Ida Boegh Andersen, Nina Mogensen, Ivan Brandslund
Background: The Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Denmark, and TIMEDICO invented and developed the Tempus600®, a pneumatic tube system (PTS). This system is only 2.5 cm in diameter and sends blood tubes directly, without packing before transport. Request forms need not be enclosed, since samples are labeled with patient and barcode ID. At the end of the pipes, a robot receives and places the tubes onto a good laboratory practice (GLP) transport system after the principle of “first in, first out” (FIFO), whereafter the tubes are delivered to centrifuges and analytical equipment. The whole system has decreased the total turnaround time (ToTAT) from 2 to 3 h to <60 min. The aim of the study was to validate the Tempus600/GLP robot system for the 89 most frequent or critical components.
Methods: Two sets of blood samples were drawn from 100 patients. One set was sent by the Tempus600/GLP robot system, and the other was couriered directly to the laboratory for analysis. Results were compared using difference plots.
Results: The results for 85 of the components did not deviate from the optimized fast courier reference transport more than could be expected by the analytical variation. O2 saturation, oxyhemoglobin, and partial pressure of oxygen (PO2) deviated considerably from a clinical point of view. Partial pressure of carbon dioxide (PCO2) results were clinically acceptable for assessing patients with obstructive lung disease for hypercapnia.
Conclusions: The Tempus600/GLP robot system can be used for transport of the majority of routinely used analytical tests.
• Received June 30, 2016.
• Accepted October 19, 2016.
• © 2016 American Association for Clinical Chemistry
Eline Sandvig Andersen and Ivan Brandslund. Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
Objectives: Pneumatic tube transportation of samples is an effective way of reducing turn-around-time, but evidence of the effect of pneumatic tube transportation on urine samples is lacking. We thus wished to investigate the effect of pneumatic tube transportation on various components in urine, in order to determine if pneumatic tube transportation of these samples is feasible.
Methods: One-hundred fresh urine samples were collected in outpatient clinics and partitioned with one partition being carried by courier to the laboratory, while the other was sent by pneumatic tube system (Tempus600). Both partitions were then analysed for soluble components and particles, and the resulting mean difference and limits of agreement were calculated.
Results: Albumin, urea nitrogen, creatinine, protein and squamous epithelial cells were unaffected by transportation in the Tempus600 system, while bacteria, renal tubular epithelial cells, white blood cells and red blood cells were affected and potassium and sodium may have been affected.
Conclusions: Though pneumatic tube transportation did affect some of the investigated components, in most cases the changes induced were clinically acceptable, and hence samples could be safely transported by the Tempus600 pneumatic tube system. For bacteria, white blood cells and red blood cells local quality demands will determine if pneumatic tube transportation is appropriate.
Clinical Chemistry and Laboratory Medicine (CCLM)
Published Online: 2020-11-23
Study on how PTS may affect sample integrity. Impact on sample integrity in relation to hemolysis and platelet assays was investigated and also a process-based and outcome-based validation model for this preanalytical component.
Juliane Suchsland, Theresa Winter, Anne Greiser, Thomas Streichert, Benjamin Otto, Julia Mayerle, Sören Runge, Anders Kallner, Matthias Nauck and Astrid Petersmann
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 Tempus 600® and courier.
Samples transported by Tempus 600® 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 Tempus 600® transport, respectively. This is considerably below the reported limit for noticeable hemolysis of 500 arbitrary units.
Tempus 600® 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 Tempus 600® transport. Based on these findings the Tempus 600® was cleared for clinical use in our hospital.
A-Jin Lee, Hun Suk Suh, Chang-Ho Jeon, Sang-Gyung Kim
Background: The 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. Methods: Paired EDTA and SST blood samples were collected from 56 randomly selected patients. Laboratory parameters were compared between PTS group and hand-delivered group.
Results: No 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.
Conclusions: All laboratories should validate the stability of the results from samples according to transportation method.
The association ’Nordisk Forening for Klinisk Kemi’ has published the article ‘Stability of Biochemical Components in Blood Samples Transported’ in the issue No. 1, vol. 25, 2013 of ‘Klinisk Biokemi i Norden’.
Mads Nybo, Merete E Lund, Kjell Titlestad, Christian U Maegaard
Background: Pneumatic transportation systems (PTSs) are increasingly used for transportation of blood samples to the core laboratory. Many studies have investigated the impact of these systems on different types of analyses, but to elucidate whether PTSs in general are safe for transportation of blood samples, existing literature on the subject was systematically assessed.
Results: Pneumatic transportation systems (PTSs) are increasingly used for transportation of blood samples to the core laboratory. Many studies have investigated the impact of these systems on different types of analyses, but to elucidate whether PTSs in general are safe for transportation of blood samples, existing literature on the subject was systematically assessed.
Conclusions: Owing to their high degree of heterogeneity, the retrieved studies were unable to supply evidence for the safety of using PTSs for blood sample transportation. In consequence, laboratories need to measure and document the actual acceleration forces in their existing PTS, instituting quality target thresholds for these measurements such as acceleration vector sums. Computer modeling might be applied to the evaluation of future PTS installations. With the increasing use of PTS, a harmonized, international recommendation on this topic is warranted.
© 2017 American Association for Clinical Chemistry.