The impact of pneumatic tube system on routine laboratory parameters: a systematic review and meta-analysis

Kapoula, Georgia V; Kontou, Panagiota I.; Bagos, Pantelis G.

doi:10.1515/cclm-2017-0008

Cited by 27 publications

(21 citation statements)

References 36 publications

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“…Pneumatic tube system caused sample hemolysis, and long‐distance PTS (1000 m) was more likely to cause hemolysis than short‐distance PTS (500 m). This finding is consistent with previous reports 1,6 . Although the hemolysis rate was up to 40% in the 1000 m‐PTS group, the highest PFH was only 15.2 mg/dL.…”

Section: Discussionsupporting

confidence: 93%

“…Pneumatic tube system (PTS) is a popular method which can quickly transport samples from the clinics to the core laboratory. It can effectively shorten the laboratory turnaround time (TAT) and also reduce the work pressure of hospital staff 1‐3 . It is ideal that samples for coagulation assays would be collected and processed to centrifugation within one hour, 4 and PTS is a great choice to meet this requirement.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 93%

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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“…The exact opposite is true for most extra-analytical process steps. These occur in many different places, mostly outside of the laboratory, involve many parties, such as patients, clinicians, nurses or sample carriers, and include many influencing variables, for instance (16): test selection (17), a process step also referred to as the prepre-analytical step (18), patient medication and fasting state, including the time of phlebotomy (19), patients' potential physical activity prior to blood collection (20,21), patient posture during phlebotomy (22,23), biological variability (24)(25)(26), as well as sample storage and transport conditions (27,28). Additionally, two of the most frequent pre-analytical errors relate to patient identification errors (29)(30)(31) and haemolysed samples (32)(33)(34)(35).…”

Section: Where Are We Now?mentioning

confidence: 99%

How do we use the data from pre-analytical quality indicators and how should we?

Cadamuro¹,

Gaksch²,

Mrazek³

et al. 2018

J. Lab. Precis. Med.

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It is impossible to imagine a modern medical laboratory without a structured quality management system in place. Nevertheless, this system usually focuses mostly on the analytical part of the total testing process (TTP), despite being aware of the fact that most errors occur in the pre-and post-analytical phases. There are many reasons possibly explaining this fact, one of them being that extra-analytical processes are hard to grasp, since they occur mostly outside of the laboratory and include many different parties. Despite these obstacles, it is mandatory to keep all steps of TTP, potentially influencing the analytical test result or their interpretation, under meticulous quality control and to improve them as much as possible, involving all health care workers contributing to sample quality. Additionally, it is necessary to collect and evaluate all data in a standardized manner, not only within one laboratory, but nationwide and internationally. This is a perquisite for valid data comparison over time (trend analysis) and benchmarking, the basis for threshold definition and continuous improvement. A widely accepted method to meet all these requirements is the concept of quality indicators (QIs). In this review, we provide an overview over this topic and we discuss an easy to use and freely available tool, aiming to aid laboratories in data collection and comparison: The QIs project of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on "Laboratory errors and patient safety" (WG-LEPS). Additionally, we provide practical suggestions on how to successfully implement QIs within any laboratory.

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“…This increases the risk of more samples being rejected due to haemolysis, with consequences of unnecessary specimen collection and increased TAT as well as the risk of falsely high concentrations of parameters sensitive to haemolysis such as potassium. [5][6][7][8][9] The architecture of each PTS is unique when it comes to manufacturer, materials, length, number of vertical drops, twist and turns and turning radius as well as sending speed, which makes the effects of transportation on sample integrity difficult to predict prior to commissioning. 10,11 Hence, the potential risk of blood sample quality being compromised when transported by PTS and the necessity to validate each PTS before transportation of blood samples have repeatedly been emphasized.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Hence, the potential risk of blood sample quality being compromised when transported by PTS and the necessity to validate each PTS before transportation of blood samples have repeatedly been emphasized. 8,11 Still, it remains up to each laboratory to define its own validation procedure and protocol, since no gold standard has yet been defined. Most studies describing PTS validation compare results between blood samples carried by hand vs. transported by PTS.…”

Section: Introductionmentioning

confidence: 99%

Pneumatic tube validation: Reducing the need for donor samples by integrating a vial-embedded data logger

Stangerup

Broell²,

Hoop³

et al. 2021

Ann Clin Biochem

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Background: The most common way to validate a pneumatic tube system (PTS) is to compare PTS transported blood samples to blood samples carried by hand. The importance of also measuring the forces inside the PTS has been emphasized. The aim of this study was to define a validation protocol using a mini data logger (VitalVial, Motryx Inc., Canada) to reduce the need for donor samples in PTS validation. Methods: As an indicator of the total vibration the blood samples are exposed to under PTS transportation, the area under the curve (AUC) was determined by a VitalVial for all hospital Tempus600 lines using a five-day validation protocol. Only the three lines with the highest AUC were clinically validated by analyzing potassium, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST). A month after PTS commissioning, a follow-up on laboratory data was performed. Results: Mean AUC of the six lines ranged between 347 and 581. The variability of the AUC was between 1.51-11.55%. In the laboratory data follow-up, an increase in LDH hemolysis was seen from the three lines with the highest AUC and the emergency department which was not detected in the clinical validation. When the Tempus600 system was in commission, a higher mean AUC was measured. Conclusion: A three-day validation protocol using VitalVials is enough to determine the stability of a Tempus600 system and can greatly reduce the need for donor samples. When in commission, the stability of the PTS should be verificated and LDH hemolysis should be routinely checked.

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The impact of pneumatic tube system on routine laboratory parameters: a systematic review and meta-analysis

Cited by 27 publications

References 36 publications

Falsely decreased FVIII activity following pneumatic tube transport

Falsely decreased FVIII activity following pneumatic tube transport

How do we use the data from pre-analytical quality indicators and how should we?

Pneumatic tube validation: Reducing the need for donor samples by integrating a vial-embedded data logger

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