Stručni rad

https://doi.org/10.11613/BM.2019.021002

An abrupt rise of coagulation error messages on ACL TOP automated analysers

Bas Calcoen ; Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
Koen Desmet ; Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
Pieter Vermeersch orcid.org/0000-0001-7076-061X ; Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium

Sažetak

Introduction: Blood coagulation tests (BCT) are very important for clinicians to diagnose bleeding or thrombotic disorders and to monitor anticoagulant
therapy.
Case description: On a Saturday morning, a laboratory technician noted an abrupt rise in the number of coagulation error messages on our ALC
TOP analysers. Visual inspection revealed the presence of partially and/or fully clotted citrate tubes and prompted the clinical biologist to further
investigate a potential preanalytical cause.
Considered causes: Partially or fully clotted blood in citrate tubes can have multiple causes including improper mixing of the tube, under- or overfilling
or combining blood samples from different tubes into one citrate tube.
What happened: The affected citrate tubes originated mostly from the same clinical departments. Moreover, all the affected tubes shared the
same lot number (1 of 7 in use at the time). Visual inspection of 7 unopened boxes of 100 citrate tubes of this lot number revealed one box with nine
completely empty and two partially filled tubes and one box with two partially filled tubes. No under-filled tubes were found in the other 5 boxes.
Discussion: The blood to additive ratio is crucial for BCT. A sudden rise in clot errors should trigger a thorough investigation to identify the cause.
Main lesson: Laboratories should regularly monitor and evaluate the percentage of clotted samples as a quality indicator at scheduled time points.
A problem with the volume of additive in citrate tubes should be considered as a possible cause.

Ključne riječi

preanalytical phase; blood coagulation test; diagnostic error; blood specimen collection

Hrčak ID:

221087

URI

https://hrcak.srce.hr/221087

Datum izdavanja:

15.6.2019.

Posjeta: 981 *