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Master Thesis

Qualification et suivi de l’acheminement des échantillons de biochimie par système pneumatique en laboratoire de biologie médicale

Abstract : Introduction: pneumatic transport potentially induces cellular lysis which can distort the results of some biochemical tests. The requirements of standard 15189 imply to control this means of transport by an initial qualification and its follow-up. Validation by assaying biological samples is difficult to implement, especially when several lines need to be qualified. We looked for a monitoring indicator that was easy to set up. Method: our study was carried out on 3 pneumatic lines, on three sites of the University Hospital of Bordeaux, on 2 biochemistry automatons, and at 3 different periods over 3 years. For the initial qualification, samples from lithium heparinate tubes were taken from healthy volunteers and sent either by tyre or courier. The clinical impact on the results of parameters likely to be affected by hemolysis was evaluated according to the COFRAC method validation recommendations. Several factors that may affect the percentage of hemolysis were tested (tire speed, tube filling, shock absorbers). Plasma hemoglobin was measured (spectrophotometric technique) and correlated with hemolysis indexes (HI) to assess the relevance of this approach for tire monitoring. Computer extractions on the HI were performed in parallel. Results: the tire significantly increases the results of potassium, LDH and ASAT. Plasma hemoglobin is systematically increased by the tyre, confirming the induction of hemolysis (on average 150%), even if there is no impact on the results. The HI of the automatons are perfectly correlated with plasma hemoglobin assays. Speed control limits hemolysis during transport. The protection of the transport bags is not effective, while filling the tubes seems central. Conclusion: the HI accurately reflects the impact of tyres on sampling, and provides hemolysis indices, service by service, taking into account pathologies. The implementation of a high-performance quality indicator for monitoring tyre qualification simplifies the initial qualification of tyres, makes it possible to monitor them and makes it possible to objectify interventions on the lines. Our study shows that, regardless of the effect of the tyre, a positive HI can be related to the pre-analytical sentence and/or the physiology of the patient. Our study also highlights the importance of having properly filled tubes regardless of the mode of transport.
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Morgane Delmotte. Qualification et suivi de l’acheminement des échantillons de biochimie par système pneumatique en laboratoire de biologie médicale. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02442987⟩

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