Comparison of pneumatic tube system with manual transport for routine chemistry, hematology, coagulation and blood gas tests

Pupek, Alex; Matthewson, Beverly; S., Whitman, Erin,; Fullarton, R.; Chen, Yu

doi:10.1515/cclm-2016-1157

Cited by 38 publications

(49 citation statements)

References 21 publications

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“…This requisitioning TAT contributes 25% to the total delay in arranging a BT [Figure 2]. It can be improved by the use of technology like pneumatic chute system[10] or by having dedicated personnel for such transports. However, studies on cost–benefit analysis would be required before such an implementation is actually attempted.…”

Section: Discussionmentioning

confidence: 99%

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Agnihotri¹,

Agnihotri²

2018

Indian Journal of Critical Care Medicine

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Background and Aim:The turnaround time (TAT) for blood transfusion (BT) is an important quality indicator for the health-care institutions undertaking this procedure. There is no established national or international benchmark for this TAT due to the dearth of a published literature. We thus studied the TAT and the contributory procedures leading to delay in commencing a red blood cell transfusion in the hospitalized patient.Materials and Methods:Delay was captured for the blood order transcription, requisitioning and sampling by the nurse, blood bank (BB) processing, blood issue, and the transfusion commencement in the hospitalized patients. The study was done prospectively over a 1-year period and involved all the patient locations spread over six floors in a tertiary care accredited hospital.Results:A total of 2022 blood requests were analyzed during the study period. Most (73%) of the blood requests were marked as urgent by the treating unit. The average time from ordering to initiation of BT was 135 min in our study. BB processes (compatibility testing and issue) comprised approximately 47% of this delay (63 min), while rest of the delay happened in the processes (ordering 13 min, sample transport 34 min, and BT commencement 25 min) outside the BB (72 min).Conclusion:Majority of the delay for blood transfusion happens due to the processes outside blood bank premises. Understanding the steps where delay happens has the potential to reduce the turnaround time for lifesaving procedures such as blood transfusion in the hospitalized patients.

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Section: Discussionmentioning

confidence: 99%

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Agnihotri¹,

Agnihotri²

2018

Indian Journal of Critical Care Medicine

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“…So far, the impacts of PTS on complete blood cell count, biochemical tests, and blood gas analysis have been reported in previous studies 6‐9 . Yet, only a limited number of coagulation tests, such as prothrombin time (PT) and activated partial thromboplastin time (APTT), have been explored 10‐13 . The aim of this study was to systematically evaluate the impact of PTS on hemostasis tests including routine coagulation tests, coagulation factor activity tests, fibrinolytic parameters, and anticoagulation indicators.…”

Section: Introductionmentioning

confidence: 99%

Falsely decreased FVIII activity following pneumatic tube transport

Wang

Liang

et al. 2020

Int J Lab Hematology

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Introduction The pneumatic tube system (PTS) is widely used for sample delivery. We aimed to investigate the impacts of PTS on hemostasis assays. Methods Triplicate samples from 30 healthy volunteers were delivered to the core laboratory manually by human courier or via the 500 m long‐distance PTS or via the 1000 m long‐distance PTS. Comparisons of 19 hemostasis tests were conducted. Results Although PT, INR, APTT, FII, FV, FVII FIX, FX, FXII, DD, α2‐PI, and PC had statistical significance (all P < .05), all had low average bias remaining within clinical acceptable limits. PTS transportation only resulted in a statistically significant and clinically relevant decrease in FVIII activity. In the 500 m‐PTS group, 66.7% (20/30) of samples for FVIII testing had a bias greater than 8.3%. Moreover, in the 1000 m‐PTS group, 96.7% (29/30) of samples had a bias of over 8.3%, and the maximal bias achieved 42.1%. Conclusions Pneumatic tube system in our institution could be used to deliver blood samples for hemostasis tests evaluated in this study except FVIII activity assay.

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“…Several papers describe how PTS may increase the risk of in vitro hemolysis [2,[8][9][10]. Clinical chemistry analyses are most often discussed in this context; however, blood gas, hematology and coagulation analyses have also been subject to evaluation when assessing the effects of PTS on specimen integrity [4,11,12]. Impact on platelet function has also been investigated, and as a possible consequence of physical stress and increased interaction between neighboring cells and the surface of the sample tube, reduced platelet activation has been shown [4,12].…”

Section: Introductionmentioning

confidence: 99%

Use of clinical data and acceleration profiles to validate pneumatic transportation systems

Gils

Broell²,

Vinholt

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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BackgroundModern pneumatic transportation systems (PTSs) are widely used in hospitals for rapid blood sample transportation. The use of PTS may affect sample integrity. Impact on sample integrity in relation to hemolysis and platelet assays was investigated and also, we wish to outline a process-based and outcome-based validation model for this preanalytical component.MethodsThe effect of PTS was evaluated by drawing duplicate blood samples from healthy volunteers, one sent by PTS and the other transported manually to the core laboratory. Markers of hemolysis (potassium, lactate dehydrogenase [LD] and hemolysis index [HI]) and platelet function and activation were assessed. Historic laboratory test results of hemolysis markers measured before and after implementation of PTS were compared. Furthermore, acceleration profiles during PTS and manual transportation were obtained from a mini g logger in a sample tube.ResultsHand-carried samples experienced a maximum peak acceleration of 5 g, while peaks at almost 15 g were observed for PTS. No differences were detected in results of potassium, LD, platelet function and activation between PTS and manual transport. Using past laboratory data, differences in potassium and LD significantly differed before and after PTS installation for all three lines evaluated. However, these estimated differences were not clinically significant.ConclusionsIn this study, we found no evidence of PTS-induced hemolysis or impact on platelet function or activation assays. Further, we did not find any clinically significant changes indicating an acceleration-dependent impact on blood sample quality. Quality assurance of PTS can be performed by surveilling outcome markers such as HI, potassium and LD.

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Comparison of pneumatic tube system with manual transport for routine chemistry, hematology, coagulation and blood gas tests

Abstract: 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.

Cited by 38 publications

References 21 publications

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Turnaround time for red blood cell transfusion in the hospitalized patient: A single-center “Blood Ordering, Requisitioning, Blood Bank, Issue (of Blood), and Transfusion Delay” study

Falsely decreased FVIII activity following pneumatic tube transport

Use of clinical data and acceleration profiles to validate pneumatic transportation systems

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