Research article: Laboratory Automation and Sensitive Analytes - National Study from Clinical Biochemistry Departments in Denmark
Rebekka Lynge, Christina Isabella Kirkvaag, Ida Hornhaver Eilenberger, Anne Marie Duus Hansen, Julie Smith
Int. J. Bio. Lab. Sci 2022(11)1:43-48【PDF】


Increased laboratory automation (LA) is becoming a necessity for high throughput centralized laboratories, however, LA provides new pre-analytical challenges. Prolonged air exposure may cause spurious analytical results for sensitive analytes when the de-capped open blood tubes are transported on assembly lines for prolonged periods and at different temperatures. This study maps LA systems in Denmark and investigates if sensitive analytes and LA is an issue of concern in Danish laboratories.
To nationally map LA and LA procedures for two sensitive analytes, blood alcohol and total carbon dioxide, a questionnaire was sent to all clinical biochemistry departments in Denmark (n=36 with inhouse analysis). Three departments were selected for further short interviews in 2020. In total, 86% (31/36) responded. Of respondents, 84% (26/31) had implemented LA: 65% with total laboratory automation and 35% with partial. When LA operated smoothly in the 26 laboratories, the median transport time was 5 minutes (range 2-90) from de-capping of blood tubes to blood analysis. Local laboratory guidelines on open tube stability of the analytes varied considerably: Blood alcohol 60 (0-300) minutes, and total carbon dioxide 60 (0-360) minutes. Consequently, some laboratories still handled sensitive analytes manually off the LA assembly line. This study demonstrated a diversity in how laboratories manage sensitive analytes and LA. This may jeopardize analytical results and patient safety, and evidence-based stability studies, international guidelines and LA technical adaptions are warranted for sensitive analytes to adopt to the contemporary LA setting.

Key words: Preanalytical; laboratory automation; blood alcohol; carbon dioxide; un-stoppered; de-capped; sensitive analytes.