The importance of preanalytics for the coagulation laboratory

G. Endler; G. Slavka; T. Perkmann; A. Haushofer

doi:10.1055/s-0037-1617045

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 2010; 30(02): 63-70
DOI: 10.1055/s-0037-1617045

Review

Schattauer GmbH

The importance of preanalytics for the coagulation laboratory

Die Bedeutung der Präanalytik für das Gerinnungslabor

G. Endler

¹Klinisches Institut für medizinische und chemische Labordiagnostik, Medizinische Universität Wien, Österreich

²Zentrallabor, Wilhelminenspital der Stadt Wien, Österreich

,

G. Slavka

²Zentrallabor, Wilhelminenspital der Stadt Wien, Österreich

,

T. Perkmann

¹Klinisches Institut für medizinische und chemische Labordiagnostik, Medizinische Universität Wien, Österreich

,

A. Haushofer

³Institut für Laboratoriumsmedizin, Landesklinikum St. Pölten, Österreich

› Institutsangaben

Abstract

Summary

Im Vergleich zu anderen Labortests weisen Gerinnungstests eine relativ große Fehleranfälligkeit und eine größere analytische Variabilität auf, was nicht zuletzt mit der relativ komplexen Präanalytik zusammenhängt. Daher mehrere Richtlinien erschienen, die helfen sollen, die Präanalytik in der Hämostaseologie zu standardisieren. Obwohl die publizierten Richtlinien zweifellos wertvolle Anhaltspunkte für die tägliche Laborpraxis darstellen, handelt es sich in einigen Bereichen um Maximalkriterien, die sich technisch und logistisch im diagnostischen Alltag nicht immer vollständig umsetzen lassen.

In diesem Übersichtsartikel sollen häufige Problemfelder in der Präanalytik der Routine-Gerinnungstests diskutiert werden. Da die Stabilität von Gerinnungstests wie z. B. der Prothrombinzeit und der partiellen Thromboplastinzeit stark von lokalen Faktoren abhängen (z. B. Röhrchentyp, Hersteller, Reagenzien und Analysesysteme) wird empfohlen, dass jedes Labor auf Basis der Richtlinien detaillierte Verfahrensanweisungen für die Ein-sender entwickelt, um die präanalytische Variabilität zu vermindern.

Zusammenfassung

Due to their complex preanalytics coagulation tests show a higher rate of rejected samples due to insufficient quality and a higher intraand inter-individual test variability. In the last years several guidelines addressed this issue in an effort to standardize preanalytic procedures. However, in daily laboratory work, these guidelines frequently cannot be fully executed, due to technical limitations or sample transport logistics. In this manuscript several important issues in sample collection, handling and transportation will be discussed. Since the stability and variability of routine coagulation tests such as prothrombin time and partial prothrombin time are significantly influenced by a number of variables such as tube type, manufacturer, reagents used and analyzer systems, it is recommended that each laboratory develops its own manuals for sample collection, based on published data and internal evaluations.

Keywords

Preanalytical errors - coagulation tests - stability

Schlüsselwörter

Präanalytischer Fehler - Gerinnungstests - Stabilität

Volltext

Referenzen

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