Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University, St. Louis, MO.
Department of Medicine, Siteman Cancer Center, Washington University, St. Louis, MO.
Clin Chem. 2019 May;65(5):694-702. doi: 10.1373/clinchem.2018.301408. Epub 2019 Feb 26.
Pneumatic tube systems (PTSs) provide rapid transport of patient blood samples, but physical stress of PTS transport can damage blood cells and alter test results. Despite this knowledge, there is limited information on how to validate a hospital PTS.
We compared 2 accelerometers and evaluated multiple PTS routes. Variabilities in PTS forces over the same routes were assessed. Response curves that demonstrate the relationship between the number and magnitude of accelerations on plasma lactate dehydrogenase (LD), hemolysis index, and potassium in PTS-transported blood from volunteers were generated. Extrapolations from these relationships were used to predict PTS routes that may be prone to false laboratory results. Historical data and prospective patient studies were compared with predicted effects.
The maximum recorded g-force was 10 for the smartphone and 22 for the data logger. There was considerable day-to-day variation in the magnitude of accelerations (CV, 4%-39%) within a single route. The linear relationship between LD and accelerations within the PTS revealed 2 PTS routes predicted to increase LD by ≥20%. The predicted increase in LD was similar to that observed in patient results when using that PTS route.
Hospital PTSs can be validated by documenting the relationship between the concentrations of analytes in plasma, such as LD, with PTS forces recorded by 3-axis accelerometers. Implementation of this method for PTS validation is relatively inexpensive, simple, and robust.
气动输送系统（PTS）提供了患者血液样本的快速运输，但 PTS 运输的物理压力会破坏血细胞并改变测试结果。尽管有这方面的知识，但关于如何验证医院 PTS 的信息有限。
我们比较了 2 个加速度计并评估了多条 PTS 路线。评估了同一路线上 PTS 力的可变性。生成了从志愿者 PTS 运输的血液中血浆乳酸脱氢酶（LD）、溶血指数和钾的加速度数量和幅度之间的关系的响应曲线。从这些关系进行外推，以预测可能导致实验室结果错误的 PTS 路线。将历史数据和前瞻性患者研究与预测效果进行了比较。
智能手机记录的最大 g 力为 10，数据记录仪为 22。在单一路线内，加速度的幅度存在相当大的日常变化（CV，4%-39%）。在 PTS 内 LD 和加速度之间的线性关系表明，有 2 条 PTS 路线预计会使 LD 增加≥20%。当使用该 PTS 路线时，预测的 LD 增加与患者结果中的观察结果相似。
可以通过记录血浆中分析物（如 LD）的浓度与三轴加速度计记录的 PTS 力之间的关系来验证医院 PTS。用于 PTS 验证的这种方法的实施相对便宜、简单且稳健。
