_ Automation and Terminologies.docx.pdf

Clinical Chemistry Lec AUTOMATION AND TERMINOLOGIES AUTOMATION TECHNIQUE, METHOD, OR SYSTEM OF OPERATING OR DWELL TIME - MAINTAIN TIME REQUIRED TO OBTAIN RESULTS...

Clinical Chemistry Lec AUTOMATION AND TERMINOLOGIES AUTOMATION TECHNIQUE, METHOD, OR SYSTEM OF OPERATING OR DWELL TIME - MAINTAIN TIME REQUIRED TO OBTAIN RESULTS AFTER THE INITIAL SAMPLING OF THE SPECIMEN CONTROLLING A PROCESS BY HIGHLY AUTOMATIC MEANS, AS BY ELECTRONIC DEVICES, REDUCING HUMAN INTERVENTION THROUGHPUT - MAXIMUM NUMBER OF SAMPLES OR TESTS TO A MINIMUM. THAT CAN BE PROCESSED IN AN HOUR THE MODERN CLINICAL CHEMISTRY LABORATORY USES A COST LABOR - MAINTENANCE, REAGENTS, CALIBRATION, HIGH DEGREE OF AUTOMATION. MANY STEPS IN THE QUALITY CONTROL, CONSUMABLES AND CAPITAL ANALYTIC PROCESS THAT WERE PREVIOUSLY PERFORMED MANUALLY CAN NOW BE PERFORMED AUTOMATICALLY, TEST - A LIST OF THE ANALYTES OR A TESTS THAT A LABORATORY WOULD BE ABLE TO PROVIDE FOR PATIENT PERMITTING THE OPERATOR TO FOCUS ON MANUAL TESTING PROCESSES AND INCREASING BOTH EFFICIENCY AND CAPACITY. WORKLOAD - A NUMBER OF TEST RESULTS THAT ARE GENERATED BY THE LABORATORY DURING A GIVEN TIME LEONARD SKEGGS RELEASED FIRST AUTO-ANALYZER; CONTINUOUS FLOW WALK-AWAY CAPABILITY - THE ABILITY OF AN OPERATOR TO PROGRAM THE INSTRUMENT TO PERFORM OTHER TASKS 1970: FIRST COMMERCIAL CENTRIFUGAL ANALYZER WHILE THE INSTRUMENT PROCESSES THE TESTS THREE PHASES OF LABORATORY TESTING: PRE-ANALYTICAL - INVOLVES SAMPLE PROCESSING BAR CODE - A MEANS OF PROVIDING POSITIVE SAMPLE IDENTIFICATION ANALYTICAL - CHEMICAL ANALYSIS SELECTIVITY - THE LOWEST VALUE THAT CAN BE RELIABLY BE DETECTED BY A METHOD WITHOUT PROVIDING A FALSE POST-ANALYTICAL - DATA MANAGEMENT POSITIVE RESULT ADVANTAGES OF AUTOMATION 1. RAPID RESULTS SPECIFICITY - THE ABILITY TO MEASURE ONLY THE ANALYTE REQUESTED 2. INCREASING IN THE NUMBER OF TESTS PERFORMED SHELF LIFE - THE TERM USED TO DEFINE REAGENT STABILITY 3. SAVES TIME AND EFFORT BEFORE USE 4. ERRORS IN CALCULATIONS AND TRANSCRIPTION ARE CARRY OVER - THIS OCCURS WHEN PREVIOUS SAMPLES HAVE REDUCED HIGHER OR LOWER RESULTS. THIS OCCURS IN SYSTEM THAT REUSE CUVETTES THAT ARE INSUFFICIENTLY WASHED AFTER 5. BETTER PRECISION AND ACCURACY EACH TESTING CYCLE 6. ELIMINATES THE NEEDS FOR PERSONNEL INCREASE MAINTENANCE TIME (DOWNTIME) - THE TIME THE ANALYZER IS NOT IN USE 7. ECONOMICAL DISADVANTAGES OF AUTOMATION OPEN REAGENT - SYSTEM A SYSTEM OTHER THAN 1. EXPENSIVE TO PURCHASE AND MAINTAIN MANUFACTURER'S REAGENTS CAN BE UTILIZED FOR MEASUREMENT 2. THERE MAY BE LIMITATIONS IN THE METHODOLOGY THAT CAN BE USED CLOSED REAGENT SYSTEM - A SYSTEM WHERE THE OPERATOR CAN ONLY USE THE MANUFACTURER'S REAGENT 3. LABORATORY PERSONNEL IS OFTEN DISCOURAGED FROM MAKING OBSERVATIONS AND USING THEIR OWN JUDGMENT BATCH TESTING - ALL SAMPLES ARE LOADED AT THE SAME ABOUT POTENTIAL PROBLEMS TIME, AND A SINGLE TEST IS CONDUCTED ON EACH SAMPLE 4. MANY SYSTEMS ARE IMPRACTICAL FOR SMALL NUMBER PARALLEL TESTING - MORE THAN ONE TEST IS ANALYZED OF SAMPLES CONCURRENTLY ON A GIVEN CLINICAL SPECIMEN DEFINITION OF TERMS TEST REPERTOIRE - NUMBER OF TESTS THAT CAN BE RANDOM ACCESS TESTING - ANY TEST CAN BE PERFORMED PERFORMED ON INSTRUMENT ON ANY SAMPLE IN ANY SEQUENCE SELECTIVE-ONLY - PERFORMS REQUESTED TESTS RSV 1  The Erythrocytes SEQUENTIAL TESTING - MULTIPLE TESTS ANALYZED ONE ONLY CUVET ARE USED HERE: AFTER ANOTHER ON A GIVEN SPECIMEN LIQUIDS ARE PUMPED THROUGH A SYSTEM OF CONTINUOUS CHEMISTRY ANALYZER OPERATION TUBING IDENTIFICATION AND PREPARATION - COLLECTION AND PREPARATION OF SAMPLE SAMPLES FLOW THROUGH A COMMON REACTION VESSEL/PATHWAY CHEMICAL REACTION - SAMPLE AND REAGENT MEASUREMENTS AND MIXING AIR BUBBLES AT REGULAR INTERVALS - INCUBATION A HEATING BATH MAINTAINS THE REQUIRED TEMPERATURE OF DATA COLLECTION AND ANALYSIS THE REACTION TO ALLOW COMPLETE COLOR DEVELOPMENT - MONITORING OR SENSING THE REACTION RESULT - QUANTITATING THE REACTION RESULT REACTION RATE IS CONTROLLED BY TEMPERATURE - VISUALIZING THE RESULTS MIXING SAMPLES AND REAGENTS: BY USING A GLASS COIL INSERTED INTO THE FLOW PATH EXAMPLE: SIMULTANEOUS MULTIPLE ANALYZER (SMA) OR TECHNICON DISADVANTAGE: ALL TEST ARE PERFORMED IN PARALLEL FEATURES: PARTS: USE OF PLASTIC TUBINGS SAMPLER TYPES OF AUTOMATIC ANALYZER INTRODUCTION OF AIR PUMPS AND MANIFOLDS FOUR TYPES: BUBBLES 1. CONTINUOUS FLOW ANALYZER 2. DISCRETE SAMPLING ANALYZER REMOVAL OF PROTEINS BY DIALYZER 3. CENTRIFUGAL ANALYZERS DIALYSIS 4. THIN FILM ANALYZERS (DRY SLIDE TECHNOLOGY) - DISCRETIONARY TYPE THE FLOW-THROUGH OF HEATING BATH - NON DISCRETIONARY TYPE CUVETTE IN INTERFERENCE CONTINUOUS FLOW ANALYZER FILTER DEVELOPED BY LEONARD SKEGGS IN 1957 RECORD READ OUT DETECTOR-RECORDER THIS SYSTEM HAS WON WIDE ACCEPTANCE IN BOTH ROUTINE AND RESEARCH LABORATORIES TECHNICON AUTOANALYZER II - CAPABLE OF RUNNING 3 DIFFERENT TESTS AT 60-80 SAMPLES/HOUR SMA 6/60 - CAPABLE OF RUNNING 6 TESTS AT 60 SAMPLES PER HOUR SMA 12/60 - CAPABLE OF RUNNING 12 TESTS AT 60 DISCRETE SAMPLING ANALYZER SAMPLES PER HOUR PRINCIPLE: EACH SAMPLE REACTION IS HANDLED IN A SEPARATE COMPARTMENT AND DOES NOT COME INTO SMAC - CAPABLE OF RUNNING 40 TESTS AT 120 SAMPLES CONTACT WITH ANOTHER SAMPLE. THE SAMPLES AND PER HOUR STANDARDS ARE HANDLED ON A BATCH BASIS AND MUST BE BROUGHT BEFORE PROCEEDING TO THE NEXT PROCEDURE. PRINCIPLE: ALL REACTIONS MUST BE CARRIED OUT UNTIL EQUILIBRIUM IS ALL SAMPLES ARE CARRIED THROUGH THE SAME ANALYSIS. REACHED. ALL SAMPLES AUTOMATICALLY PASS FROM ONE-STEP TO DUPONT ACA ANOTHER WITHOUT WAITING TO BRING THE SAMPLES TO THE SAME STAGE OF COMPLETION. THE REACTIONS ARE NOT ABBOTT ABA-100 BIOCHROMATIC ANALYZER, NECESSARILY CARRIED TO EQUILIBRIUM SINCE SAMPLES AND ABA-200 AND VP ANALYZER STANDARDS ARE TREATED EXACTLY ALIKE. BECKMAN ASTRA 8 AND ASTRA 4 RSV 2  The Erythrocytes BECKMAN DSA THIN FILM ANALYZERS PRINCIPLE: AMERICAN MONITOR KDA A 16 MM CHIP THAT CONTAINS SEVERAL VERY THIN LAYERS ACCEPTS A METER DROP OF SERUM, SPREADS IT EVENLY MOST POPULAR AND VERSATILE ANALYZER- MEASURES ONLY INTO A REAGENT LAYER, AND THEN CONFINES THE COLORED THE TESTS ON A SAMPLE PRODUCT TO THE FIXED AREA FOR REFLECTANCE SPECTROPHOTOMETRY. REQUIRES ONLY 2-6ML OF THE SAMPLE 1. SPREADING LAYER - TOP LAYER CAPABLE OF RUNNING 2. REAGENT LAYER MULTIPLE-TESTS-ONE-SAMPLE-AT-A-TIME (SEQUENTIAL 3. INDICATOR LAYER TESTING) 4. SUPPORT LAYER - BOTTOM LAYER EACH SAMPLE-REAGENT MIXTURE HANDLED SEPARATELY IN KODAK EKTACHEM ITS OWN REACTION VESSEL VITROS FOR DRY SLIDE TECHNOLOGY (REFLECTANCE PHOTOMETRY), THE SPREADING LAYER PERMITS A RAPID BECKMAN ASTRA UNIFORM SPREADING LAYER OVER THE REAGENT ROCHE COBAS INTEGRA 80D MIXING: MAGNETIC DRIVEN TEFLON STIRRING BAR (BECKMAN), FORCEFUL DISPENSING, MAGNETIC STIRRING BARS (ASTRA), ROTATING PADDLE AND ULTRASONIC ENERGY (PARAMAX) EXAMPLES: VITROS, BECKMAN ASTRA, ROCHE COBAS INTEGRA 800 MAJOR ADVANTAGE: RANDOM ACCESS CAPABILITY- ALLOWS STAT SAMPLES TO BE EASILY TESTED CENTRIFUGAL ANALYZERS IT USES THE FORCE GENERATED BY CENTRIFUGATION REAGENTS TO TRANSFER SPECIMEN AND LIQUIDS ARE PLACED IN SEPARATE CUVET FOR MEASUREMENT AT THE PERIMETER OF SPINNING ROTOR (1000 RPM) IT USES ACCELERATION AND DECELERATION OF THE ROTOR TO TRANSFER THE REAGENTS AND SAMPLE FROM ONE CHAMBER TO ANOTHER MIXING: COBAS-BIO (ROCHE), IL-MONARCH * MAJOR ADVANTAGE: BATCH ANALYSIS (DISCRETE BATCH TYPE SYSTEM) PRINCIPLE: AS THE ROTOR IS ACCELERATED, CENTRIFUGAL FORCE MOVES THE REAGENTS AND SAMPLE TO A MIXING CHAMBER AND THEN THROUGH A SMALL CHANNEL INTO THE CUVETTE. AS THE FILLED CUVETTE ROTATES PAST A FIXED LIGHT BEAM, THE ABSORBANCE OF THE REACTION IS MEASURED SPECTROPHOTOMETRICALLY 1. CENTIFICHEM 2. ROTOCHEM RSV 3