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Chapter
Clinical Laboratory Chemistry
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Clinical Laboratory ChemistrySunheimer • Graves
Laboratory Automation
3
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level I
1. List four advantages of automated chemical analysis.
2. Define the following terms: throughput, test menu, carryover, discrete testing, random-access testing, open-reagent analyzer, and closed-reagent analyzer.
3. Identify five laboratory tasks associated with the preanalytical stages of laboratory testing.
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level I
4. Identify three reasons why automation is necessary.
5. Give examples of how automated analyzers perform the following functions:
a. Mixingb. Incubatingc. Transferring reagents
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level I
6. List four tasks associated with the analytical stage of laboratory testing.
7. Identify five demands placed on the laboratory that serve to drive automation.
8. List three techniques used to mix samples and reagents in an automated system.
9. Identify three techniques used to incubate samples and reagents.
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level I
10.List three drawbacks of total laboratory automation.
11. Identify three tasks associated with the post-analytical stage of laboratory testing.
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level II
1. Explain the concept of total laboratory automation.
2. Distinguish the three stages of laboratory testing from one another.
3. Differentiate between proportioning reagent by volumetric addition and by continuous flow.
4. Explain the operating principle of a Peltier thermal electric module.
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Clinical Laboratory ChemistrySunheimer • Graves
Objectives Level II
5. Distinguish between workstation and work cell.
6. Explain the principle used for clot detection in automated analyzers.
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Clinical Laboratory ChemistrySunheimer • Graves
Three Stages of Testing
• Preanalytical
• Analytical
• Postanalytical
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Clinical Laboratory ChemistrySunheimer • Graves
Preanalytical Stage
• Methods to transport specimens– Human carriers or runners– Pneumatic tube delivery systems– Electric-track-driven vehicles– Mobile robots – Conveyors and/or track systems
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Clinical Laboratory ChemistrySunheimer • Graves
Specific Tasks Performed by Automated Sample Processors
• Presorting of samples
• Centrifugation
• Sufficient sample volume check
• Detection of the presence of clots in the samples
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Clinical Laboratory ChemistrySunheimer • Graves
Specific Tasks Performed by Automated Sample Processors
• Removal of tube stoppers (decapping)
• Secondary tube labeling
• Aliquotting of samples
• Destination sorting into analyzer racks
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Clinical Laboratory ChemistrySunheimer • Graves
Tasks Performed in Analytical Stage of Testing
• Sample introduction
• Dispense reagents:– Open-reagent system– Closed-reagent system
• Mixing
• Incubation
• Detection
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Clinical Laboratory ChemistrySunheimer • Graves
Figure 3-1 COBAS Integra 800. Courtesy of Roche Diagnostics
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Clinical Laboratory ChemistrySunheimer • Graves
Postanalytical Stage of Testing
• Signal processing
• Data processing by computers includes: – Data acquisition – Calculations– Monitoring and displaying data
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Clinical Laboratory ChemistrySunheimer • Graves
Automated System Designs
• Total laboratory automated systems (TLAs)
• Integrated modular systems
• Workstations
• Work cells– Figures 3-2 and 3-3
• Fully integrated systems
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Clinical Laboratory ChemistrySunheimer • Graves
Figure 3-2 Siemens StreamLAB. Courtesy of Siemans Healthcare Diagnostics
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Clinical Laboratory ChemistrySunheimer • Graves
Figure 3-3 Siemens Work Cell CDX. Courtesy of Siemans Healthcare Diagnostics
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Clinical Laboratory ChemistrySunheimer • Graves
Put It All Together
Figure 3-4 Roche Modular Analytics Serum Work Area. Courtesy of Roche Diagnostics
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Clinical Laboratory ChemistrySunheimer • Graves
Future Trends
• Intelligent Laboratory Systems
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Clinical Laboratory ChemistrySunheimer • Graves
Figure 3-5 Siemens Dimension Vista 1500. Courtesy of Siemans Healthcare Diagnostics
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Clinical Laboratory ChemistrySunheimer • Graves
Molecular Diagnostics Analyzers
• Automated bench top analyzer for amplification and detection of PCR testing.
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Clinical Laboratory ChemistrySunheimer • Graves
Figure 3-6 Roche COBAS Amplicor Analyzer Automated Real-Time PCR System. Courtesy of Roche Diagnostics