroughs in the recent history of laboratory diagnostics. In a model of total laboratory automation (TLA), many analyzers performing different types of tests on different sample matrices are physically integrated as modular systems or physically connected by assembly lines. The opportunity to integrate multiple diagnostic specialties to one single track seems effective to improve efficiency, organization, standardization, quality and safety of laboratory testing, whilst also providing a significant return of investment on the long-term and enabling staff requalification. On the other hand, developing a model of TLA also presents some potential problems, mainly represented by higher initial costs, enhanced expenditure for supplies, space requirements and infrastructure constraints, staff overcrowding, increased generation of noise and heat, higher risk of downtime, psychological dependence, critical issues for biospecimen management, disruption of staff trained in specific technologies, along with the risk of transition toward a manufacturer’s-driven laboratory. As many ongoing technological innovations coupled with the current scenario, profoundly driven by cost-containment policies, will promote further diffusion of laboratory automation in the foreseeable future, here we provide a personal overview on some potential advantages and limitations of TLA.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry , University Hospital of Verona , Piazzale LA Scuro , 37134 Verona , Italy
| | - Giorgio Da Rin
- Laboratory Medicine , San Bassiano Hospital , Bassano del Grappa , Italy
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8
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Abstract
Hemostasis testing is critical to many hemorrhagic and thrombotic disorders, wherein laboratory diagnostics can provide critical information for diagnosis, prognostication, and therapeutic monitoring. Due to this crucial role in modern medicine, hemostasis tests should be carried out at their highest degree of quality, thus encompassing standardization and monitoring of all phases of the testing process. It is now clearly established that the preanalytical phase is the most critical and vulnerable part of the total testing process, since up to 70% of diagnostic errors are due to highly manual activities encompassing patient preparation and collection of biological samples, as well as handling, transportation, preparation and storage of blood specimens. Due to the peculiar sample matrix required for hemostasis testing (i.e., plasma anticoagulated with buffered sodium citrate), additional critical issues may impair the reliability of these tests. Therefore, this article aims to provide an updated overview of the most important preanalytical variables that may ultimately impair the quality of hemostasis and thrombosis testing.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Piazzale LA Scuro, 10, Verona, 37134, Italy.
| | - Emmanuel J Favaloro
- Haematology Department, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, NSW Health Pathology, Westmead, NSW, 2145, Australia
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9
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Magnette A, Chatelain M, Chatelain B, Ten Cate H, Mullier F. Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories. Thromb J 2016; 14:49. [PMID: 27999475 PMCID: PMC5154122 DOI: 10.1186/s12959-016-0123-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 12/01/2016] [Indexed: 11/10/2022] Open
Abstract
Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results. Pre-analytical errors may occur throughout the testing process and arise from unsuitable, inappropriate or wrongly handled procedures. Problems may arise during the collection of blood specimens such as misidentification of the sample, use of inadequate devices or needles, incorrect order of draw, prolonged tourniquet placing, unsuccessful attempts to locate the vein, incorrect use of additive tubes, collection of unsuitable samples for quality or quantity, inappropriate mixing of a sample, etc. Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage. Laboratory errors can often have serious adverse consequences. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can also have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as "diagnostic". Controlling pre-analytical variables is critical since this has a direct influence on the quality of results and on their clinical reliability. The accurate standardization of the pre-analytical phase is of pivotal importance for achieving reliable results of coagulation tests and should reduce the side effects of the influence factors. This review is a summary of the most important recommendations regarding the importance of pre-analytical factors for coagulation testing and should be a tool to increase awareness about the importance of pre-analytical factors for coagulation testing.
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Affiliation(s)
- A Magnette
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), NARILIS, Haematology Laboratory, B-5530 Yvoir, Belgium
| | - M Chatelain
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), NARILIS, Haematology Laboratory, B-5530 Yvoir, Belgium
| | - B Chatelain
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), NARILIS, Haematology Laboratory, B-5530 Yvoir, Belgium
| | - H Ten Cate
- Maastricht University Medical Centre and Cardiovascular Research Institute (CARIM), Department of Internal Medicine, Maastricht, The Netherlands
| | - F Mullier
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), NARILIS, Haematology Laboratory, B-5530 Yvoir, Belgium
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Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, Kristensen GB, Ibarz M, Panteghini M, Plebani M, Nybo M, Smellie S, Zaninotto M, Simundic AM. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med 2016; 53:357-70. [PMID: 25490032 DOI: 10.1515/cclm-2014-1051] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 10/28/2014] [Indexed: 11/15/2022]
Abstract
Laboratory diagnostics develop through different phases that span from test ordering (pre-preanalytical phase), collection of diagnostic specimens (preanalytical phase), sample analysis (analytical phase), results reporting (postanalytical phase) and interpretation (post-postanalytical phase). Although laboratory medicine seems less vulnerable than other clinical and diagnostic areas, the chance of errors is not negligible and may adversely impact on quality of testing and patient safety. This article, which continues a biennial tradition of collective papers on preanalytical quality improvement, is aimed to provide further contributions for pursuing quality and harmony in the preanalytical phase, and is a synopsis of lectures of the third European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled 'Preanalytical quality improvement. In pursuit of harmony' (Porto, 20-21 March 2015). The leading topics that will be discussed include unnecessary laboratory testing, management of test request, implementation of the European Union (EU) Directive on needlestick injury prevention, harmonization of fasting requirements for blood sampling, influence of physical activity and medical contrast media on in vitro diagnostic testing, recent evidence about the possible lack of necessity of the order of draw, the best practice for monitoring conditions of time and temperature during sample transportation, along with description of problems emerging from inappropriate sample centrifugation. In the final part, the article includes recent updates about preanalytical quality indicators, the feasibility of an External Quality Assessment Scheme (EQAS) for the preanalytical phase, the results of the 2nd EFLM WG-PRE survey, as well as specific notions about the evidence-based quality management of the preanalytical phase.
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12
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Lesche D, Geyer R, Lienhard D, Nakas CT, Diserens G, Vermathen P, Leichtle AB. Does centrifugation matter? Centrifugal force and spinning time alter the plasma metabolome. Metabolomics 2016; 12:159. [PMID: 27729833 PMCID: PMC5025507 DOI: 10.1007/s11306-016-1109-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/23/2016] [Indexed: 03/28/2023]
Abstract
BACKGROUND Centrifugation is an indispensable procedure for plasma sample preparation, but applied conditions can vary between labs. AIM Determine whether routinely used plasma centrifugation protocols (1500×g 10 min; 3000×g 5 min) influence non-targeted metabolomic analyses. METHODS Nuclear magnetic resonance spectroscopy (NMR) and High Resolution Mass Spectrometry (HRMS) data were evaluated with sparse partial least squares discriminant analyses and compared with cell count measurements. RESULTS Besides significant differences in platelet count, we identified substantial alterations in NMR and HRMS data related to the different centrifugation protocols. CONCLUSION Already minor differences in plasma centrifugation can significantly influence metabolomic patterns and potentially bias metabolomics studies.
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Affiliation(s)
- Dorothea Lesche
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, INO F, 3010 Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Roland Geyer
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, INO F, 3010 Bern, Switzerland
| | - Daniel Lienhard
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, INO F, 3010 Bern, Switzerland
| | - Christos T. Nakas
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, INO F, 3010 Bern, Switzerland
- Laboratory of Biometry, University of Thessaly, Volos, Greece
| | - Gaëlle Diserens
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- Departments of Clinical Research and Radiology (AMSM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Vermathen
- Departments of Clinical Research and Radiology (AMSM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander B. Leichtle
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, INO F, 3010 Bern, Switzerland
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Abstract
The impact of laboratory medicine on clinical cardiology has dramatically increased over the years and a lot of cardiovascular biomarkers have been recently proposed. In order to avoid clinical mistakes, physicians should be well aware of all the aspects, which could affect the quality of laboratory results, remembering that pre-analytic variability is an often overlooked significant source of bias, determining the vast majority of laboratory errors. This review addresses the determinants of pre-analitycal variability in cardiovascular biomarker testing, focusing on the most widespread biomarkers, which are cardiac troponins and natriuretic peptides.
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Affiliation(s)
- Roberto Cemin
- 1 Department of Cardiology, San Maurizio Regional Hospital of Bolzano, Bolzano, Italy ; 2 Clinical Pathology Laboratory, Hospital of Merano, Merano, Italy
| | - Massimo Daves
- 1 Department of Cardiology, San Maurizio Regional Hospital of Bolzano, Bolzano, Italy ; 2 Clinical Pathology Laboratory, Hospital of Merano, Merano, Italy
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