Extending laboratory automation to the wards: effect of an innovative pneumatic tube system on diagnostic samples and transport time.

BACKGROUND: The innovative pneumatic tube system (iPTS) transports one sample at a time without the use of cartridges and allows rapid sending of samples directly into the bulk loader of a laboratory automation system (LAS). We investigated effects of the iPTS on samples and turn-around time (TAT). METHODS: During transport, a mini data logger recorded the accelerations in three dimensions and reported them in arbitrary area under the curve (AUC) units. In addition representative quantities of clinical chemistry, hematology and coagulation were measured and compared in 20 blood sample pairs transported by iPTS and courier. RESULTS: Samples transported by iPTS were brought to the laboratory (300 m) within 30 s without adverse effects on the samples. The information retrieved from the data logger showed a median AUC of 7 and 310 arbitrary units for courier and iPTS transport, respectively. This is considerably below the reported limit for noticeable hemolysis of 500 arbitrary units. CONCLUSIONS: iPTS reduces TAT by reducing the hands-on time and a fast transport. No differences in the measurement results were found for any of the investigated 36 analytes between courier and iPTS transport. Based on these findings the iPTS was cleared for clinical use in our hospital.

Long-term stability of glucose: 96-h study using Terumo Glycaemia tubes.

BACKGROUND: Long transportation times of samples can occur due to centralization of laboratories, and also in, for instance epidemiological multicenter studies with one core laboratory. Unsatisfactory glycolysis inhibition is known to threaten the correct measurements of glucose concentration in patient samples. In former studies Terumo Glycaemia tubes proved to be superior to other anticoagulant systems for time periods of up to 24 h. We investigated long-term stability of glucose concentration in Terumo Glycaemia tubes for up to 96 h at room temperature and imitated transport conditions by continuous sample shaking. METHODS: Human venous blood samples were collected from 40 healthy blood donors using Terumo Glycaemia tubes. Immediately after sampling, tubes were mixed according to the manufactures recommendations. To simulate transportation conditions samples were placed on a shaker for the entire study period and maintained at room temperature. Samples were (re)centrifuged at 0, 24, 36, 48, 72 and 96 h prior to measuring glucose concentration. The glucose concentration at 0 h was used as baseline for evaluation of long-term stability. RESULTS: The recovery of glucose was 100% throughout the study, including the 96-h measurements. Deviations of single glucose measurements were within the imprecision of the measurement procedure. CONCLUSIONS: Terumo Glycaemia tubes can effectively stabilize glucose in whole blood samples kept at room temperature on a shaker during a 96-h time period. Therefore, we consider Terumo Glycaemia tubes as a suitable glucose stabilizing tube for long intervals between sample collection and glucose quantification.

The 99th percentile and imprecision of point-of-care cardiac troponin I in comparison to central laboratory tests in a large reference population.

OBJECTIVES: Determination of cardiac troponin (cTn) is central in the emergency department (ED) for the diagnosis of myocardial infarction. In view of adverse effects of long waiting time on patient outcome, implementation of point-of-care-testing (POCT) is suggested if the turn-around-time is longer than 60min. The present study aimed to determine the 99th percentile and imprecision of two POCT in a healthy population measuring cTnI and cTnT and compare these analytical characteristics against three central laboratory test (CLT) for cTnI. DESIGN & METHODS: CTnI and cTnT were determined in parallel by means of the AQT90 FLEX analyzer in about 2250 plasma samples from individuals with known health status. Results were compared to previously determined performance data of three CLT. RESULTS: The 99th percentile of cTnI in the POCT was determined at 19ng/L, the lowest concentration with an imprecision of 10% was reached at 22ng/L while an imprecision of 20% was reached at 13ng/L. Age, sex, or physical activity did not affect the 99th percentile of cTnI. Compared to CLT the AQT90 cTnI POCT the analytical performance was equivalent. The cTnT POCT could not be assessed due a considerable number of high values and an inadequate imprecision profile. CONCLUSION: While the cTnI POCT showed analytical performance comparable to CLT, the results of the cTnT assay on the same device did not suffice to determine a reliable 99th percentile. The present evaluation supports the usage of the cTnI POCT, but application of the cTnT POCT needs further evaluation.