Navigating preanalytical challenges: a real-world study on single-tube pneumatic tube systems

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Preanalytical Variables

Background:

• Pneumatic tube systems (PTS) enhance laboratory sample transport efficiency.
• Potential preanalytical errors, such as hemolysis and altered test results due to sample resting times before PTS transport, require investigation.

Purpose of the Study:

• To evaluate the impact of a novel single-tube PTS with deceleration on routine biochemical parameters.
• To assess the effects of pre-transport sample resting times on the accuracy of biochemical tests.

Main Methods:

• A prospective study involving 34 outpatients, with four blood samples collected per participant.
• Samples were allocated to immediate PTS transport, PTS after 15-min rest, PTS after 30-min rest, or manual delivery.
• Twenty-two biochemical parameters were measured, with results compared to manual delivery and assessed against allowable error limits.

Main Results:

• Lactate dehydrogenase (LDH) levels were significantly elevated in all PTS groups compared to manual delivery.
• The bias for LDH was clinically acceptable only with immediate PTS transport; delays increased bias beyond acceptable limits.
• Glucose showed significant but clinically acceptable variations; other parameters remained within acceptable limits.

Conclusions:

• The single-tube PTS is appropriate for transporting blood specimens for biochemical analysis.
• Minimizing pre-transport delays is crucial for maintaining the reliability of biochemical results from silica-clot activator tubes.
• Resting time before PTS transport should be a critical factor in laboratory validation protocols.