Pneumatic tube system induced haemolysis: assessing sample type                susceptibility to haemolysis

Sodi, Ravinder; Darn, Simon M; Stott, Anthony

doi:10.1258/000456304323019631

Cited by 58 publications

(41 citation statements)

References 5 publications

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“…The effects of PTSs on laboratory results have been described previously; these effects manifest primarily as hemolysis (1 ) leading to increases in potassium concentration and lactate dehydrogenase (LDH) activity (2,3 ) and other changes. For certified laboratories, it is essential to control preanalytical factors caused by different means of transportation.…”

confidence: 98%

“…For certified laboratories, it is essential to control preanalytical factors caused by different means of transportation. Each installation of a PTS is dependent on architecture, technical considerations, and length differences, thus necessitating evaluation of every single system as a unique entity, as previously recommended (2 ). Here we describe an approach to the evaluation of the PTS by use of mini-data loggers to measure temperature, humidity, pressure, and acceleration, in combination with the assessment of hematological parameters, standard clinical chemistry variables, blood coagulation, erythrocyte sedimentation rate, and blood gas analysis.…”

confidence: 99%

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Determination of Hemolysis Thresholds by the Use of Data Loggers in Pneumatic Tube Systems

et al. 2011

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BACKGROUND Pneumatic tube systems (PTSs) for the transport of blood samples are regaining popularity in medical centers after earlier reports that their use could introduce preanalytical distortions such as hemolysis and changes in blood gases. METHODS We drew duplicate blood samples from 30 volunteers. One sample was hand transported, and the other sample was transported through a PTS together with a mini–data logger that provided continuous measurements of temperature, humidity, pressure, and acceleration. After transport the samples were analyzed at the same time. We looked for possible relationships of the transport method and the parameters measured by the data loggers with differences in hematological parameters, standard clinical chemistry analyses, blood coagulation, erythrocyte sedimentation rate, and blood gas analysis. RESULTS There were no significant differences in temperature, humidity, and pressure between the methods of transport, but we observed significant differences in 3-axis accelerations. The combined effect of these forces could be described by the right-tailed area under the vector sum acceleration distribution. Our data show that this area correlated with PTS speed and that PTS speed and the area under the curve exhibited a direct relation to the degree of hemolysis. CONCLUSIONS Assessment of 3-axis acceleration by use of data loggers can be used to identify preanalytical deviations that result from the transportation of blood samples in PTSs. Our approach could be used for the evaluation and regular control of PTSs without the need for repeated blood drawing and laboratory analyses.

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confidence: 98%

confidence: 99%

Determination of Hemolysis Thresholds by the Use of Data Loggers in Pneumatic Tube Systems

et al. 2011

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“…Pre-transport centrifugation also increases the percentage of hemolyzed specimens. For inpatients, the pneumatic tube transport system has also been implicated in in vitro hemolysis (31). Critical conditions for centrifugation include the time between collection and processing, extreme conditions of temperatures and speed, poor separator barrier integrity and re-centrifugation.…”

Section: Sources Of In Vivo and In Vitro Hemolysismentioning

confidence: 99%

Preanalytical quality improvement: from dream to reality

Lippi

Chance

Church³

et al. 2011

Clinical Chemistry and Laboratory Medicine

278

187

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Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as ''the brain to brain cycle'' by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be ''intercepted'' before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.

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“…To explore this interpretation an additional CSF group with the same red cell dilutions but which was not transported would need to be included. While not undertaken in this study, Wenham et al 10 essentially compared no transport to pneumatic tube transport and failed to demonstrate a consistent increase in NOA with increasing red cell count in the samples which were not transported. This finding suggests that addition of red cells is not the only factor in affecting levels of oxyhaemoglobin.…”

Section: Discussionmentioning

confidence: 62%

“…Pneumatic transport tubes are often used to transport pathology specimens and are known to cause haemolysis of red blood cells under certain circumstances. 8,10,11 The most detailed reference for the detection of bilirubin by spectrophotometry, the UK National Guidelines, has been developed by the working group of the UK National External Quality Assessment Scheme for Immunochemistry and was initially published in 2003 6 and revised in 2008. 3 The laboratory at our study institution uses this reference as the basis for their method of bilirubin detection by spectrophotometry.…”

Section: Introductionmentioning

confidence: 99%

Pneumatic tube transport of blood-stained cerebrospinal fluid specimens has no clinically relevant effect on rates of haemolysis compared to manual transport

2015

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Background: Pneumatic tube transport of pathology specimens from the emergency department to the laboratory for analysis is a widely used practice. When compared to manual specimen transport, it results in savings in both time and labour. Sampling of cerebrospinal fluid still forms part of the workup of patients with suspected subarachnoid haemorrhage. There are claims in the literature that transport of cerebrospinal fluid samples by pneumatic tube results in excess haemolysis, which interferes with cerebrospinal fluid analysis for the presence of bilirubin. The aim of our study was to ascertain whether pneumatic tube transport of blood-stained cerebrospinal fluid to the laboratory, results in clinically significantly higher levels of haemolysis compared with manual transport of the same specimens. Methods: Stored cerebrospinal fluid was spiked with varying amounts of red blood cells creating 72 specimens of varying red cell concentration. Half of these specimens were transported to the laboratory manually while the other half were sent by pneumatic tube transport. The rates of haemolysis were compared between the pneumatic tube and manual transport samples. Results: There was no clinically significant difference in the rates of haemolysis between the samples transported to the laboratory by pneumatic tube compared with those moved manually. Conclusions: Pneumatic tube transport of cerebrospinal fluid to the laboratory is not associated with clinically significantly higher rates of haemolysis when compared to manual transport.

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Pneumatic tube system induced haemolysis: assessing sample type susceptibility to haemolysis

Cited by 58 publications

References 5 publications

Determination of Hemolysis Thresholds by the Use of Data Loggers in Pneumatic Tube Systems

Determination of Hemolysis Thresholds by the Use of Data Loggers in Pneumatic Tube Systems

Preanalytical quality improvement: from dream to reality

Pneumatic tube transport of blood-stained cerebrospinal fluid specimens has no clinically relevant effect on rates of haemolysis compared to manual transport

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