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Mattiello CJ, Stickle DF. Jerk (d(acceleration)/dt) as an operative variable in pneumatic tube transport (PTT). Lab Med 2024:lmae055. [PMID: 39023241 DOI: 10.1093/labmed/lmae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Jerk, the rate of change of acceleration (d(acceleration)/dt), is a known operative variable in public transportation safety, but this term has never appeared in the literature regarding pneumatic tube transport (PTT) and specimen integrity. We investigated profiles of acceleration and jerk for 2 PTT routes within our hospital system. METHODS Acceleration data were collected for PTT for 2 routes (A, B) using an accelerometer. Acceleration vectors (a) were analyzed in terms of distributions of jerk (da/dt), and distributions of θ, the angle between successive acceleration vectors. RESULTS Routes A and B had transit times of approximately 300 s. Acceleration vectors (a) ranged in magnitude from 0 to 8 g. For B, a > 1.2 g comprised 29.0% of results, compared to 13.5% of results for A (ratio = 2.1). Jerk ranged from 0 to 94 g/s. For B, jerk > 0.5 g/s comprised 71.9% of results, compared to 32.5% of results for A (ratio = 2.2). θ ranged from 0 to 180 degrees. For B, θ > 5 degrees comprised 59.3% of results, compared to 26.6% of results for A (ratio = 2.2). CONCLUSION Differences in distribution in acceleration, jerk, and θ ran in parallel as variables for comparison between 2 PTT routes. Jerk and θ are likely to be operative variables in effects of PTT.
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Affiliation(s)
| | - Douglas F Stickle
- Department of Pathology, Jefferson University Hospital, Philadelphia, PA, USA
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2
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Obel LM, Adelborg K, Pottegård A, Sørensen HT, Nybo M. Considerations for the use of biochemical laboratory registry data in clinical and public health research. J Clin Epidemiol 2024; 170:111337. [PMID: 38556100 DOI: 10.1016/j.jclinepi.2024.111337] [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] [Received: 10/27/2023] [Revised: 03/17/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES To inform researchers of central considerations and limitations when applying biochemical laboratory-generated registry data in clinical and public health research. STUDY DESIGN AND SETTING After review of literature on registry-based studies and the utilization of clinical laboratory registry data, relevant paragraphs and their applicability toward the creation of considerations for the use of biochemical registry data in research were evaluated. This led to the creation of an initial ten considerations. These were elaborated, edited, and merged after several read-throughs by all authors and discussed thoroughly under influence by the authors' personal experiences with laboratory databases and research registries in Denmark, leading to the formulation of five central considerations with corresponding items and illustrative examples. RESULTS We recommend that the following considerations should be addressed in studies relying on biochemical laboratory-generated registry data: why are biochemical laboratory data relevant to examine the hypothesis, and how were the variable(s) utilized in the study? What were the primary indications for specimen collection in the study population of interest? Were there any pre-analytical circumstances that could influence the test results? Are data comparable between producing laboratories and within the single laboratory over time? Is the database representative in terms of completeness of study populations and key variables? CONCLUSION It is crucial to address key errors in laboratory registry data and acknowledge potential limitations.
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Affiliation(s)
- Lasse M Obel
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense Denmark.
| | - Kasper Adelborg
- Department of Clinical Biochemistry, Gødstrup Regional Hospital, Herning, Denmark; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Anton Pottegård
- Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Mads Nybo
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense Denmark
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Lippi G, Mattiuzzi C, Favaloro EJ. Artificial intelligence in the pre-analytical phase: State-of-the art and future perspectives. J Med Biochem 2024; 43:1-10. [PMID: 38496022 PMCID: PMC10943465 DOI: 10.5937/jomb0-45936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 03/19/2024] Open
Abstract
The use of artificial intelligence (AI) has become widespread in many areas of science and medicine, including laboratory medicine. Although it seems obvious that the analytical and post-analytical phases could be the most important fields of application in laboratory medicine, a kaleidoscope of new opportunities has emerged to extend the benefits of AI to many manual labor-intensive activities belonging to the pre-analytical phase, which are inherently characterized by enhanced vulnerability and higher risk of errors. These potential applications involve increasing the appropriateness of test prescription (with computerized physician order entry or demand management tools), improved specimen collection (using active patient recognition, automated specimen labeling, vein recognition and blood collection assistance, along with automated blood drawing), more efficient sample transportation (facilitated by the use of pneumatic transport systems or drones, and monitored with smart blood tubes or data loggers), systematic evaluation of sample quality (by measuring serum indices, fill volume or for detecting sample clotting), as well as error detection and analysis. Therefore, this opinion paper aims to discuss the state-of-the-art and some future possibilities of AI in the preanalytical phase.
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Affiliation(s)
- Giuseppe Lippi
- University of Verona, Section of Clinical Biochemistry and School of Medicine, Verona, Italy
| | - Camilla Mattiuzzi
- Hospital of Rovereto, Provincial Agency for Social and Sanitary Services (APSS), Medical Direction, Trento, Italy
| | - Emmanuel J. Favaloro
- Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, Department of Haematology, NSW Health Pathology, Westmead Hospital, Westmead, NSW Australia
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Makhlouf R, Fendri S, Jallouli D, Labiadh Z, Fritis L, Chaabouni K, Elleuch A, Ayadi FM. Influence of pneumatic tube delivery system on laboratory results. Ann Clin Biochem 2023:45632231213743. [PMID: 37921518 DOI: 10.1177/00045632231213743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
INTRODUCTION The pneumatic tube system (PTS) is an automated and fast modality of transportation of biological samples, but it has been reported to induce preanalytical errors. AIM To study the influence of transportation by PTS on biochemistry tests which are particularly sensitive to haemolysis and atmospheric pressure variation. MATERIALS AND METHODS We compared laboratory results of arterial blood gas, sodium, potassium, chloride, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, glucose and haemolysis index of samples conveyed simultaneously by PTS and by courier. RESULTS We recruited 30 patients from the sampling room and 40 patients from the intensive care unit. Transport through PTS resulted in a significant increase in aspartate aminotransferase and potassium without exceeding the limits of acceptability. Potassium was significantly more increased for samples transported in a higher speed line (p = .048) but without exceeding the limits of acceptability. No significant impact was noted on haemolysis indices. The pO2 variations due to PTS transportation exceeded the limit of acceptability with significant intra-individual variations. CONCLUSION Our PTS is validated for biochemistry tests results. It reduces turnaround times without affecting sample quality. However, the interpretation of arterial blood gas results should be careful for samples transported by PTS.
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Affiliation(s)
- Rihab Makhlouf
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
| | - Sana Fendri
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
| | - Dana Jallouli
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
| | - Zeinab Labiadh
- Higher School of Health Sciences and Techniques of Sfax, University of Sfax, Tunisia
| | - Lotfi Fritis
- Biomedical Department, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Khansa Chaabouni
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
| | - Aida Elleuch
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
| | - Fatma Makni Ayadi
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia
- Research Laboratory LR19ES13 Medicine school of Sfax, University of Sfax, Tunisia
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5
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Bowen RAR, Esguerra V, Arboleda E, Cheng P, Hu B. Impact of blood collection devices and mode of transportation on peripheral venous blood gas parameters. Clin Chim Acta 2023; 548:117464. [PMID: 37399883 DOI: 10.1016/j.cca.2023.117464] [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] [Received: 05/05/2023] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Peripheral venous blood (PVB) gas analysis has become an alternative to arterial blood gas (BG) analysis in assessing acid-base balance. This study aimed to compare the effects of blood collection devices and modes of transportation on peripheral venous BG parameters. METHODS PVB-paired specimens were collected from 40 healthy volunteers into blood gas syringes (BGS) and blood collection tubes (BCT), transported by either a pneumatic tube system (PTS) or human courier (HC) to the clinical laboratory, and compared using a two-way ANOVA or Wilcoxon signed-rank test. To determine clinical significance, the PTS and HC-transported BGS and BCT biases were compared to the total allowable error (TEA). RESULTS PVB partial pressure of oxygen (pO2), fractional oxyhemoglobin (FO2Hb), fractional deoxyhemoglobin (FHHb), and oxygen saturation (sO2) showed statistically significant differences between BGS and BCT (p < 0.0001). Compared to HC-transported BGS and BCT, statistically significant increases in pO2, FO2Hb, sO2, oxygen content (only in BCT) (all p < 0.0001), and base excess extracellular (only in BCT; p < 0.0014) concentrations and a statistically significant decrease in FHHb concentration (p < 0.0001) were found in BGS and BCT delivered by PTS. The biases between PTS- and HC-transported BGS and BCT exceeded the TEA for many BG parameters. CONCLUSIONS Collecting PVB in BCT is unsuitable for pO2, sO2, FO2Hb, FHHb, and oxygen content determinations.
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Affiliation(s)
- Raffick A R Bowen
- Department of Pathology, Stanford Health Care, Stanford, CA 94305, United States.
| | - Vanessa Esguerra
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
| | | | - Phil Cheng
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
| | - Bing Hu
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
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Yodchai K, Khaorapapong T, Karnjanadecha M, Songsriboonsit B. Development of a notification delivery specimen system for perioperative Thai nurses via the LINE application. Digit Health 2023; 9:20552076231211242. [PMID: 37928332 PMCID: PMC10623984 DOI: 10.1177/20552076231211242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Objective The aim of the study was to develop and examine satisfaction in using a notification delivery specimen system for perioperative Thai nurses through the LINE application. Methods Design and development research was used in the study and 100 perioperative nurses were recruited from the three operating theatres in hospital settings in Thailand. Data analysis was performed using descriptive statistics. Results The overall satisfaction in using a notification delivery specimen system for perioperative Thai nurses through the LINE application was at the high level (M = 4.09, SD = 0.75). The perioperative nurses reported ease of use and safety scored high (M = 4.24, SD = 0.62), followed by sharpness of figures and the coloured light alert (M = 4.15, SD = 0.92), sending messages via LINE notification, and delivering the specimen quickly within the time period (M = 4.10, SD = 0.69). Conclusion The notification delivery specimen system, designed specifically for perioperative Thai nurses and integrated with the LINE application, yielded exceptionally high levels of satisfaction among users. These promising results suggest the potential for widespread adoption in various hospital settings in the coming years.
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Affiliation(s)
- Kantaporn Yodchai
- Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | | | | | - Buppha Songsriboonsit
- Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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7
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Pierre CC, Wiencek JR. The impact of environmental factors on external and internal specimen transport. Clin Biochem 2022; 115:13-21. [PMID: 36379239 DOI: 10.1016/j.clinbiochem.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/25/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022]
Abstract
The environment that a clinical specimen is exposed to is an important preanalytical factor in laboratory testing. There are numerous environmental conditions that a specimen may experience before it arrives at the clinical laboratory for analysis. Specimens collected at offsite locations are typically stored at the site and transported to the clinical laboratory via courier. Depending on the geographic location, season, method of storage and method of transport, the specimen can experience varying climate conditions that can lead to inaccurate test results. Specimens collected within the healthcare institution are not exempt from suboptimal storage and transport environments. For example, specimens transported via pneumatic tube systems can experience extreme agitation and rapid accelerations and decelerations. Suboptimal storage and transport temperatures occur less frequently within health systems due to multiple regulatory requirements for temperature monitoring; however, temperature monitoring may not occur at every stage of the preanalytical phase. This review will highlight both internal and external environmental conditions that can cause preanalytical errors in clinical laboratory testing. Strategies to mitigate environmentally-induced preanalytical errors and regulatory gaps for environmental monitoring in the preanalytical phase will also be discussed.
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Affiliation(s)
- Christina C Pierre
- Department of Pathology and Laboratory Medicine, Penn Medicine Lancaster General Hospital, Lancaster, PA 17604-3555, United States
| | - Joesph R Wiencek
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1301 Medical Center Drive, Nashville, TN 37232-5310, United States.
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8
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Reichert L, Wallner S, Burkhardt R, Offner R, Ahrens N, Hähnel V. Triple apheresis platelet concentrate quality after pneumatic tube system, conveyor box, and courier transport: An observational study. Health Sci Rep 2022; 5:e596. [PMID: 35425867 PMCID: PMC8989271 DOI: 10.1002/hsr2.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Lena Reichert
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
| | - Stefan Wallner
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
| | - Ralph Burkhardt
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
| | - Robert Offner
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
| | - Norbert Ahrens
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
- MVZ for Laboratory Medicine Raubling, amedes Labor Raubling Germany
| | - Viola Hähnel
- Institute for Clinical Chemistry and Laboratory Medicine University Hospital Regensburg Regensburg Germany
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Kitchen S, Adcock DM, Dauer R, Kristoffersen AH, Lippi G, Mackie I, Marlar RA, Nair S. International Council for Standardization in Haematology (ICSH) recommendations for processing of blood samples for coagulation testing. Int J Lab Hematol 2021; 43:1272-1283. [PMID: 34581008 DOI: 10.1111/ijlh.13702] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/27/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
This guidance document has been prepared on behalf of the International Council for Standardization in Haematology (ICSH). The aim of the document is to provide guidance and recommendations for the processing of citrated blood samples for coagulation tests in clinical laboratories in all regions of the world. The following areas are included in this document: Sample transport including use of pneumatic tubes systems; clots in citrated samples; centrifugation; primary tube storage and stability; interfering substances including haemolysis, icterus and lipaemia; secondary aliquots-transport, storage and processing; preanalytical variables for platelet function testing. The following areas are excluded from this document, but are included in an associated ICSH document addressing collection of samples for coagulation tests in clinical laboratories; ordering tests; sample collection tube and anticoagulant; preparation of the patient; sample collection device; venous stasis before sample collection; order of draw when different sample types are collected; sample labelling; blood-to-anticoagulant ratio (tube filling); influence of haematocrit. The recommendations are based on published data in peer-reviewed literature and expert opinion.
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Affiliation(s)
- Steve Kitchen
- Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
| | - Dorothy M Adcock
- Laboratory Corporation of America Holdings, Burlington, North Carolina, USA
| | - Ray Dauer
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Ann-Helen Kristoffersen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Ian Mackie
- Research Department of Haematology, University College London, London, UK
| | - Richard A Marlar
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
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10
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Ding X, Wen X, Wang L, Chen T, Zhou G, He H, Xin X. Effects of a pneumatic tube system on the hemolysis of blood samples: a PRISMA-compliant meta-analysis. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:343-352. [PMID: 34109899 DOI: 10.1080/00365513.2021.1930140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many studies have explored how using a pneumatic tube system (PTS) is related to the hemolysis of blood samples, but their conclusions have been inconsistent. This meta-analysis was to clarify whether using a PTS induces the hemolysis of blood samples. The PubMed, Embase, Scopus, CNKI, CqVip, SinoMed and WanFang databases were searched for studies published between January 1970 and August 2019. The primary outcomes were the hemolysis rate and hemolysis index of blood samples after applying a PTS and manual transportation. We estimated the pooled risk ratio (RR) and the standardized mean difference (SMD), using random-effects models. This meta-analysis included 29 studies covering 3121 blood samples. No significant differences were found between the PTS and manual-transportation groups in the hemolysis rate [RR: 0.99, 95% confidence interval (CI): 0.57 to 1.70], hemolysis index (SMD: 0.19, 95% CI: -0.00 to 0.38), or level of potassium (SMD: 0.05, 95% CI: -0.03 to 0.12), alanine aminotransferase (SMD: 0.00, 95% CI: -0.10 to 0.11), or aspartate aminotransferase (SMD: 0.04, 95% CI: -0.08 to 0.17). However, lactate dehydrogenase (LDH) level was significantly higher in the PTS group than in the manual-transportation group (SMD: 0.20, 95% CI: 0.06 to 0.34). Subgroup analysis revealed that the LDH level was clearly higher in the PTS group than in the manual-transportation group only when the PTS speed was ≥6 m/s or when the PTS distance was ≥250 m. According to this meta-analysis, PTSs were associated with alterations in LDH measurements, so it is sensible that each hospital validates and monitors their PTSs.
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Affiliation(s)
- Xuemei Ding
- Nursing Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Nursing, Binzhou Medical College, Yantai, China
| | - Xiulin Wen
- Nursing Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Liying Wang
- Department of Nursing, Medical College of Yan'an University, Yan'an, China
| | - Ting Chen
- Department of Nursing, Medical College of Yan'an University, Yan'an, China
| | - Guangxia Zhou
- Nursing Department, Xi'an Fourth Hospital, Xi'an, Shanxi, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xia Xin
- Nursing Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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11
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Cadamuro J, von Meyer A, Johannis W, Haschke-Becher E, Keppel MH, Streichert T. Effect of five different pneumatic tube carrier inserts on mechanical sample stress: a multicentre evaluation. Clin Chem Lab Med 2021; 59:e313-e316. [PMID: 33655735 DOI: 10.1515/cclm-2020-1818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/16/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Alexander von Meyer
- Institute for Laboratory Medicine and Medical Microbiology, Medizet, München-Klinik, Munich, Germany
| | - Wibke Johannis
- Institute for Clinical Chemistry, University Hospital Köln, Cologne, Germany
| | | | - Martin H Keppel
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Streichert
- Institute for Clinical Chemistry, University Hospital Köln, Cologne, Germany
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12
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Stangerup I, Broell F, Hoop JVD, Sennels HP. Pneumatic tube validation: Reducing the need for donor samples by integrating a vial-embedded data logger. Ann Clin Biochem 2021; 58:280-288. [PMID: 33478238 DOI: 10.1177/0004563221992822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The most common way to validate a pneumatic tube system is to compare pneumatic tube system-transported blood samples to blood samples carried by hand. The importance of measuring the forces inside the pneumatic tube system has also been emphasized. The aim of this study was to define a validation protocol using a mini data logger (VitalVial, Motryx Inc., Canada) to reduce the need for donor samples in pneumatic tube system validation. METHODS As an indicator of the total vibration, the blood samples are exposed to under pneumatic tube system transportation; the area under the curve was determined by a VitalVial for all hospital Tempus600 lines using a five-day validation protocol. Only the three lines with the highest area under the curves were clinically validated by analysing potassium, lactate dehydrogenase and aspartate aminotransferase. A month after pneumatic tube system commissioning, a follow-up on laboratory data was performed. RESULTS Mean area under the curve of the six lines ranged between 347 and 581. The variability of the area under the curve was between 1.51 and 11.55%. In the laboratory data follow-up, an increase in lactate dehydrogenase haemolysis was seen from the three lines with the highest area under the curve and the emergency department, which was not detected in the clinical validation. When the Tempus600 system was in commission, a higher mean area under the curve was measured. CONCLUSION A three-day validation protocol using VitalVials is enough to determine the stability of a Tempus600 system and can greatly reduce the need for donor samples. When in commission, the stability of the pneumatic tube system should be verified and lactate dehydrogenase haemolysis should be routinely checked.
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Affiliation(s)
- Ida Stangerup
- Department of Clinical Biochemistry, Bispebjerg, Frederiksberg University Hospital, Copenhagen, Denmark
| | | | | | - Henriette P Sennels
- Department of Clinical Biochemistry, Bispebjerg, Frederiksberg University Hospital, Copenhagen, Denmark
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13
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Lorenzen H, Frøstrup AB, Larsen AS, Fenger MS, Dahdouh S, Zoel-Ghina R, Nielsen LK. Pneumatic tube transport of blood samples affects global hemostasis and platelet function assays. Int J Lab Hematol 2021; 43:1207-1215. [PMID: 33538112 DOI: 10.1111/ijlh.13470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pneumatic tube systems (PTS) are frequently used for rapid and cost-effective transportation of blood samples to the clinical laboratory. The impact of PTS transport on platelet function measured by the Multiplate system and global hemostasis measured by the TEG 5000 was evaluated. METHODS Paired samples from healthy adult individuals were obtained at two study sites: Rigshospitalet (RH) and Nordsjaellands Hospital (NOH). One sample was transported by PTS and one manually (non-PTS). Platelet function was assessed by platelet aggregation (Multiplate) and global hemostasis was assessed by a variety of thrombelastography (TEG) assays. Multiplate (n = 39) and TEG (n = 32) analysis was performed at site RH, and Multiplate (n = 28) analysis was performed at site NOH. RESULTS A significant higher agonist-induced platelet aggregation was found for PTS samples compared to manual transport at site NOH (P < .02, all agonists). No significant difference was found at site RH (P > .05, all agonists). For Kaolin TEG, samples transported by PTS showed a significant lower R-time and higher Angle (P < .001). No significant differences in MA and LY30 was found (P > .05). ACT of RapidTEG was significantly reduced (P = .001) and MA of Functional Fibrinogen TEG was significantly increased (P < .001) after PTS transport. No significant impact of PTS was observed for TEG assays with heparinase (P > .05). CONCLUSIONS Depending on the type of PTS, transportation by PTS affected platelet aggregation measured by Multiplate. Furthermore, PTS alters TEG parameters possibly reflecting coagulation factors. Clinical laboratories should evaluate the effect of the local PTS on Multiplate and TEG results.
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Affiliation(s)
| | - Ann-Britt Frøstrup
- Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Immunology, Zealand University Hospital, Roskilde, Denmark
| | - Anja S Larsen
- Department of Clinical Immunology, Nordsjaellands Hospital, Hillerød, Denmark
| | - Michelle S Fenger
- Faculty of Health, University College Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark
| | - Sanne Dahdouh
- Faculty of Health, University College Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Nordsjaellands Hospital, Hillerød, Denmark
| | - Randa Zoel-Ghina
- Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark
| | - Leif K Nielsen
- Faculty of Health, University College Copenhagen, Copenhagen, Denmark
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14
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Enko D, Kriegshäuser G. Letter to the Editor regarding "Liquid biopsy in oncology: a consensus statement of the Spanish society of pathology and the Spanish society of medical oncology". Clin Transl Oncol 2021; 23:1494-1495. [PMID: 33528812 DOI: 10.1007/s12094-020-02527-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- D Enko
- Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria
| | - G Kriegshäuser
- Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
- IHR LABOR Medical Diagnostic Laboratories, Wagramer Straße 144, 1220, Vienna, Austria.
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15
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Mrazek C, Lippi G, Keppel MH, Felder TK, Oberkofler H, Haschke-Becher E, Cadamuro J. Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions. Biochem Med (Zagreb) 2021; 30:020502. [PMID: 32550813 PMCID: PMC7271754 DOI: 10.11613/bm.2020.020502] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022] Open
Abstract
Laboratory analyses are crucial for diagnosis, follow-up and treatment decisions. Since mistakes in every step of the total testing process may potentially affect patient safety, a broad knowledge and systematic assessment of laboratory errors is essential for future improvement. In this review, we aim to discuss the types and frequencies of potential errors in the total testing process, quality management options, as well as tentative solutions for improvement. Unlike most currently available reviews on this topic, we also include errors in test-selection, reporting and interpretation/action of test results. We believe that laboratory specialists will need to refocus on many process steps belonging to the extra-analytical phases, intensifying collaborations with clinicians and supporting test selection and interpretation. This would hopefully lead to substantial improvements in these activities, but may also bring more value to the role of laboratory specialists within the health care setting.
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Affiliation(s)
- Cornelia Mrazek
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Giuseppe Lippi
- Section of Clinical Chemistry, University of Verona, Verona, Italy
| | - Martin H Keppel
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Thomas K Felder
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Hannes Oberkofler
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
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16
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Johannessen KA, Wear NKS, Toska K, Hansbo M, Berg JP, Fosse E. Pathologic Blood Samples Tolerate Exposure to Vibration and High Turbulence in Simulated Drone Flights, but Plasma Samples Should be Centrifuged After Flight. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2021; 9:4000110. [PMID: 33542860 PMCID: PMC7851058 DOI: 10.1109/jtehm.2021.3053172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/23/2020] [Accepted: 01/14/2021] [Indexed: 01/27/2023]
Abstract
Objective. Most of the previous studies of drone transport of blood samples examined normal blood samples transported under tranquil air conditions. We studied the effects of 1- and 2-hour drone flights using random vibration and turbulence simulation (10-30 g-force) on blood samples from 16 healthy volunteers and 74 patients with varying diseased. Methods: Thirty-two of the most common analytes were tested. For biochemical analytes, we used plasma collected in lithium heparin tubes with and without separator gel. Gel samples were analyzed for the effect of separation by centrifugation before or after turbulence. Turbulence was simulated in an LDS V8900 high-force shaker using random vibration (range, 5–200 Hz), with samples randomly allocated to 1- or 2-hour flights with 25 or 50 episodes of turbulence from 10 to 30 G. Results: For all hematologic and most biochemical analytes, test results before and after turbulence exposure were similar (bias < 12%, intercepts < 10%). However, aspartate aminotransferase, folate, lactate dehydrogenase and lipid index increased significantly in samples separated by gel and centrifugation prior to vibration and turbulence test. These changes increased form 10 G to 30 G, but were not observed when the samples were separated after vibration and turbulence. Conclusions: Whole blood showed little vulnerability to turbulence, whereas plasma samples separated from blood cells by gel may be significantly influenced by turbulence when separated by spinning before the exposure. Centrifugation of plasma samples collected in tubes with separator gel should be avoided before drone flights that could be subject to turbulence.
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Affiliation(s)
- Karl Arne Johannessen
- The Intervention CenterOslo University Hospital0188OsloNorway.,Faculty of MedicineInstitute of Health and Society, University of Oslo0372OsloNorway
| | | | - Karin Toska
- Department of Medical BiochemistryOslo University Hospital0188OsloNorway.,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo0372OsloNorway.,Faculty of MedicineInstitute of Basic Medical Sciences, University of Oslo0372OsloNorway
| | - Morten Hansbo
- The Norwegian Defense Research Establishment2007OsloNorway
| | - Jens Petter Berg
- Faculty of MedicineInstitute of Clinical Medicine, University of Oslo0372OsloNorway
| | - Erik Fosse
- The Intervention CenterOslo University Hospital0188OsloNorway.,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo0372OsloNorway
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17
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Kavsak PA, de Wit K, Worster A. Clinical chemistry tests for patients with COVID-19 - important caveats for interpretation. Clin Chem Lab Med 2020; 58:1142-1143. [PMID: 32301748 DOI: 10.1515/cclm-2020-0436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Peter A Kavsak
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.,Juravinski Hospital and Cancer Centre, 711 Concession Street Hamilton, Hamilton, ON L8V 1C3, Canada
| | - Kerstin de Wit
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Andrew Worster
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
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18
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Franks CE, Krekeler JA, Gronowski AM, Farnsworth CW. A Comparison of Four 3-Axis-Accelerometers for Monitoring Hospital Pneumatic Tube Systems. J Appl Lab Med 2020; 5:1345-1350. [PMID: 32588046 DOI: 10.1093/jalm/jfaa081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/11/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Validation of hospital pneumatic tube systems (PTS) is recommended to predict and prevent errors caused by sample hemolysis. 3-Axis accelerometer dataloggers have been successfully implemented as tools for PTS validation, but the most suitable device for such validation has not been investigated. The aim of this study was to evaluate the performance of four commercially available 3-axis accelerometers for PTS validation. METHODS PCE-VD3 (PCE), CEM DT-178A (CEM), Extech VB300 (EXT), and MSR 145 (MSR) dataloggers were placed into a single PTS carrier and repeatedly transported through one of three PTS routes. The number and magnitude of accelerations within each PTS route was collected by each device. Deming regression analysis was used to compare device performance. RESULTS The MSR datalogger captured the greatest number of g-forces >3 g, 5 g, 10 g, and 15 g, and the greatest magnitude of g-force (26.7 g) relative to the other devices (CEM: 23.0 g, EXT: 23.3 g, PCE: 23.7 g). As a result of increased sampling frequency, the MSR recorded the lowest AUC and the greatest number of g-forces exceeding 3 g relative to the other devices. Subjectively, the data were difficult to extract from 4 tested devices. CONCLUSIONS Commercially available dataloggers differ in their ability to detect the number and magnitude of g-forces within PTSs. We recommend that one device be used to perform all PTS evaluations, with baseline evaluations for tolerable AUC, number, and magnitude of g-forces established internally. Lack of harmonization, cumbersome data processing, and time-consuming data analysis are substantial barriers to universal implementation of dataloggers for PTS validation and monitoring.
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Affiliation(s)
- Caroline E Franks
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - James A Krekeler
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - Ann M Gronowski
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - Christopher W Farnsworth
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
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19
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Plebani M. Clinical laboratory: Factory or zero kilometer service? Clin Chim Acta 2020; 503:228-230. [DOI: 10.1016/j.cca.2019.11.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/18/2022]
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20
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Gils C, Nybo M. Quality Control of Preanalytical Handling of Blood Samples for Future Research: A National Survey. J Appl Lab Med 2020; 5:83-90. [PMID: 31811074 DOI: 10.1373/jalm.2019.029942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/11/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Assessment and control of preanalytical handling of blood samples for future research are essential to preserve integrity and assure quality of the specimens. However, investigation is limited on how quality control of preanalytical handling of blood samples is performed by biobanks. METHODS A questionnaire was sent to all Danish departments of clinical biochemistry, all Danish departments of clinical immunology, the Danish Health Surveillance Institution and the Danish Cancer Society. The questionnaire consisted of questions regarding preanalytical handling of samples for future research. The survey was carried out from October 2018 until the end of January 2019. RESULTS A total of 22 departments (78%) replied, of which 17 (77%) performed preanalytical quality control of the blood samples. This quality control consisted of patient preparation, temperature surveillance of freezers, maintenance of centrifuges, and visual inspection for hemolysis, lipemia, and sample volume. Automated sample check for hemolysis, icterus, and lipemia interferences was performed by 41% of respondents, not performed by 50% of respondents, and 9% did not answer. The majority (55%) of the participants stated that they had no local standard operating procedure for preanalytical handling of samples for research projects. CONCLUSIONS The preanalytical phase for blood samples obtained and preserved for future research in Denmark is highly heterogeneous, although many aspects (e.g., hemolysis, which also affects DNA analyses, metabolomics, and proteomics) seems highly relevant to document. Our findings emphasize the need to optimize and standardize best practices for the preanalytical phase for blood samples intended for use in future research projects.
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Affiliation(s)
- Charlotte Gils
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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21
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Gils C, Broell F, Vinholt PJ, Nielsen C, Nybo M. Use of clinical data and acceleration profiles to validate pneumatic transportation systems. ACTA ACUST UNITED AC 2019; 58:560-568. [PMID: 31804954 DOI: 10.1515/cclm-2019-0881] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/03/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Modern pneumatic transportation systems (PTSs) are widely used in hospitals for rapid blood sample transportation. The use of PTS may affect sample integrity. Impact on sample integrity in relation to hemolysis and platelet assays was investigated and also, we wish to outline a process-based and outcome-based validation model for this preanalytical component.
Methods
The effect of PTS was evaluated by drawing duplicate blood samples from healthy volunteers, one sent by PTS and the other transported manually to the core laboratory. Markers of hemolysis (potassium, lactate dehydrogenase [LD] and hemolysis index [HI]) and platelet function and activation were assessed. Historic laboratory test results of hemolysis markers measured before and after implementation of PTS were compared. Furthermore, acceleration profiles during PTS and manual transportation were obtained from a mini g logger in a sample tube.
Results
Hand-carried samples experienced a maximum peak acceleration of 5 g, while peaks at almost 15 g were observed for PTS. No differences were detected in results of potassium, LD, platelet function and activation between PTS and manual transport. Using past laboratory data, differences in potassium and LD significantly differed before and after PTS installation for all three lines evaluated. However, these estimated differences were not clinically significant.
Conclusions
In this study, we found no evidence of PTS-induced hemolysis or impact on platelet function or activation assays. Further, we did not find any clinically significant changes indicating an acceleration-dependent impact on blood sample quality. Quality assurance of PTS can be performed by surveilling outcome markers such as HI, potassium and LD.
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Affiliation(s)
- Charlotte Gils
- Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Odense C , Denmark
- Clinical Institute , University of Southern Denmark , Odense , Denmark
| | | | - Pernille J. Vinholt
- Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Odense C , Denmark
- Clinical Institute , University of Southern Denmark , Odense , Denmark
| | - Christian Nielsen
- Department of Clinical Immunology , Odense University Hospital , Odense , Denmark
| | - Mads Nybo
- Clinical Institute , University of Southern Denmark , Odense , Denmark
- Department of Clinical Diagnostics , Hospital of South West Jutland , Esbjerg , Denmark
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22
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Chay JWM, Kim JH, B M Taha NS, Chiew SH, Chin KW, Lim SH, Ho LP. Urgent Delivery - Validation and Operational Implementation of Urgent Blood Delivery by Modern High Speed Hospital Pneumatic Tube System to Support Bleeding Emergencies Within a Hospital Massive Transfusion Protocol. Lab Med 2019; 50:e59-e69. [PMID: 31051501 DOI: 10.1093/labmed/lmz012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Timely blood delivery to patients with critical bleeding poses logistic challenges. A modern, high speed hospital pneumatic tube system (PTS) is one solution, but blood units may be subjected to high-speed torque and acceleration/deceleration forces. OBJECTIVE To validate a new PTS system for potential use at our 1,400-bed hospital in Singapore. METHOD Our validation included red blood cells, platelets, thawed plasma, and cryoprecipitate units transported from the blood bank for a distance of 820 meters (PTS track), at a velocity of 3-6 meters per second. Transit time, temperature, bag integrity, and blood quality were assessed visually and through analytical testing on pre- and post-PTS specimens. RESULTS Blood units arrived physically intact in less than 8 minutes. The temperature for each was within the acceptable range. Comparative testing of pre-PTS and post-PTS specimens showed no significant difference in physical quality and analyzed parameters (P> .05). CONCLUSIONS High speed PTS transportation of blood components has satisfactory fidelity and speed, without significant impact on quality. As a result, we incorporated PTS blood delivery into the hospital massive-transfusion protocol and successfully operationalized that new system.
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Affiliation(s)
- Jason Wai Mun Chay
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Ji Hyun Kim
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Nur Shahirah B M Taha
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Siew Hong Chiew
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Kwong Weng Chin
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Shu Hong Lim
- Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
| | - Liam Pock Ho
- Department of Pathology and Laboratory Medicine, Singapore General Hospital, Singapore.,Department of Pathology and Laboratory Medicine, Sengkang General Hospital, Singapore
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23
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Farnsworth CW, Webber DM, Krekeler JA, Budelier MM, Bartlett NL, Gronowski AM. Parameters for Validating a Hospital Pneumatic Tube System. Clin Chem 2019; 65:694-702. [PMID: 30808643 DOI: 10.1373/clinchem.2018.301408] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/04/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pneumatic tube systems (PTSs) provide rapid transport of patient blood samples, but physical stress of PTS transport can damage blood cells and alter test results. Despite this knowledge, there is limited information on how to validate a hospital PTS. METHODS We compared 2 accelerometers and evaluated multiple PTS routes. Variabilities in PTS forces over the same routes were assessed. Response curves that demonstrate the relationship between the number and magnitude of accelerations on plasma lactate dehydrogenase (LD), hemolysis index, and potassium in PTS-transported blood from volunteers were generated. Extrapolations from these relationships were used to predict PTS routes that may be prone to false laboratory results. Historical data and prospective patient studies were compared with predicted effects. RESULTS The maximum recorded g-force was 10g for the smartphone and 22g for the data logger. There was considerable day-to-day variation in the magnitude of accelerations (CV, 4%-39%) within a single route. The linear relationship between LD and accelerations within the PTS revealed 2 PTS routes predicted to increase LD by ≥20%. The predicted increase in LD was similar to that observed in patient results when using that PTS route. CONCLUSIONS Hospital PTSs can be validated by documenting the relationship between the concentrations of analytes in plasma, such as LD, with PTS forces recorded by 3-axis accelerometers. Implementation of this method for PTS validation is relatively inexpensive, simple, and robust.
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Affiliation(s)
- Christopher W Farnsworth
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - Daniel M Webber
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - James A Krekeler
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - Melissa M Budelier
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO
| | - Nancy L Bartlett
- Department of Medicine, Siteman Cancer Center, Washington University, St. Louis, MO
| | - Ann M Gronowski
- Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO;
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24
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Nybo M, Cadamuro J, Cornes MP, Gómez Rioja R, Grankvist K. Sample transportation – an overview. Diagnosis (Berl) 2018; 6:39-43. [DOI: 10.1515/dx-2018-0051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/22/2018] [Indexed: 01/25/2023]
Abstract
Abstract
Transportation of blood samples is a major part of the preanalytical pathway and can be crucial in delaying laboratory results to the clinicians. A variety of aspects however makes sample transportation a complex, challenging and often overlooked task that needs thorough planning and dedicated resources. The purpose of this review is to outline the options available for this task and to emphasize the preanalytical aspects that need consideration in this process, e.g. performance specifications for sample transportation as stated in ISO standards 15189 and 20658, quality control of automated transportation systems, monitoring of sample integrity parameters and temperature surveillance in general and for external samplers in particular. All these are tasks that the laboratory must assure on a daily basis in terms of continuous quality control, and simultaneously the laboratory must remain alert to alterations in clinical demands (sample frequency, turn-around-times) and new regulations within this area (e.g. the recent General Data Protection Regulation from the EU).
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Affiliation(s)
- Mads Nybo
- Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Sdr. Boulevard 29 , Odense 5000 , Denmark
| | - Janne Cadamuro
- Department of Laboratory Medicine , Paracelsus Medical University , Salzburg , Austria
| | - Michael P. Cornes
- Department of Clinical Chemistry , Worcestershire Acute Hospitals NHS Trust , Worcester , UK
| | | | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University , Umeå , Sweden
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25
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Zilberman-Rudenko J, Zhao FZ, Reitsma SE, Mitrugno A, Pang J, Shatzel JJ, Rick B, Tyrrell C, Hasan W, McCarty OJT, Schreiber MA. Effect of Pneumatic Tubing System Transport on Platelet Apheresis Units. Cardiovasc Eng Technol 2018; 9:515-527. [PMID: 29785664 PMCID: PMC6168073 DOI: 10.1007/s13239-018-0361-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/08/2018] [Indexed: 01/23/2023]
Abstract
Platelet apheresis units are transfused into patients to mitigate or prevent bleeding. In a hospital, platelet apheresis units are transported from the transfusion service to the healthcare teams via two methods: a pneumatic tubing system (PTS) or ambulatory transport. Whether PTS transport affects the activity and utility of platelet apheresis units is unclear. We quantified the gravitational forces and transport time associated with PTS and ambulatory transport within our hospital. Washed platelets and supernatants were prepared from platelet apheresis units prior to transport as well as following ambulatory or PTS transport. For each group, we compared resting and agonist-induced platelet activity and platelet aggregate formation on collagen or von Willebrand factor (VWF) under shear, platelet VWF-receptor expression and VWF multimer levels. Subjection of platelet apheresis units to rapid acceleration/deceleration forces during PTS transport did not pre-activate platelets or their ability to activate in response to platelet agonists as compared to ambulatory transport. Platelets within platelet apheresis units transported via PTS retained their ability to adhere to surfaces of VWF and collagen under shear, although platelet aggregation on collagen and VWF was diminished as compared to ambulatory transport. VWF multimer levels and platelet GPIb receptor expression was unaffected by PTS transport as compared to ambulatory transport. Subjection of platelet apheresis units to PTS transport did not significantly affect the baseline or agonist-induced levels of platelet activation as compared to ambulatory transport. Our case study suggests that PTS transport may not significantly affect the hemostatic potential of platelets within platelet apheresis units.
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Affiliation(s)
- Jevgenia Zilberman-Rudenko
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA.
| | - Frank Z Zhao
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Stephanie E Reitsma
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Annachiara Mitrugno
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Jiaqing Pang
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Joseph J Shatzel
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Beth Rick
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Christina Tyrrell
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Wohaib Hasan
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Owen J T McCarty
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Martin A Schreiber
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
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26
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Nissen PH, Wulff DE, Tørring N, Hvas AM. The impact of pneumatic tube transport on whole blood coagulation and platelet function assays. Platelets 2018; 29:421-424. [DOI: 10.1080/09537104.2018.1430361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Peter H. Nissen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Dorte E. Wulff
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Tørring
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Mette Hvas
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
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