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Review ArticleMini-Review

Blood Sample Transportation by Pneumatic Transportation Systems: A Systematic Literature Review

Mads Nybo, Merete E. Lund, Kjell Titlestad, Christian U. Maegaard
DOI: 10.1373/clinchem.2017.280479 Published April 2018
Mads Nybo
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark;
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  • For correspondence: mads.nybo@rsyd.dk
Merete E. Lund
Department of Clinical Immunology, Odense University Hospital, Odense, Denmark;
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Kjell Titlestad
Department of Clinical Immunology, Odense University Hospital, Odense, Denmark;
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Christian U. Maegaard
Facilities Management, Odense University Hospital, Odense, Denmark.
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    Fig. 1. Flow chart of retrieved, excluded and included studies.

    Publications were considered irrelevant if the subject was completely different (solid particles, transport velocity evaluation, etc.).

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    Table 1.

    The studies included, with the PTSs and patient populations investigated.

    StudyPneumatic transportation systemStudy population
    Victor Peter (29)AerocomMedical ICU patients
    Tiwari (30)AtlasHealthy volunteers
    Sodi (31)Atlas systemConsenting patients
    Zaman (32)GCT 3000 AerocomPatients on pneumology wards or referred to LFT
    Gossez (27)HÖRTIG rohrpostHealthy donors
    Kocak (20)MP10000 SumetzbergerHealthy blood donors
    Astles (33)Not specifiedICU and for elective surgery
    Braun (34)Not specifiedPatients scheduled for coronary angiography
    Collinson (35)Not specifiedICU patients
    Colucci (36)Not specifiedHealthy volunteers
    Glas (37)Not specifiedPatients undergoing general or trauma surgery
    Gomez-Rioja (38)Not specifiedHealthy volunteers
    Kavsak (39)Not specifiedInpatients from ED, ICU, hematology/oncology, and surgery
    Phelan (40)Not specifiedDatabase extract of patient sample values
    Thalén (41)Not specifiedHealthy volunteers, ICU (8 patients), and cardiovascular clinic
    Lima-Oliveira (28)Op1000 (Oppent SpA)Healthy volunteers
    Al-Riyami (15)SumetzbergerThalassemia major patients and normal blood donors
    Cui (16)SumetzbergerHealthy blood donors
    Koroglu (17)Sumetzberger58 pancytopenia cases with acute leukemia
    Kriegshäuser (18)SumetzbergerHealthy volunteers
    Streichert (19)SumetzbergerHealthy volunteers
    Espinosa (3)SwisslogHealthy blood donors
    Evliyaoglu (4)SwisslogInpatients
    Kara (5)SwisslogUnpaired; 49/53 inpatients
    Martin (7)SwisslogPatients with normal hemostasis
    Strubi-Vuillaume (8)SwisslogPatients in a nursery unit
    Sylte (9)SwisslogOutpatients
    Lancé (13)Swisslog-ErgoTransElective cardiothoracic surgery
    Andersen (25)TempusOutpatients
    Suchsland (26)TempusHealthy volunteers
    Fernandes (10)TransLogic CTS-20Inpatients at 2 different wards
    Keshgegian (11)TransLogic CTS-20Out- and inpatients
    Kratz (12)TransLogic (now Swisslog)Healthy volunteers
    Amann (21)Transmatic; TransroHealthy volunteers
    Sari (14)TranspoNet (Swisslog)Healthy volunteers
    Böckel-Frohnhöfer (23)TransroDepartments offering a maximum medical service spectrum
    Hübner (24)TransroHealthy volunteers
    Bolliger (22)TR-MC 2000id, TransroPatients scheduled for coronary artery bypass surgery
    Koessler (6)TVS (Swisslog-Telelift)Healthy volunteers
    • View popup
    Table 2.

    Tubes investigated, the analyses conducted, and the conclusions of the studies.

    StudyTubes usedCOAGROTEMPFTHEMABGCHEMHIConclusion
    Sodi (31)Serum, serum gel, lithium heparin, K2EDTA, fluoride EDTACompared with serum, with gel plain serum samples are more prone to hemolysis
    Böckel-Frohnhöfer (23)Lithium heparinSignificant differences for all analytes
    Fernandes (10)Not specifiedNo significant difference in hemolysis rate
    Gomez-Rioja (38)Lithium heparinA strong linear relation between the TSSAC and hemolysis degree, evidenced by HI and increase in potassium, LD, and ASAT
    Kara (5)Without anticoagulant, heparin, K2EDTA or citrate532-fold higher degree of hemolysis, and differences in potassium, LDH and ALAT
    Phelan (40)For potassium (not specified)No effect
    Cui (16)Clot activator, lithium heparinSignificant changes in LDH, while potassium had a slightly rising trend
    Kavsak (39)Lithium heparin, pooled samplesSamples from hematology/oncology did not differ, while LDH differed significantly for all wards
    Strubi-Vuillaume (8)Lithium heparinMedian bias 18.8%. Reduced with bubble wrapping or using Monovette lithium heparin tubes in aspiration mode
    Sylte (9)Gel tubesThe specific sample handling had small but significant effects on results for LD, potassium, glucose, and magnesium
    Tiwari (30)Not specifiedAt high speed, all 3 indices of hemolysis (Hb, K +, and LD) were elevated
    Evliyaoglu (4)Heparin, citrateA positive correlation was observed between distance and hemolysis
    Koroglu (17)EDTA and serum gelErroneously low PLT counts in patients with leukemia
    Suchsland (26)Lithium heparin, K2EDTA, sodium citrateNo effect
    Koessler (6)All kinds of tubesIncrease in LD, decrease in leukemia and lymphoma, PT and D-dimer, reduced stimulation of PAC-1 activation; the changes would however not change the clinical interpretation
    Andersen (25)Fluoride and citrate, K2EDTA, sodium citrate, lithium heparinOnly O2 saturation, oxyhemoglobin, and pO2 deviated with clinical significance
    Streichert (19)K2EDTA, coagulation, NH4-heparin, serumSpeed and the area under the curve exhibited a direct relation to the degree of hemolysis; also, the maximum deviation for a number of components were >20%
    Keshgegian (11)All kinds of tubesNo effect
    Astles (33)Blood gas syringesOver a wide range, pO2 tended toward 160 mmHg, which poses a risk of clinical misinterpretation
    Collinson (35)Preheparinised syringesSignificant alterations in pO2, no effect on pCO2 or pH values
    Victor Peter (29)Blood gas syringesClinically unacceptable pO2 values
    Zaman (32)Blood gas syringesIf air bubbles cannot be excluded, PTS is not an appropriate transport for pO2 measurement. No effect on pCO2 or pH
    Al-Riyami (15)K2EDTANo effect
    Gossez (27)EDTANo effect
    Lima-Oliveira (28)K2EDTANo effect
    Sari (14)K2EDTANo effect
    Kocak (20)K3EDTA, citrateNo effect
    Kratz (12)K2EDTA, citrateNo clinically significant effect
    Lancé (13)K2EDTA, sodium citrate, citrate + corn trypsin inhibitorNo effect except for NATEM assays
    Martin (7)Sodium citrate (?)Thromboelastometry parameters are significantly altered, but in patients with normal hemostasis, the alterations were small and without clinical consequence
    Amann (21)Trisodium citrateThe higher the acceleration forces, the more ROTEM parameters are influenced
    Colucci (36)Trisodium citrateNo effect
    Espinosa (3)Citrated venous samplesSpecial consideration regarding interpretation of R parameter
    Glas (37)Hirudin, citrateInvalid results in MEA, while only CT in EXTEM was affected
    Bolliger (22)HirudinSignificant influence on Multiplate platelet function testing
    Braun (34)HirudinTransport of correctly prepared samples does not alter the results of platelet function testing
    Hübner (24)HirudinImpaired platelet aggregation
    Thalén (41)HirudinA reduction of area under the curve values of up to a 100% of the average
    Kriegshäuser (18)aK3EDTANo effect
    • COAG, coagulation; ROTEM, rotational thromboelastometry; PFT, platelet function testing; BG, blood gases; HEMA, hematology; CHEM, chemistry/immunochemistry; HI, hemolysis index.

    • ↵a This study included none of the tests mentioned, but only free DNA concentration in plasma from whole blood samples.

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Clinical Chemistry: 64 (5)
Vol. 64, Issue 5
May 2018
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Blood Sample Transportation by Pneumatic Transportation Systems: A Systematic Literature Review
Mads Nybo, Merete E. Lund, Kjell Titlestad, Christian U. Maegaard
Clinical Chemistry May 2018, 64 (5) 782-790; DOI: 10.1373/clinchem.2017.280479
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Blood Sample Transportation by Pneumatic Transportation Systems: A Systematic Literature Review
Mads Nybo, Merete E. Lund, Kjell Titlestad, Christian U. Maegaard
Clinical Chemistry May 2018, 64 (5) 782-790; DOI: 10.1373/clinchem.2017.280479

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