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1.
Ann Biol Clin (Paris) ; 78(5): 555-564, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026350

RESUMO

Biochemical diagnosis of hereditary metabolic diseases requires the detection and simultaneous identification of a large number of compounds, hence the interest in metabolic profiles. Amino acid chromatography allows the identification and quantification of more than forty compounds. As part of the accreditation process for medical biology examinations according to standard NF EN ISO 15189, the group from SFEIM recommends an approach to accredit amino acid chromatography. Validation parameters and recommendations are discussed in this specific framework.


Assuntos
Aminoácidos/análise , Cromatografia/normas , Testes Diagnósticos de Rotina/normas , Erros Inatos do Metabolismo/diagnóstico , Acreditação/normas , Adulto , Aminoácidos/sangue , Aminoácidos/líquido cefalorraquidiano , Aminoácidos/urina , Amniocentese/normas , Líquido Amniótico/química , Análise Química do Sangue/métodos , Análise Química do Sangue/normas , Coleta de Amostras Sanguíneas/normas , Criança , Cromatografia/métodos , Cromatografia Líquida/normas , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Recém-Nascido , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/líquido cefalorraquidiano , Erros Inatos do Metabolismo/urina , Triagem Neonatal/métodos , Triagem Neonatal/normas , Fase Pré-Analítica , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/normas , Espectrometria de Massas em Tandem/normas , Urinálise/métodos , Urinálise/normas , Coleta de Urina/normas
2.
Int J Hematol ; 112(5): 614-620, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32929688

RESUMO

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.


Assuntos
Testes de Coagulação Sanguínea/métodos , Testes de Coagulação Sanguínea/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Consenso , Manejo de Espécimes/métodos , Manejo de Espécimes/normas , Centrifugação , Humanos
3.
Ann Biol Clin (Paris) ; 78(5): 537-546, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32933890

RESUMO

Biochemical diagnosis of hereditary metabolic diseases requires the detection and simultaneous identification of a large number of compounds, hence the interest in metabolic profiles. Acylcarnitine profile allows the identification and quantification of more than thirty compounds. As part of the accreditation process for medical biology examinations according to standard NF EN ISO 15189, the group from SFEIM recommends an approach to accredit acylcarnitine profile. Validation parameters and recommendations are discussed in this specific framework.


Assuntos
Carnitina/análogos & derivados , Serviços de Laboratório Clínico/normas , Testes Diagnósticos de Rotina/normas , Erros Inatos do Metabolismo/diagnóstico , Acreditação , Adulto , Amniocentese/métodos , Amniocentese/normas , Líquido Amniótico/química , Análise Química do Sangue/métodos , Análise Química do Sangue/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Carnitina/análise , Carnitina/sangue , Carnitina/urina , Criança , Cromatografia em Papel/normas , Feminino , Humanos , Recém-Nascido , Masculino , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/urina , Triagem Neonatal/métodos , Triagem Neonatal/normas , Fase Pré-Analítica/métodos , Fase Pré-Analítica/normas , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/normas , Urinálise/métodos , Urinálise/normas , Coleta de Urina/métodos , Coleta de Urina/normas
4.
Ann Biol Clin (Paris) ; 78(4): 454-460, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32616472

RESUMO

Blood angiotensin-converting enzyme (ACE) assay is now realized by the determination of enzyme activity on synthetic substrate, mostly furylacryloyl-phenylalanyl-L-glycyl-L-glycine (FAPGG). The matrix can be serum or heparin-plasma, with or without a separator; the assay developed on serum or plasma is not adapted to other matrix such as cerebrospinal fluid where the ACE activity is much lower. This assay has been adapted on a number of automated biochemistry analyzers with the specifications of the supplier of reagents, sometimes with modification of volumes or times for analysis. Samples can be stored at +4̊C for at least for one week, freezing at -20̊C is possible but refreezing is not advised. The assay is linear from 10 to 200 UI/L. Fidelity is excellent after calibration of the assay. Accuracy can be calculated from IQA and EQA results, and the analytical uncertainty is between 2% and 5% in function of the serum ACE value. Usual values will be soon available from studies on age brackets and sex, because ACE activity seems to be more elevated in boys during adolescence. At signature, it is interesting to have medical information on the diagnosis of sarcoidosis or its treatment including ACE inhibitors as a proof of intake; we can give a commentary on elevation of serum ACE activity from other causes than sarcoidosis and the causes for low activities.


Assuntos
Análise Química do Sangue/métodos , Peptidil Dipeptidase A/análise , Peptidil Dipeptidase A/sangue , Biomarcadores/análise , Biomarcadores/sangue , Análise Química do Sangue/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Granuloma/sangue , Granuloma/diagnóstico , Granuloma/terapia , Humanos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas , Fase Pré-Analítica , Reprodutibilidade dos Testes , Sarcoidose/sangue , Sarcoidose/diagnóstico , Sarcoidose/terapia , Sensibilidade e Especificidade , Estudos de Validação como Assunto
5.
Rev Lat Am Enfermagem ; 28: e3263, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491118

RESUMO

OBJECTIVE: to develop and validate the first immersive virtual reality simulation addressing vacuum blood collection in adult patients - VIDA-Nursing v1.0. METHOD: methodological study to validate 14 steps of the vacuum blood collection procedure in adults, designed to develop the immersive virtual reality simulator VIDA-Nursing v1.0. It was assessed by 15 health workers and 15 nursing undergraduate students in terms of visual, interactive, movement simulation reality, teaching and user-friendly aspects. RESULTS: the workers considered 79.6% of the items to be valid, while the students considered 66.7% of the items valid; most of the demands can be implemented in the system by improving future versions. CONCLUSION: the simulator was considered a promising and innovative tool to teach vacuum blood collection in adults as it can be combined with other resources currently used to introduce this topic and technique in the education of undergraduate nursing students.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Bacharelado em Enfermagem/métodos , Treinamento por Simulação/métodos , Estudantes de Enfermagem , Realidade Virtual , Adulto , Coleta de Amostras Sanguíneas/instrumentação , Coleta de Amostras Sanguíneas/normas , Feminino , Humanos , Invenções , Masculino , Pessoa de Meia-Idade , Vácuo , Adulto Jovem
7.
Vox Sang ; 115(6): 488-494, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32240545

RESUMO

Plasma provided by COVID-19 convalescent patients may provide therapeutic relief as the number of COVID-19 cases escalates steeply worldwide. Prior findings in various viral respiratory diseases including SARS-CoV-related pneumonia suggest that convalescent plasma can reduce mortality, although formal proof of efficacy is still lacking. By reducing viral spread early on, such an approach may possibly downplay subsequent immunopathology. Identifying, collecting, qualifying and preparing plasma from convalescent patients with adequate SARS-CoV-2-neutralizing Ab titres in an acute crisis setting may be challenging, although well within the remit of most blood establishments. Careful clinical evaluation should allow to quickly establish whether such passive immunotherapy, administered at early phases of the disease in patients at high risk of deleterious evolution, may reduce the frequency of patient deterioration, and thereby COVID-19 mortality.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Segurança do Sangue/métodos , Segurança do Sangue/normas , Coleta de Amostras Sanguíneas/normas , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Humanos , Imunização Passiva/métodos , Imunização Passiva/normas , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/terapia
8.
Transfusion ; 60(5): 997-1002, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32275069

RESUMO

BACKGROUND: Effective and financially viable mitigation approaches are needed to reduce bacterial contamination of platelets in the US. Expected costs of large-volume delayed sampling (LVDS), which would be performed by a blood center prior to shipment to a hospital, were compared to those of pathogen reduction (PR), point-of-release testing (PORt), and secondary bacterial culture (SBC). METHODS: Using a Markov-based decision-tree model, the financial and clinical impact of implementing all variants of LVDS, PR, PORt, and SBC described in FDA guidance were evaluated from a hospital perspective. Hospitals were assumed to acquire leukoreduced apheresis platelets, with LVDS adding $30 per unit. Monte Carlo simulations were run to estimate the direct medical costs for platelet acquisition, testing, transfusion, and possible complications associated with each approach. Input parameters, including test sensitivity and specificity, were drawn from existing literature and costs (2018US$) were based on a hospital perspective. A one-way sensitivity analysis varied the assumed additional cost of LVDS. RESULTS: Under an approach of LVDS (7-day), the total cost per transfused unit is $735.78, which falls between estimates for SBC (7-day) and PORt. Assuming 20,000 transfusions each year, LVDS would cost $14.72 million annually. Per-unit LVDS costs would need to be less than $22.32 to be cheaper per transfusion than all other strategies, less than $32.02 to be cheaper than SBC (7-day), and less than $196.19 to be cheaper than PR (5-day). CONCLUSIONS: LVDS is an effective and cost-competitive approach, assuming additional costs to blood centers and associated charges to hospitals are modest.


Assuntos
Infecções Bacterianas/prevenção & controle , Contaminação de Medicamentos/prevenção & controle , Controle de Infecções , Transfusão de Plaquetas/economia , Transfusão de Plaquetas/estatística & dados numéricos , Plaquetoferese , Cultura Primária de Células/economia , Infecções Bacterianas/economia , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/transmissão , Bancos de Sangue/economia , Bancos de Sangue/normas , Bancos de Sangue/estatística & dados numéricos , Plaquetas/microbiologia , Segurança do Sangue/economia , Segurança do Sangue/métodos , Segurança do Sangue/normas , Coleta de Amostras Sanguíneas/efeitos adversos , Coleta de Amostras Sanguíneas/economia , Coleta de Amostras Sanguíneas/normas , Coleta de Amostras Sanguíneas/estatística & dados numéricos , Custos e Análise de Custo , Testes Diagnósticos de Rotina/economia , Testes Diagnósticos de Rotina/normas , Testes Diagnósticos de Rotina/estatística & dados numéricos , Contaminação de Medicamentos/economia , Contaminação de Medicamentos/estatística & dados numéricos , Estudos de Viabilidade , Humanos , Ciência da Implementação , Controle de Infecções/economia , Controle de Infecções/métodos , Técnicas Microbiológicas , Plaquetoferese/efeitos adversos , Plaquetoferese/economia , Plaquetoferese/métodos , Plaquetoferese/normas , Cultura Primária de Células/métodos , Cultura Primária de Células/normas , Cultura Primária de Células/estatística & dados numéricos , Comportamento de Redução do Risco , Tamanho da Amostra , Fatores de Tempo , Tempo para o Tratamento/economia , Tempo para o Tratamento/estatística & dados numéricos , Reação Transfusional/economia , Reação Transfusional/epidemiologia , Reação Transfusional/microbiologia , Reação Transfusional/prevenção & controle
9.
Transfusion ; 60(5): 1042-1049, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32187700

RESUMO

BACKGROUND: Some jurisdictions require leukoreduction of cellular blood components. The only whole blood collection set with a platelet-saving filter uses citrate-phosphate-dextrose (CPD) as storage solution. Substituting CPD with citrate-phosphate-dextrose-adenine (CPDA-1) increases shelf life from 21 to 35 days. This would simplify prehospital and rural resupply and reduce wastage. We investigated in vitro quality and hemostatic properties of CPDA-1 whole blood leukoreduced with a platelet-saving filter. STUDY DESIGN AND METHODS: CPDA-1 whole blood was leukoreduced using a platelet-saving filter and stored 35 days. EDQM requirements, hematology, metabolic parameters, thromboelastography, light transmission aggregometry, fibrinogen, factor VIII, and interleukin-6 were measured on Days 0, 1, 14, 21, and 35 and compared to non-leukoreduced blood. RESULTS: All units met EDQM requirements. Leukoreduction yielded residual white blood cell count <1 × 106 and 87% platelet recovery on Day 1. It caused reduction in thromboelastography parameters, but not aggregometry response. No hemolysis >0.8% was observed. Factor VIII was higher on Day 35 in the leukoreduced group, 37.9 (95% CI: 26.0, 49.8) versus 13.8 (9.4, 18.2) IU/dL. In both groups, aggregation was significantly reduced by Day 14. Thromboelastography showed remaining platelet activity on Day 35, MA 46.9 (42.1, 51.7) in the leukoreduced and 44.3 (39.6, 49.0) mm in the non-leukoreduced group. Fibrinogen was within reference ranges at Day 35 (>2 g/dL). Interleukin-6 was not detectable. CONCLUSION: Leukoreducing CPDA-1 whole blood with a platelet-saving filter did not compromise hemostatic properties. We encourage development of a single bag CPDA-1 whole blood collection set with in-line platelet-saving filter.


Assuntos
Adenina/química , Preservação de Sangue/métodos , Coleta de Amostras Sanguíneas/métodos , Citratos/química , Temperatura Baixa , Glucose/química , Procedimentos de Redução de Leucócitos/métodos , Fosfatos/química , Adenina/farmacologia , Sangue/efeitos dos fármacos , Plaquetas/citologia , Plaquetas/efeitos dos fármacos , Preservação de Sangue/normas , Coleta de Amostras Sanguíneas/normas , Citratos/farmacologia , Filtração/métodos , Glucose/farmacologia , Hemólise/efeitos dos fármacos , Hemostasia/efeitos dos fármacos , Humanos , Técnicas In Vitro , Procedimentos de Redução de Leucócitos/normas , Fosfatos/farmacologia , Agregação Plaquetária/efeitos dos fármacos , Contagem de Plaquetas , Controle de Qualidade , Refrigeração/métodos
10.
Lab Med ; 51(1): 41-46, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31185079

RESUMO

OBJECTIVE: To determine a method to reduce specimen hemolysis rates in pediatric blood specimens. METHODS: A total of 290 blood specimens from pediatric patients were classified into the capped group or uncapped group. The hemolysis index and levels of lactate dehydrogenase (LDH) were measured using an automated biochemical analyzer. Also, we performed a paired test to measure the concentration of free hemoglobin in specimens from 25 randomly selected healthy adult volunteers, using a direct spectrophotometric technique. RESULTS: The hemolytic rate of capped specimens was 2-fold higher than that of uncapped specimens. We found significant differences for LDH. Also, there was a significant difference in the concentration of free hemoglobin in the random-volunteers test. CONCLUSIONS: Eliminating the residual negative pressure of vacuum blood-collection tubes was effective at reducing the macrohemolysis and/or microhemolysis rate.


Assuntos
Coleta de Amostras Sanguíneas/normas , Hemólise , Adolescente , Adulto , Coleta de Amostras Sanguíneas/efeitos adversos , Coleta de Amostras Sanguíneas/instrumentação , Coleta de Amostras Sanguíneas/métodos , Criança , Feminino , Hemoglobinas/análise , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Vácuo
12.
Gen Comp Endocrinol ; 287: 113324, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31733208

RESUMO

There is growing interest in the use of glucocorticoid (GC) hormones to understand how wild animals respond to environmental challenges. Blood is the best medium for obtaining information about recent GC levels; however, obtaining blood requires restraint and can therefore be stressful and affect GC levels. There is a delay in GCs entering blood, and it is assumed that blood obtained within 3 min of first disturbing an animal reflects a baseline level of GCs, based largely on studies of birds and mammals. Here we present data on the timing of changes in the principle reptile GC, corticosterone (CORT), in four reptile species for which blood was taken within a range of times 11 min or less after first disturbance. Changes in CORT were observed in cottonmouths (Agkistrodon piscivorus; 4 min after first disturbance), rattlesnakes (Crotalus oreganus; 2 min 30 s), and rock iguanas (Cyclura cychlura; 2 min 44 s), but fence lizards (Sceloporus undulatus) did not exhibit a change within their 10-min sampling period. In both snake species, samples taken up to 3-7 min after CORT began to increase still had lower CORT concentrations than after exposure to a standard restraint stressor. The "3-min rule" appears broadly applicable as a guide for avoiding increases in plasma CORT due to handling and sampling in reptiles, but the time period in which to obtain true baseline CORT may need to be shorter in some species (rattlesnakes, rock iguanas), and may be unnecessarily limiting for others (cottonmouths, fence lizards).


Assuntos
Coleta de Amostras Sanguíneas/veterinária , Corticosterona/sangue , Répteis/sangue , Restrição Física/fisiologia , Agkistrodon/sangue , Animais , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/psicologia , Coleta de Amostras Sanguíneas/normas , Corticosterona/análise , Crotalus/sangue , Técnicas de Diagnóstico Endócrino/normas , Técnicas de Diagnóstico Endócrino/veterinária , Manobra Psicológica , Iguanas/sangue , Lagartos/sangue , Restrição Física/psicologia , Estresse Psicológico/sangue , Estresse Psicológico/etiologia , Fatores de Tempo
13.
Vox Sang ; 115(2): 148-158, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31729051

RESUMO

BACKGROUND AND OBJECTIVES: Planning platelet collection and inventory must rely not only on adequate forecasts of transfusion demand but also sophisticated mathematical modeling techniques. This research aims to develop a better demand forecasting model of apheresis platelets and a mathematical programming model to determine the best target amounts of apheresis platelet collection. MATERIALS AND METHODS: Time series data of apheresis platelets collected from donors and platelets supplied to hospitals daily in Taipei Blood Center from January 2014 to December 2015 was used to fit a forecasting model which combines a regression-type model for formulating the deterministic trends and seasonal variation and an autoregressive moving average model (ARMA) for explaining remaining serial correlations. A seasonal autoregressive integrated moving average (SARIMA) model was also used for benchmarking the prediction performance. A linear programming model was then formulated to solve for the optimal daily target collection volumes that maximize the total social benefits. RESULTS: The time series model achieved good predictive power with a mean absolute percentage error less than 10%. The appropriateness of the proposed target collection volumes was also verified by using a simulation model, and the proportion of the total platelets requested by hospitals that can be filled by collected apheresis platelets can increase significantly by using the new policy. CONCLUSION: The methods proposed in this study can be easily implemented to enhance the management efficiency of blood collecting and supplying of a blood center, and to decrease the costs of the blood outdates and shortages.


Assuntos
Plaquetas/citologia , Coleta de Amostras Sanguíneas/métodos , Modelos Teóricos , Plaquetoferese/métodos , Coleta de Amostras Sanguíneas/normas , Humanos , Plaquetoferese/normas , Estações do Ano
14.
Biochem Med (Zagreb) ; 30(1): 011002, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31839729

RESUMO

Rejection of the sample with repeated blood withdrawal is always an unwanted consequence of sample nonconformity and preanalytical errors, especially in the most vulnerable population - children. Here is presented a case with unexpected abnormal coagulation test results in a 2-year-old child with no previously documented coagulation disorder. Child is planned for tympanostomy tubes removal under the anaesthesia driven procedure, and preoperative coagulation tests revealed prolonged prothrombin time, activated partial thromboplastin time and thrombin time, with fibrinogen and antithrombin within reference intervals. From the anamnestic and clinical data, congenital coagulation disorder was excluded, and with further investigation, sample mismatch, clot presence and accidental ingestion of oral anticoagulant, heparin contamination or vitamin K deficiency were excluded too. Due to suspected EDTA carryover during blood sampling another sample was taken the same day and all tests were performed again. The results for all tests were within reference intervals confirming EDTA effect on falsely prolongation of the coagulation times in the first sample. This case can serve as alert to avoid unnecessary loss in terms of blood withdrawal repetitions and discomfort of the patients and their relatives, tests repeating, prolonging medical procedures, and probably delaying diagnosis or proper medical treatment. It is the responsibility of the laboratory specialists to continuously educate laboratory staff and other phlebotomists on the correct blood collection as well as on its importance for the patient's safety.


Assuntos
Transtornos da Coagulação Sanguínea/diagnóstico , Coleta de Amostras Sanguíneas/normas , Testes de Coagulação Sanguínea , Pré-Escolar , Erros de Diagnóstico , Ácido Edético/química , Humanos , Tempo de Tromboplastina Parcial , Fase Pré-Analítica , Tempo de Protrombina , Valores de Referência
15.
Rev. latinoam. enferm. (Online) ; 28: e3263, 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101709

RESUMO

Objective: to develop and validate the first immersive virtual reality simulation addressing vacuum blood collection in adult patients - VIDA-Nursing v1.0. Method: methodological study to validate 14 steps of the vacuum blood collection procedure in adults, designed to develop the immersive virtual reality simulator VIDA-Nursing v1.0. It was assessed by 15 health workers and 15 nursing undergraduate students in terms of visual, interactive, movement simulation reality, teaching and user-friendly aspects. Results: the workers considered 79.6% of the items to be valid, while the students considered 66.7% of the items valid; most of the demands can be implemented in the system by improving future versions. Conclusion: the simulator was considered a promising and innovative tool to teach vacuum blood collection in adults as it can be combined with other resources currently used to introduce this topic and technique in the education of undergraduate nursing students.


Objetivo: desenvolver e validar a primeira versão do simulador de realidade virtual imersiva no procedimento de coleta de sangue a vácuo no paciente adulto - VIDA-Enfermagem v1.0. Método: estudo com delineamento metodológico para validar 14 etapas do procedimento de coleta de sangue a vácuo no adulto, projetadas para o desenvolvimento do simulador de realidade virtual imersiva VIDA-Enfermagem v1.0, o qual foi avaliado por 15 profissionais da saúde e 15 graduandos de enfermagem em relação aos aspectos visual, interativo, realidade de simulação do movimento, pedagógico e esforço de utilização. Resultados: de maneira geral foram considerados válidos 79,6% dos itens avaliados pelos profissionais e 66,7% dos itens avaliados pelos graduandos, sendo que a maioria das necessidades de melhorias do sistema é passível de correção no incremento das próximas versões. Conclusão: o simulador foi considerado como ferramenta promissora e inovadora para o ensino da coleta de sangue a vácuo no adulto, enquanto estratégia a ser combinada com recursos utilizados atualmente na educação de graduandos de enfermagem que estão iniciando o estudo da temática e da técnica.


Objetivo: desarrollar y validar la primera versión del simulador de realidad virtual inmersivo en el procedimiento de recolección de vacío de sangre en pacientes adultos: VIDA-Enfermería v1.0. Método: estudio con diseño metodológico para validar 14 pasos del procedimiento de extracción de sangre al vacío en adultos, diseñado para el desarrollo del simulador inmersivo de realidad virtual VIDA-Enfermería v1.0, que fue evaluado por 15 profesionales de la salud y 15 estudiantes universitarios de enfermería con relación a los aspectos visual, interactiva, realidad de movimiento, pedagógico y esfuerzo de uso. Resultados: en general, el 79.6% de los ítems evaluados por los profesionales y el 66.7% de los ítems evaluados por los estudiantes de pregrado se consideraron válidos, y la mayoría de las necesidades de mejoras del sistema están sujetas a corrección en el incremento de las próximas versiones. Conclusión: el simulador fue considerado como una herramienta prometedora e innovadora para enseñar la extracción de sangre al vacío en adultos, como una estrategia que se combina con los recursos utilizados actualmente en la educación de estudiantes de enfermería que están comenzando a estudiar el tema y la técnica.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estudantes de Enfermagem , Coleta de Amostras Sanguíneas/normas , Bacharelado em Enfermagem , Invenções , Treinamento por Simulação/métodos , Realidade Virtual
16.
Niger J Clin Pract ; 22(12): 1693-1697, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793476

RESUMO

Objectives: This study aims to measure the level of knowledge of the nurses who collect blood cultures at our hospital, and after providing the necessary training, evaluate the distribution of microbial growth and rate of contamination in blood cultures that are referred to our laboratory during a 1-year term. Methods and Materials: A survey was conducted to assess the level of knowledge regarding blood culture acquisition with the participation of 99 nurses at our hospital in October 2017. Blood cultures sent to our laboratory during 2017 May-October were retrospectively evaluated in terms of their results, contamination rates, and number of bottles. Taking survey results into account, monthly trainings were provided to the nurses for 6 months starting from October 2017, and blood culture results and error rates were investigated prospectively. Results: It was determined from the survey results that the level of knowledge regarding the need to wipe the rubber septum of the blood culture bottle with alcohol prior to adding the blood sample (23.2%) and definition of a blood culture set (25.3%) were quite low. It was found that while the contamination rate prior to training was 6.4%, it fell to 3.7% after training, and although the rate of single-bottle cultures was 6.3% before training, it decreased by 2.0%. Conclusions: Standardizing blood culture acquisition with the provided training will produce maximal benefit for every laboratory in terms of cost and workload.


Assuntos
Hemocultura/normas , Coleta de Amostras Sanguíneas/normas , Sangue/microbiologia , Contaminação de Equipamentos/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros/psicologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Estudos Retrospectivos , Inquéritos e Questionários
17.
Ann Biol Clin (Paris) ; 77(6): 665-667, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31859643

RESUMO

Continuous monitoring of the performances of blood culture instrument can be based on the indicators proposed by the QUAMIC. Of these, the analytic performance indicator evaluates the rate of false-positive vials. False-positives vials can be reported by the device in case of leukocytosis or when vials are overfilled. In our laboratory, we record prospectively in our software all false positive vials as well as the position used for their incubation. These data are analyzed at least twice a year. For the first half of 2016, this strategy allowed us to identify a defective position. We then evaluated the impact of this anomaly as very weak. The one-year follow-up after the position repair confirmed a correction of the problem. Thus, traceability of positions reporting unexplained false-positive vials (i.e. neither due to leukocytosis nor overfilled vials) can allow laboratories to identify a defective position. This survey, if done prospectively, is simple to perform and not time-consuming. It could usefully complement the analytical performance indicator based on the false-positive rate.


Assuntos
Hemocultura/instrumentação , Análise de Falha de Equipamento , Leucocitose/diagnóstico , Artefatos , Hemocultura/métodos , Hemocultura/normas , Coleta de Amostras Sanguíneas/instrumentação , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Meios de Cultura/farmacologia , Reações Falso-Positivas , Seguimentos , Violeta Genciana , Humanos , Contagem de Leucócitos/instrumentação , Contagem de Leucócitos/normas , Leucocitose/sangue , Fenazinas , Reprodutibilidade dos Testes
18.
Ann Biol Clin (Paris) ; 77(6): 669-680, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31859644

RESUMO

Although the use of EDTA-containing collection tubes is known to stabilize the complement analytes and to make the results more reliable, no external quality assessment (EQA) scheme based on EDTA plasma samples is available to date in France. Consequently, a number of clinical laboratories currently participate to EQA program on samples whose matrix is different from their routine practice. The aim of this work was to offer a new external quality assessment scheme, as an inter-laboratory exchange (ILE). The ILE samples come from pooled EDTA plasmas of healthy subjects and are diluted to obtain distinct control levels. The protocol has been validated on CH50, C3, C4 and C1-inhibitor measurements, through: (i) a stability study of post-centrifugation storage of EDTA plasma samples at room temperature, 4̊C and -20̊C; (ii) the demonstration of the linearity of the dilution steps; and (iii) a stability study of the diluted samples. Our results demonstrate a four-weeks stability of the ILE samples prepared and stored according to our protocol. Those results are compatible with the ILE implementation constraints, and the program has been implemented in January 2018. The one-year ILE implementation experience is also presented. The newly implemented ILE will be useful for the accreditation of the complement activity of French laboratories using EDTA plasma samples.


Assuntos
Análise Química do Sangue/métodos , Coleta de Amostras Sanguíneas , Proteínas do Sistema Complemento/análise , Ácido Edético/química , Plasma/química , Análise Química do Sangue/normas , Preservação de Sangue/métodos , Preservação de Sangue/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Proteínas do Sistema Complemento/efeitos dos fármacos , Proteínas do Sistema Complemento/metabolismo , Ácido Edético/farmacologia , Excipientes/química , Excipientes/farmacologia , Humanos , Ensaio de Proficiência Laboratorial , Plasma/efeitos dos fármacos , Plasma/metabolismo , Estabilidade Proteica/efeitos dos fármacos , Garantia da Qualidade dos Cuidados de Saúde/métodos , Controle de Qualidade , Fatores de Tempo , Transportes/normas
20.
J Appl Lab Med ; 3(6): 925-935, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31639684

RESUMO

BACKGROUND: Potassium EDTA (kEDTA) contamination of serum samples is common, causing spurious hyperkalemia, hypozincemia, and hypocalcemia that if unrecognized may adversely affect patient care. Gross kEDTA contamination is easy to detect, but identification of spurious electrolytes due to small amounts of contamination requires measurement of serum EDTA. We validated an EDTA assay on the Abbott Architect and reassessed its value in identifying kEDTA contamination and in studying mechanisms for contamination. METHODS: Within- and between-batch imprecision, linearity, recovery, interference, and carryover were assessed. Serum supplemented with k2EDTA plasma, to mimic sample contamination, was used to study its effect on potassium, calcium, zinc, magnesium, and alkaline phosphatase. Our current laboratory protocol for identification of kEDTA contamination, based on measurement of serum calcium, was compared to that of EDTA measurement. RESULTS: The EDTA assay displayed acceptable performance characteristics. Hemoglobin was a positive interferent. EDTA was detectable in serum contaminated with 1% (v:v) k2EDTA plasma. An increase in serum potassium of 0.54 mmol/L (11.9%) was observed at a measured EDTA concentration of 0.19 mmol/L, equivalent to 3.2% (v:v) contamination. At this EDTA concentration reductions were also observed in zinc (71%), calcium (1%), alkaline phosphatase (ALP) (4%), and magnesium (2.4%). The serum EDTA assay detected contamination in 31/106 patient samples with hyperkalemia (potassium ≥6.0mmol/L), 20 of which were undetected by the current laboratory protocol. CONCLUSIONS: The EDTA assay displayed acceptable performance, with the ability to reliably measure EDTA at low concentrations. Only a small amount of kEDTA causes significant spurious hyperkalemia and is only reliably detected with EDTA measurement.


Assuntos
Coleta de Amostras Sanguíneas , Ácido Edético , Contaminação de Equipamentos/prevenção & controle , Hiperpotassemia , Hipocalcemia , Fosfatase Alcalina/sangue , Anticoagulantes/farmacologia , Biomarcadores/sangue , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , Cálcio/sangue , Técnicas de Laboratório Clínico/métodos , Ácido Edético/farmacologia , Humanos , Hiperpotassemia/sangue , Hiperpotassemia/diagnóstico , Hipocalcemia/sangue , Hipocalcemia/diagnóstico , Valores Críticos Laboratoriais , Magnésio/sangue , Potássio/sangue , Reprodutibilidade dos Testes , Zinco/sangue
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