The effects of transport by pneumatic tube system on blood cell count, erythrocyte sedimentation and coagulation tests

Koçak, Fatma Emel; Yöntem, Mustafa; Yücel, Özlem Eşki; Cilo, Mustafa; Genç, Osman; Meral, Ayfer

doi:10.11613/bm.2013.024

Cited by 24 publications

(13 citation statements)

References 18 publications

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“…In this study, there were no statistical significant differences for CBC, WBC differential count, and ESR between both methods. Results of the present study correspond well with those of the earlier studies which reported that PTS does not affect hematology parameters [3] , [9] , [10] , [11] . A recent study found no statistical differences for CBC, and ESR between the PTS and hand-carried method [10] .…”

Section: Discussionsupporting

confidence: 93%

“…Results of the present study correspond well with those of the earlier studies which reported that PTS does not affect hematology parameters [3] , [9] , [10] , [11] . A recent study found no statistical differences for CBC, and ESR between the PTS and hand-carried method [10] . In this study, CBC parameters and ESR were analyzed using the Beckman Coulter LH780 Gen-S system and Alifax-SPA Test 1 HDL system, respectively.…”

Section: Discussionsupporting

confidence: 93%

“…It has also been demonstrated previously that clinically insignificant but statistically significant results on the mean platelet component were observed between PTS and manual transportation [3] . In another study, there was no effect on the mean platelet component [10] . Recent study found no statistically significant effects of PTS transport on platelet aggregation in patients with anti-platelet therapy [13] .…”

Section: Discussionmentioning

confidence: 89%

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Effects of one directional pneumatic tube system on routine hematology and chemistry parameters; A validation study at a tertiary care hospital

Lee

Suh

Jeon

et al. 2017

Practical Laboratory Medicine

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BackgroundThe validation of sample stability through pneumatic tube system (PTS) is essential. The objective of this study was to evaluate the effects of PTS transportation on laboratory results.MethodsPaired EDTA and SST blood samples were collected from 56 randomly selected patients. Laboratory parameters were compared between PTS group and hand-delivered group.ResultsNo statistical differences were observed for complete blood counts, white blood cell differential parameters, erythrocyte sedimentation rate and most chemistry parameters between PTS and hand-delivered transport procedures. Mean platelet volume results obtained from samples transported through PTS were lower than that obtained from samples transported through hand-delivered method (P = 0.001). The results of aspartate aminotransferase (P = 0.000), lactate dehydrogenase (P = 0.000), and hemolysis index (P = 0.000) from PTS group were higher than that from hand-delivered group.ConclusionsAll laboratories should validate the stability of the results from samples according to transportation method.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

Effects of one directional pneumatic tube system on routine hematology and chemistry parameters; A validation study at a tertiary care hospital

Lee

Suh

Jeon

et al. 2017

Practical Laboratory Medicine

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“…These errors are particularly more likely for leukemic patients with fragile leukocyte membranes [ 8 ]. The PTS effects are associated with transportation speed, acceleration and deceleration, spin times at corners, distance to station, and a lack of cushioning [ 9 – 11 ]. The aim of this prospective study was to assess the potential influence of the use of a PTS for routine hematological tests and determine whether PTS interferes with complete blood cell counts (CBC) and causes unnecessary transfusions.…”

Section: Introductionmentioning

confidence: 99%

Assessing Safety of Pneumatic Tube System (PTS) for Patients with Very Low Hematologic Parameters

et al. 2016

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BackgroundPreventive interventions save lives during the process of chemotherapy for hematologic malignancies, when a hematology laboratory can ensure accurate results. The use of a pneumatic tube system (PTS) is associated with measurement errors and unnecessary transfusions. The aim of this study was to evaluate pre-analytical errors associated with transportation method (PTS versus hand-delivered) and to investigate whether there are unnecessary transfusion events in pancytopenia leukemia patients with very low hematological parameters.Material/MethodsA total of 140 paired blood collections were performed for hemogram and biochemistry assays. Paired EDTA and serum gel blood samples were collected from 58 cases with acute leukemia on different days. For each pair, one sample was hand-delivered by a courier (Group 1) while the other sample was transported through a PTS (Group 2).ResultsThe hand-delivered method showed that some platelet transfusions were unnecessary for different thrombocyte cut-off values. Calculated unnecessary platelet (PLT) transfusion ratios when using PTS (PLT <30×103/μL, 16.3%; PLT <25×103/μL, 16.4%; PLT <20×103/μL, 80.3%; PLT <15×103/μL, 48.6%; and PLT <10×103/μL, 150.0%) were found to be statistically significant (p=0.002, p=0.046, p<0.000, p=0.028, and p<0.000, respectively). In contrast, for RBC transfusion ratios, although the ratios were high in Group 2, we found no significant difference between the two groups; (HGB <8.0 g/dL, 23.3%; HGB <9.0 g/dL, 25.0%, HGB<10.0 g/dL, 19.3%) and (p=0.002, p=0.085, p<0.160, and p=0.235, respectively).ConclusionsAlthough our results cannot be universally applied, physicians should be careful, skeptical, and suspicious of transfusion decisions in hematology clinics and consider potential analytical and pre-analytical errors in cases of severe cytopenia when using PTS.

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“…Ellis and Hasan both led ED-based studies that revealed significantly increased specimen hemolysis rates after pneumatic tube systems were installed 5,6. In contrast, other studies of pneumatic tube use demonstrated no significant changes in hemolysis rates 8,9,11–15. Because of this discrepancy in the literature, and in search of techniques to lower our own institution’s hemolysis rates, we sought to determine whether hemolysis rates of blood samples obtained in the ED were increased when transported in a pneumatic tube system versus being hand carried to the lab.…”

Section: Introductionmentioning

confidence: 99%

Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?

Phelan

Reineks

Hustey

et al. 2016

WestJEM

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IntroductionOur goal was to determine if the hemolysis among blood samples obtained in an emergency department and then sent to the laboratory in a pneumatic tube system was different from those in samples that were hand-carried.MethodsThe hemolysis index is measured on all samples submitted for potassium analysis. We queried our hospital laboratory database system (SunQuest®) for potassium results for specimens obtained between January 2014 and July 2014. From facility maintenance records, we identified periods of system downtime, during which specimens were hand-carried to the laboratory.ResultsDuring the study period, 15,851 blood specimens were transported via our pneumatic tube system and 92 samples were hand delivered. The proportions of hemolyzed specimens in the two groups were not significantly different (13.6% vs. 13.1% [p=0.90]). Results were consistent when the criterion was limited to gross (3.3% vs 3.3% [p=0.99]) or mild (10.3% vs 9.8% [p=0.88]) hemolysis. The hemolysis rate showed minimal variation during the study period (12.6%–14.6%).ConclusionWe found no statistical difference in the percentages of hemolyzed specimens transported by a pneumatic tube system or hand delivered to the laboratory. Certain features of pneumatic tube systems might contribute to hemolysis (e.g., speed, distance, packing material). Since each system is unique in design, we encourage medical facilities to consider whether their method of transport might contribute to hemolysis in samples obtained in the emergency department.

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The effects of transport by pneumatic tube system on blood cell count, erythrocyte sedimentation and coagulation tests

Cited by 24 publications

References 18 publications

Effects of one directional pneumatic tube system on routine hematology and chemistry parameters; A validation study at a tertiary care hospital

Effects of one directional pneumatic tube system on routine hematology and chemistry parameters; A validation study at a tertiary care hospital

Assessing Safety of Pneumatic Tube System (PTS) for Patients with Very Low Hematologic Parameters

Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?

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