Böckel-Frohnhöfer Nicole, Hübner Ulrich, Hummel Björn, Geisel Jürgen
University Hospital of Saarland, Clinical Chemistry and Laboratory Medicine/Central Laboratory , Homburg , Germany.
Scand J Clin Lab Invest. 2014 Oct;74(7):599-602. doi: 10.3109/00365513.2014.921931. Epub 2014 Jun 9.
Pneumatic tube systems are widely used in hospitals. Advantages are high speed and rapid availability of the samples. However, the transportation by pneumatic tube promotes haemolysis. Haemolysis interferes with many spectrophotometric assays and is a common problem in clinical laboratories. The haemolysis index (HI) as a semi-quantitative representation of the level of haemolysis was compared in unpaired tube-transported and hand-delivered routine lithium heparinate plasma samples (n = 1368 and n = 837, respectively). Additionally, the HI distribution was measured in lithium heparinate plasma samples with a HI above the threshold value of 20 and in paired serum samples after transportation by pneumatic tube system. HI values above 20 can interfere with the selected assays: Creatine kinase (CK), creatine kinase-MB (CK-MB) and alanine aminotransferase (ALT) activities. These parameters were determined to demonstrate how haemolysis affects the results. 17.5% of the tube-transported plasma samples and 2.6% of the hand-delivered plasma samples had a HI above 20. The median HI in pneumatic tube-transported lithium heparinate plasma was 85 and 33 in the paired serum samples. The median HI difference between paired plasma and serum was 46. Blood samples in lithium heparinate tubes may be substantially more susceptible to haemolysis by pneumatic tube transportation than serum tube samples. Although our results cannot be universally applied to laboratories with different pneumatic tube systems, it is recommended that each laboratory evaluate carefully the degree of haemolysis after the transportation by the own pneumatic tube system and in terms of the sample type.
气动管道系统在医院中被广泛使用。其优点是速度快且样本能快速送达。然而，通过气动管道运输会促进溶血。溶血会干扰许多分光光度法检测，是临床实验室中常见的问题。对未配对的通过管道运输和人工递送的常规肝素锂血浆样本（分别为n = 1368和n = 837）的溶血指数（HI）作为溶血水平的半定量表示进行了比较。此外，还测量了HI高于阈值20的肝素锂血浆样本以及通过气动管道系统运输后的配对血清样本中的HI分布。HI值高于20会干扰所选检测：肌酸激酶（CK）、肌酸激酶同工酶MB（CK-MB）和丙氨酸氨基转移酶（ALT）活性。测定这些参数以证明溶血如何影响结果。17.5%的通过管道运输的血浆样本和2.6%的人工递送的血浆样本的HI高于20。气动管道运输的肝素锂血浆的HI中位数为85，配对血清样本中的HI中位数为33。配对血浆和血清之间的HI中位数差异为46。肝素锂管中的血液样本可能比血清管样本更容易因气动管道运输而发生溶血。尽管我们的结果不能普遍适用于使用不同气动管道系统的实验室，但建议每个实验室仔细评估自身气动管道系统运输后以及根据样本类型的溶血程度。
