title: Effect of acceleration forces during transport through a pneumatic tube system on ROTEM® analysis.
abstract: BACKGROUND
  ROTEM® is considered a helpful point-of-care device to monitor blood coagulation in emergency situations. Centrally performed analysis is desirable but rapid transport of blood samples is an important prerequisite. The effect of acceleration forces on sample transport through a pneumatic tube system on ROTEM® should be tested at each institution to exclude a pre-analytical influence. The aims of the present work were: (i) to investigate the effect of pneumatic tube transport on ROTEM® parameters; (ii) to compare blood sample transport via pneumatic tube vs. manual transportation; and (iii) to determine the effect of acceleration forces on ROTEM® parameters.
  
  
  METHODS
  This is a single centre study with 20 healthy volunteers. Five whole blood samples were transferred to the central haematology laboratory by either normal transport or pneumatic delivery with different speed and acceleration forces. EXTEM, INTEM, FIBTEM and APTEM were analysed in parallel with two ROTEM® devices and compared. Acceleration forces were measured during transport with two different instruments.
  
  
  RESULTS
  Increment of transport time, speed and distance resulted in an augmentation of acceleration forces and peaks. All results of the ROTEM® analysis after manual transport or pneumatic delivery were within normal range. However, increase in acceleration forces resulted in minimally but statistically significant changes in multiple ROTEM® parameters. The higher the acceleration forces, the more ROTEM® parameters are influenced.
  
  
  CONCLUSIONS
  Acceleration forces during transport through a pneumatic tube system have an influence on ROTEM® parameters. Prior to transfer blood samples via pneumatic tube system these influences should be tested to exclude clinically relevant blood coagulation activation in vitro.
authors.affiliation: Department of Anaesthesiology and Pain Therapy, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Amann
authors.forename: Christine
authors.initials: C
authors.lastname: Zehntner
authors.forename: Florian
authors.initials: F
authors.lastname: Marti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colucci
mesh_terms: D000328:Adult; D001800:Blood Specimen Collection / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D013916:Thrombelastography / Q000295:instrumentation* / Q000379:methods