Blood gas analysis: POCT versus central laboratory on samples sent by a pneumatic tube system

AbstractBackground:The pneumatic tube system (PTS) is commonly used in modern clinical laboratories to provide quick specimen delivery. However, its impact on sample integrity and laboratory testing results are still debatable. In addition, each PTS installation and configuration is unique to its institution. We sought to validate our Swisslog PTS by comparing routine chemistry, hematology, coagulation and blood gas test results and sample integrity indices between duplicate samples transported either manually or by PTS.Methods:Duplicate samples were delivered to the core laboratory manually by human courier or via the Swisslog PTS. Head-to-head comparisons of 48 routine chemistry, hematology, coagulation and blood gas laboratory tests, and three sample integrity indices were conducted on 41 healthy volunteers and 61 adult patients.Results:The PTS showed no impact on sample hemolysis, lipemia, or icterus indices (all p<0.05). Although alkaline phosphatase, total bilirubin and hemoglobin reached statistical significance (p=0.009, 0.027 and 0.012, respectively), all had very low average bias which ranged from 0.01% to 2%. Potassium, total hemoglobin and percent deoxyhemoglobin were statistically significant for the neonatal capillary tube study (p=0.011, 0.033 and 0.041, respectively) but no biases greater than ±4% were identified for these parameters. All observed differences of these 48 laboratory tests were not clinically significant.Conclusions:The modern PTS investigated in this study is acceptable for reliable sample delivery for routine chemistry, hematology, coagulation and blood gas (in syringe and capillary tube) laboratory tests.

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Evaluation of Pneumatic-Tube System for Delivery of Blood Specimens

Clinical Chemistry ◽

10.1093/clinchem/17.12.1160 ◽

1971 ◽

Vol 17 (12) ◽

pp. 1160-1164 ◽

Cited By ~ 26

Author(s):

Harold Steige ◽

James D Jones

Keyword(s):

Mean Value ◽

Central Laboratory ◽

Tube System ◽

Pneumatic Tube ◽

Laboratory Error ◽

Normal Individuals ◽

The Mean ◽

Blood Specimens ◽

Monitoring Devices ◽

Pneumatic Tube System

Abstract Blood specimens from normal individuals and patients (with and without blood dyscrasias) were sent through a 1,423-m pneumatic-tube system that included two monitoring devices, three switches, and 67 bends (62 with a 152-cm radius and 5 with a 76-cm radius), and then returned to the central laboratory. Each specimen was thus subjected to twice the trauma it usually would receive during transit. After transit, these specimens and duplicates kept in the laboratory were analyzed in the same manner for serum or plasma Na, K, Cl, CO2, Ca, Pi, LDH, urea, uric acid, glucose, creatinine, total protein, fibrinogen, hemoglobin, and bilirubin. Filling the tubes completely with blood and using a foam-rubber-Iined vinyl insert to hold the specimen tubes in the carrier decreased the differences attributable to transportation. Allowing the blood to clot before transport did not alter the results. Increases attributable to transport occurred only in hemoglobin, LDH, and K. Values were altered considerably less when the transported aliquot made only one leg of the trip via pneumatic tube. The alterations observed for the remaining analyses were within laboratory error. The pH of whole blood and the mean for PCO2 were not significantly altered, while the mean value for PO2, was increased 1.7 (0.5 to 4.5) mm Hg on transport.

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PENGELOLAAN LABORATORIUM UNIT GAWAT DARURAT

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v16i2.981 ◽

2018 ◽

Vol 16 (2) ◽

pp. 102

Author(s):

J. Nugraha

Keyword(s):

Accurate Result ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Definitive Diagnosis ◽

Blood Gas ◽

Emergency Unit ◽

Central Laboratory ◽

Special Character ◽

Diagnosis Of Infection ◽

Diagnosis Of Diseases

The need for comprehensive and independent services in the emergency unit led to a need for a special laboratory organization inthe unit. The simple laboratory organization has a special character that has a rapid and an accurate result, but it only provides certainparameters, which related to emergency condition. In the emergency unit laboratory tests are preferred to support the procedure ofdiagnosis and clinical decisions rather than to ensure that definitive diagnosis can be continued later, when the patient was moved tothe ward. The test is chosen to support the diagnosis of diseases which requiring immediate treatment, such as myocardial infarction,stroke, emergency surgery preparation, the diagnosis of infection and electrolyte tests and blood gas analysis especially for critically illpatients. Back up instruments should be provided that can be operated anytime when there is congestion, an ideally means that willnot interrupted the services. The laboratory needs an emergency unit that can be served by means of a simple, fast, accurate thoroughtest, and it is cheap as well. The unit should also linked to LIS and HIS. So that the results can be known or accepted in all parts of thehospital. The advantage of a special laboratory emergency unit in this case may accelerate the time of service as well as saving energyand the communications will be more simple, compared to the central laboratory, and should be operated for 24 hours.

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