Center for Laboratory Medicine, St. Gallen, Switzerland.
Clin Chem Lab Med. 2013 Jun;51(6):1273-8. doi: 10.1515/cclm-2012-0625.
Laboratories today face increasing pressure to automate operations due to increasing workloads and the need to reduce expenditure. Few studies to date have focussed on the laboratory automation of preanalytical coagulation specimen processing. In the present study, we examined whether a clinical chemistry automation protocol meets the preanalytical requirements for the analyses of coagulation.
During the implementation of laboratory automation, we began to operate a pre- and postanalytical automation system. The preanalytical unit processes blood specimens for chemistry, immunology and coagulation by automated specimen processing. As the production of platelet-poor plasma is highly dependent on optimal centrifugation, we examined specimen handling under different centrifugation conditions in order to produce optimal platelet deficient plasma specimens. To this end, manually processed models centrifuged at 1500 g for 5 and 20 min were compared to an automated centrifugation model at 3000 g for 7 min.
For analytical assays that are performed frequently enough to be targets for full automation, Passing-Bablok regression analysis showed close agreement between different centrifugation methods, with a correlation coefficient between 0.98 and 0.99 and a bias between -5% and +6%. For seldom performed assays that do not mandate full automation, the Passing-Bablok regression analysis showed acceptable to poor agreement between different centrifugation methods.
A full automation solution is suitable and can be recommended for frequent haemostasis testing.
由于工作量增加和减少支出的需求,当今实验室面临着越来越大的操作自动化压力。迄今为止,很少有研究关注凝血分析前标本处理的实验室自动化。在本研究中,我们研究了一个临床化学自动化方案是否符合凝血分析的分析前要求。
在实施实验室自动化的过程中,我们开始运行一个分析前和分析后的自动化系统。该分析前单元通过自动化标本处理来处理化学、免疫和凝血的血液标本。由于血小板缺乏血浆的产生高度依赖于最佳离心,我们研究了不同离心条件下的标本处理,以产生最佳的血小板缺乏血浆标本。为此,我们将手动处理的 1500g 离心 5 分钟和 20 分钟的模型与 3000g 离心 7 分钟的自动化离心模型进行了比较。
对于经常进行以至于可以成为全自动化目标的分析测定,Passing-Bablok 回归分析显示不同离心方法之间有密切的一致性,相关系数在 0.98 到 0.99 之间,偏差在-5%到+6%之间。对于不要求全自动化的很少进行的测定,Passing-Bablok 回归分析显示不同离心方法之间的一致性可以接受但较差。
对于频繁的止血测试,全自动化解决方案是合适的,并且可以推荐使用。