Indexing
All Issues
Submission
Author Guidelines
Reviewers
Editorial Members
Publication Fee
Vol.3 , No. 1, Publication Date: Mar. 2, 2016, Page: 20-23
 to the testing laboratory. The present study evaluated the changes in the levels of enzymes in two different tube system transports within the hospital system. Two tubes of blood, one SST (Serum) tube and one Lithium Heparin (Plasma) tube, were collected simultaneously from 31 (Site 1) and 22 (Site 2) volunteers. Both tubes were hand carried to the lab and levels of LDH, AST, ALT, ALK PHOS, GGT and K were measured. These tubes were then hand-carried back to the site of collection and transported to the testing lab respective site pneumatic tube systems. The average carrier travel distance for Site 1 is 2911 feet and Site 2 is 1200 feet. Average travel sped of carriers at both locations is 28 feet per second. Both serum and plasma enzyme levels were measured using AU 680 and analyzer (Beckman Coulter Inc, Brea CA). Significant differences between plasma levels of LDH are observed when comparing the results of untubed blood vs. blood transported through pneumatic tube system. The length of travel of the tube has significant influence on various analytes and percent bias is high for ALT and AST at Site 1, but these differences are not statistically significant. On the other hand no significant differences are observed in serum levels of all enzymes. Hemolysis measured by Spectral index did not show any hemolysis of both serum and plasma tubes. Stability of plasma specimens are also decreased by 3 days when they are stored refrigerated. LDH levels are significantly elevated based on the length of tube travel in plasma and not in serum. Careful validation is needed when implementing plasma tubes for chemistry analytes, especially when transported through pneumatic tube systems.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | L. V. Rao, Department of Hospital Labs/ Pathology, UMass Memorial Medical Center, Worcester, MA, USA. |
| [2] | L. M. Snyder, Department of Hospital Labs/ Pathology, UMass Memorial Medical Center, Worcester, MA, USA. |
Pneumatic tube systems of various lengths are routinely used in many hospitals to transport blood collection tubes (serum, plasma, whole blood) to the testing laboratory. The present study evaluated the changes in the levels of enzymes in two different tube system transports within the hospital system. Two tubes of blood, one SST (Serum) tube and one Lithium Heparin (Plasma) tube, were collected simultaneously from 31 (Site 1) and 22 (Site 2) volunteers. Both tubes were hand carried to the lab and levels of LDH, AST, ALT, ALK PHOS, GGT and K were measured. These tubes were then hand-carried back to the site of collection and transported to the testing lab respective site pneumatic tube systems. The average carrier travel distance for Site 1 is 2911 feet and Site 2 is 1200 feet. Average travel sped of carriers at both locations is 28 feet per second. Both serum and plasma enzyme levels were measured using AU 680 and analyzer (Beckman Coulter Inc, Brea CA). Significant differences between plasma levels of LDH are observed when comparing the results of untubed blood vs. blood transported through pneumatic tube system. The length of travel of the tube has significant influence on various analytes and percent bias is high for ALT and AST at Site 1, but these differences are not statistically significant. On the other hand no significant differences are observed in serum levels of all enzymes. Hemolysis measured by Spectral index did not show any hemolysis of both serum and plasma tubes. Stability of plasma specimens are also decreased by 3 days when they are stored refrigerated. LDH levels are significantly elevated based on the length of tube travel in plasma and not in serum. Careful validation is needed when implementing plasma tubes for chemistry analytes, especially when transported through pneumatic tube systems.
Keywords
Pneumatic Tube, Enzymes, LDH, Liver enzymes
Reference
| [01] | Guss DA, Chan TC, Killeen JP. The impact of pneumatic tube and computerized physician order management on laboratory turnaround time. Ann Emerg Med. 2008; 181-185. |
| [02] | Collinson PO, John CM, Gaze DC et al. Changes in blood gas samples produced by a pneumatic tube system. J Clin Pathol. 2002; 55: 105-107. |
| [03] | Stair TO, Howell JM, Fitzgerald DJ et al. Hemolysis of blood specimensd transported from ED to laboratory by pneumatic tibe. Am J Emerg Med. 1995; 13: 484. |
| [04] | Sodi R, Darn SM, Stott A. Pneumatic tube system induced haemolysis: assessing sample type susceptibility to haemolysis. Ann Clin Biochem. 2004; 41: 237–240. |
| [05] | Kapoula G, Filntitis I, Karampousli E et al. Pneumatic tube transport system for blood samples: Evaluation of its effect on hemolysis. Scientific Chronicles. 2015; 20: 194-199. |
| [06] | Kellerman PS, Thornbery JM. Pseudohyperkalemia due to pneumatic tube transport in a leukemic patient. Am J Kidney Dis. 2005; 46: 746–748. |
| [07] | Poznanski W, Smith K, Bodley F. Implementation of a pneumatic tube system for transport of blood specimens. Am J Clin Pathol. 1978: 70: 291–295. |
| [08] | Strubi-Vuillaume I, Carlier V, Obeuf C et al. Gentle blood aspiration and tube cushioning reduce pneumatic tube system interference in lactate dehydrogenase assays. Ann Clin Biochem. 2015. PMID 25911571. |
| [09] | Yuan-hua Wei, Chun-bing Zhang, Xua-wen Tang, Ming0de Ji. The feasibility of using Lithium Heparin Plasma from a gel separator tube as a substitute for serum in clinical biochemical tests. Lab Medicine. 2010; 41: 215-219. |
| [10] | Felder RA. Preanalytical errors introduced by sample-transportation systems: A mean to access them. Clinical Chemistry. 2011; 57: 1349-1350. |
| [11] | Plebani M, Zaninotto M. Pneumatic tube delivery systems for patient samples: evidence of quality and quality of evidence. Clin Chem Lab Med 2011; 49: 1242-1246. |
| [12] | Hasan K, Aysegul B, Ahmet AK et al. Hemolysis associated with pneumatic tube system transport for blood samples. Pak J Med Sci. 2014; 30: 50-53. |
| [13] | Ming Cui, Rongrong Jing, Huimin Wang. Changes of Serum LDH and Potassium levels prodeuced by a pneumatic tube system. Lab Medicine. 2009; 40: 728-731. |
