Sample transport by pneumatic tube system alters results of multiple electrode aggregometry but not rotational thromboelastometry. 2013

Michael Glas, and Dietmar Mauer, and Hazim Kassas, and Thomas Volk, and Sascha Kreuer
Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital , Kirrberger Strasse, D-66421 Homburg (Saar) , Germany. michael.glas@uks.eu

Pneumatic tube systems (PTS) present a convenient way for blood sample transport in medical facilities. Associated preanalytical interference in various tests is largely unknown. Implementing point-of-care coagulation management at our institution, we investigated multiple electrode aggregometry (MEA) and rotational thromboelastometry (ROTEM) after PTS transportation. Whole blood samples from patients undergoing general or trauma surgery were analysed by MEA after collection (baseline, '0 × PTS') and sent on a predefined PTS track (n = 12). MEA was repeated after samples travelled the track 4 ('4 × PTS'), 8 ('8 × PTS') and 12 times ('12 × PTS') and compared with stationary controls analysed at the same time. Samples for ROTEM (n = 6) were analysed after collection and travelling the track 12 times. An acceleration detector recorded g-forces on the PTS track. At '0 × PTS' no significant differences in MEA results were detected. Values were significantly lower for transported samples compared with controls ('4 × PTS' to '12 × PTS', p < 0.001). Furthermore, MEA results of PTS samples were significantly decreased for '4 × PTS' to '12 × PTS' compared to baseline (p < 0.001). Except for the clotting time in EXTEM PTS transport did not significantly alter results for investigated ROTEM parameters, compared with baseline and stationary controls. Acceleration detector readout revealed alternating g-forces between -6.3 and +5.9 during transport. PTS transport caused invalid results in MEA while only one ROTEM parameter was found to be affected in this study. Variable acceleration during transport provides a potential reason for platelet activation. The authors recommend sample transport by hand or the device to be placed patient-side when MEA is performed.

UI MeSH Term Description Entries
D008297 Male Males
D010979 Platelet Function Tests Laboratory examination used to monitor and evaluate platelet function in a patient's blood. Function Test, Platelet,Function Tests, Platelet,Platelet Function Test,Test, Platelet Function,Tests, Platelet Function
D001780 Blood Coagulation Tests Laboratory tests for evaluating the individual's clotting mechanism. Coagulation Tests, Blood,Tests, Blood Coagulation,Blood Coagulation Test,Coagulation Test, Blood,Test, Blood Coagulation
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013048 Specimen Handling Procedures for collecting, preserving, and transporting of specimens sufficiently stable to provide accurate and precise results suitable for clinical interpretation. Specimen Collection,Collection, Specimen,Collections, Specimen,Handling, Specimen,Handlings, Specimen,Specimen Collections,Specimen Handlings
D013916 Thrombelastography Use of a thrombelastograph, which provides a continuous graphic record of the physical shape of a clot during fibrin formation and subsequent lysis. Thromboelastography,Thromboelastometry
D019095 Point-of-Care Systems Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry. Bedside Computing,Point of Care Technology,Bedside Technology,Point-of-Care,Bedside Technologies,Computing, Bedside,Point of Care,Point of Care Systems,Point-of-Care System,Systems, Point-of-Care,Technologies, Bedside,Technology, Bedside

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