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OBJECTIVES: Recent advances in damage control resuscitation have advocated a push for early transfusion to maintain circulating volume and minimization of crystalloid use. While measures such as using rapid-matched group specific blood or uncrossmatched blood have been implemented to shorten this wait, delivery times can still be improved. We explored reducing delivery times by use of a pneumatic tube delivery system already built in our hospital. Few studies have evaluated this using fresh blood samples for one-way transport. We modified and evaluated our pneumatic tube delivery system for delivery timings and quality parameters; designing a robust protocol that also tested aged blood for simulated returns unlike other previous studies. METHODS: Delivery timings of emergency blood products by our present portering system were collected and compared against that of products sent through the pneumatic tube system (PTS). The samples sent through the PTS were also tested and analyzed for temperature, quality, and hemolysis in accordance with established blood banking quality guidelines. RESULTS: Blood products delivered by our PTS showed satisfactory conformance with all parameters of temperature, timing, and hemolysis. We showed a significant reduction in transport delivery times from mean of 8 min 43 s to 2 min 23 s. CONCLUSIONS: Delivery of blood products by our modified PTS is safe and significantly reduces delivery time. This time savings could be clinically significant in resuscitation. Usage of the PTS could also cut down on workforce utilization of porters, freeing them up for other tasks in the hospital.
RESUMO
Background The measurement of hemoglobin A1c (HbA1c) is important for diagnosing diabetes mellitus as well as assessing glycemic control in diabetic patients. Commutable whole blood certified reference materials (CRMs) are needed in the measurement of HbA1c for method validation and/or as quality controls. Methods We developed three levels of hemolyzed whole blood CRMs for HbA1c. The certified values were determined using liquid chromatography-isotope dilution tandem mass spectrometry method (LC-IDMS/MS) where two "signature" hexapeptides of HbA1c and hemoglobin A0 (HbA0) were used as the calibration standards. The concentrations of the hexapeptide solutions were determined by amino acid analysis by the LC-IDMS/MS method using amino acid CRMs as the calibration standards. The commutability study was conducted by measuring 25 patient specimens and the whole blood CRMs by both LC-IDMS/MS method and various routine methods using six different clinical analyzers. Results The certified values were determined to be 35.1±2.0, 50.3±1.9 and 65.8±2.6 mmol/mol, respectively. These CRMs showed good commutability on five of the six clinical analyzers but showed poor commutability on one of the clinical analyzers that used similar method as two other analyzers where good commutability was observed. Conclusions With certified target values based on metrological traceability and good commutability on most of the clinical analyzers, the developed whole blood CRMs can be used for method validation or as quality control materials in the measurement of HbA1c. The commutability study results also underscored the need of commutability testing of clinical CRMs using various clinical analyzers.
