MLS 1004SEF Clinical Chemistry & Immunology Lecture 2 2024 PDF

Introduction to MLS Instrumentation II MLS 1004SEF Clinical Chemistry & Immunology Common Equipment & Tests Simon Fung Senior Lecturer/SMT 25 Jan 2024 Highlights 1. Routine chemistry analyser (Cobas Pure) Component Principles/technologies of analyte measurement in common tests (e.g Liver/renal fun...

Introduction to MLS Instrumentation II MLS 1004SEF Clinical Chemistry & Immunology Common Equipment & Tests Simon Fung Senior Lecturer/SMT 25 Jan 2024 Highlights 1. Routine chemistry analyser (Cobas Pure) Component Principles/technologies of analyte measurement in common tests (e.g Liver/renal function, cholesterol etc.) 2. Urgent bench analyser Blood gas analyser (tests e.g pH, PO2, PCO2,HCO3, dyshemoglobins) Osmometer (test e.g blood/urine osmolality) https://www.researchgate.net/figure/Technicon-AutoAnalyzer-1-Published-with-the-express-permission-of-SEAL-Analytical-Inc_fig1_278792274 https://www.seal-analytical.com/Products/Segmented-Flow-Analyzers/AutoAnalyzer-II https://www.researchgate.net/figure/22-Operating-scheme-of-the-AutoAnalyzer-Unit_fig2_333852698 Modular components - Cobas Pure Autoanalyzer Versatile, like robotic station Integration of modular analytical units: c303 - Clinical Chemistry Analytical Unit e402 – Immunochemistry Analytical Unit c303 Main routine chemistry test (CHO/Protein/Lipid/Enzyme etc.), endocrinology test, tumour markers, drug etc. Well known test menu with many different tests with plasma/serum/urine, by categories e.g. LFT, RFT, cholesterol profile etc. Throughput and capacity Up to 450 photometric tests/hour Up to 450 ISE tests/hour Up to 750 Photometric & ISE tests/hour 42 reagent positions Measurement methodologies e.g.:  Spectrophotometric e.g. absorbance  Immunochemistry: Chemiluminescence(CL) or Electrochemiluminescence (ECL)  Indirect Ion-Selective Electrode (ISE) e.g. electrolytes: Na, K, Cl https://www.youtube.com/watch?v=I3idOHUvK0U e402 Immunochemistry analyzer (Immunoassay免疫测定法 + Chemical methods) Endocrine tests e.g. Thyroid hormones, TSH Throughput and capacity Up to 120 tests/hour/28reagent positions 28 reagent positions Measurement Methodologies e.g. Chemiluminescence (CL) or Electrochemiluminescence (ECL) Specification for e402 (Immunology tests) e.g. thyroid hormones – fT4, fT3,STSH STAT Separate STAT entry Flexibility on sample loading, result availability Application on urgent lab for tests e.g. Na, K, Cr, Troponins Features (Time) Reduced hands-on time for operator (elaborate more…) Automated maintenance (acid-alkali wash) Predictive loading list (One stop, transparency) Reduced calibration efforts (AutoCal) Short and Predictable Turn Around Times Fast Reaction times Full transparency of time to result (?through control software) Broadest assay menu, Longest onboard stability Up to 4 months for Immunochemistry Up to 6 months for Clinical Chemistry Error-free handling with RFID General/Others In term of time, space, team: Compact Size ,Consolidation of CC & IM High performing, seamless by design portfolio for your future Proven track record of pioneering lab solutions Roche Remote CareGiver Sustainable development Commitment to innovation Roche cobas 8100 Automated Workflow Series | Roche Workflow Solutions Blood Gas Analyser - RADIOMETER ABL 90 FLEX Use whole blood Direct measurement with ISE for pH, O2, CO2, electrolytes Co-oximeter for various hemglobins e.g CO-Hb, Met-Hb Prompt result for such urgent vital tests, bed side testing/monitoring in wards Diseases/disorders  Diabetic Ketoacidosis (DKA), electrolyte imbalance, CO poisoning Need intensive maintenance e.g. clog with whole blood Video show The ABL90 FLEX PLUS blood gas analyzer (Features) ABL90 Flex (general) How to use a Blood Gas Analyser – YouTube (operation) Arterial (routine use) & venous blood https://acutecaretesting.org/en/articles/central-venous-blood-gas-analysis Osmometer -Osmo1  Mainly measure on osmotically active substances in plasma/serum/urine i.e osmolality  Colligative properties 依数性质  depend on solute to solvent particle ratio, not solvent chemical nature  Measurement principle  Freezing point depression Measurement principle Freezing point depression (DTf) DTf = (Kf)(m) DT represents the freezing point depression: DT = Tf°- Tf Tf° is the freezing point of the pure solvent. Tf is the freezing point of the solution. Kf is the molal freezing point depression constant. The value of Kf is characteristic for a given solvent. The units of Kf are given in °C/m m is the molality of the solution. m = moles of solute/ kg of solvent. Video : Advanced Instruments Osmometer | Freezing Point Measurement Clinical Utility Urgent vital tests/bench related to disorders in clinical laboratory e.g DM, analgesics overdose, Pseudohyponatraemia Glucose, protein, triglyceride(Endogenous/Internal) e.g. hyperglycemic hyperosmolar nonketotic coma [HHNK] Ethanol, salicylate, other ingested drug or toxic substances etc.(Exogenous/External) Pseudohyponatraemia (low Na, normal osmolality) in presence of protein/triglyceride (reduced osmolality due to volume exclusion, measured by indirect ISE) # Elevated Osmolal gap (e.g. >10) indicate likely the presence of e.g. exogenous substance in toxicology # OG is calculated by the difference between actual & calculated osmolality Analytical measurement principle - need the Chemistry, calibration and control (information insert)…. 1) 2) 3) 4) Spectrophotometry (End point/Kinetics); Enzyme Kinetics Turbidity & Nephelometry (Scattering light) Electrochemluminescence/Chemiluminescence ISE Colorimetric- [Absorbance(Ab) change)] e.g. End point mode Colorimetric - Rate of absorbance change e.g.(Kinetic mode) Same for application in enzyme kinetics measurement e.g. liver enzymes Turbidity & Nephelometry Turbidimetry is the process of measuring the loss of intensity of the light transmitted through a sample caused by the scattering effect of insoluble particles. Similarly to absorbance. In contrast, Nephelometry detects that is scattered at various angles; and the scattered light yields a small signal that must be amplified Both Turbidimetry & Nephelometry are used to measure concentrations of large particles ( e.g Ag-Ab complexs, prealbumin, Other serum protein), that because of their size cannot be measured by absorption spectroscopy C-reactive protein (CRP) -inflammation marker (Turbidimetry in Roche autoanalyzer) Albumin, IgM (Immunoturbidimetry-Roche) Electrochemiluminescence Immunoassay (ECLIA) e.g. β-hCG, TSH https://labogids.sintmaria.be/sites/default/files/files/hcg-beta_2018-08_v18.pdf Principle of Sandwich Electroluminescence Immunoassay (ECLIA) https://dokumen.tips/documents/elecsys-hcg-stat-elecsys-2010-cobas-e-411-analyzer-hcg-stat-elecsys-2010.html?page=1 Chemiluminescence (CLIA) https://www.youtube.com/watch?app=desktop&v=RMMZ3rnzUHM Firefly Ion Selective Electrode Ion Selective Electrode and Electrolyte analyser ; Live Demonstration https://studylib.net/doc/25425896/nerst https://slideplayer.com/slide/12016037/ Exclusion effect in Pseudohyponatraemia by Indirect ISE method (e.g. Cobas analyser) Common Tests in Cobas Pure 1. Renal function tests (blood/urine test) Na+, K+, Urea, Creatinine for acute RF & CKD 2. Liver function tests (blood test) TP, Alb, Bilirubin, Liver enzyme for cholestasis, cirrhosis & liver cancer 3. Blood cholesterol & cardiac profile tests Total cholesterol, Triglyceride, LDL, HDL, & cardiac markers 4. Thyroid function tests Thyroid stimulating hormone (TSH), thyroid hormones – free T4, free T3 5. Tumour markers Serum marker e.g. AFP, CA19.9, CA125, anti-IgM for NPC/genetic marker Urine marker e.g VMA for neuroblastoma Renal function tests (blood/urine test) Na+, K+, Urea, Creatinine e.g. for dehydration, acute renal failure, chronic kidney diseases https://nurseslabs.com/wpcontent/uploads/2022/05/04Serum-Electrolytes-NormalLab-Values-Cheat-Sheet%E2%80%93-Nurseslabsscaled.jpg Liver function tests (blood) e.g. Total protein, Alb, Bilirubin, Liver enzyme Diseases/disorders Cholestasis Cirrhosis liver cancer etc. https://nurseslabs.com/wpcontent/uploads/2022/05/06-Liver-FunctionStudies-Normal-Lab-Values-Cheat-Sheet%E2%80%93-Nurseslabs-scaled.jpg Cholesterol & cardiac markers tests (blood) e.g. Total cholesterol (TG), Triglyceride (TG), LDL, HDL Diseases/disorders - Cardiovascular disease (CVD) e.g. Stroke, Acute myocardial infarction (AMI) https://nurseslabs.com/wpcontent/uploads/2022/05/08-Cardiac-MarkersThyroid-Function-Test-and-HIV-AIDS-TestingNormal-Lab-Values-Cheat-Sheet-%E2%80%93Nurseslabs-scaled.jpg Thyroid function tests (blood) e.g. TSH, thyroid hormones – fT4, fT3 Diseases/disorders hyperthyroidism hypothyroidism Thyroid cancer https://nurseslabs.com/wp-content/uploads/2022/05/08-Cardiac-Markers-Thyroid-Function-Test-and-HIV-AIDSTesting-Normal-Lab-Values-Cheat-Sheet-%E2%80%93-Nurseslabs-scaled.jpg Serum tumour markers AFP (liver) PSA (prostate) CA19.9 (pancreatic) CA125 (ovary) anti-IgM for NPC/genetic marker Urine marker e.g VMA for neuroblastoma Why to measure VMA Neuroblastoma (神经母细胞瘤) Surgical emergency Cobas Pure Cobass Pure Module Clinical Chemistry And Immunochemistry Analyser | Chemistry Working in Lab – YouTube How to run QC/Quality Controls on Roshe cobas e 402 and cobas c 303?#hospital #lab #mlt #machine (youtube.com) How we Calibrate Roshe cobas e402 and cobas c303(ISE Calibration)#ytstudio#mltiktok#hospital#machine (youtube.com) Total Laboratory Automation (TLA) cobas 8100 Automated Workflow Series | Roche Workflow Solutions Total Lab Automation - Reference site Daily prep and maintenance overview for your cobas 8000 modular analyzer series For complete mindset for use of autoanalyser Automated Clinical Chemistry Analyzer - Part 1 Introduction – YouTube Automated Clinical Chemistry Analyzer - Part 2 Reagents & Photometers Automated Clinical Chemistry Analyzer - Part 3 Photometric Calibration, Quality Control (QC)& Assays – YouTube Automated Clinical Chemistry Analyzer - Part 4 Photometric Calibration – YouTube Automated Clinical Chemistry Analyzer - Part 5 Quality Control (QC) – YouTube Reference and web link given before Clinical Chemistry/Clinical Lab Insight into a Clinical Chemistry Lab Clinical Chemistry 1 Instrumentation part 1 (Lecture) Clinical Chemistry 1 Instrumentation part 2 (Lecture) Clinical Laboratory Instrumentation (Background) - Part 1 Clinical Laboratory Instrumentation (Background) - Part 2 Total Laboratory Automation (TLA) Roche  cobas 8100 Automated Workflow Series | Roche Workflow Solutions - YouTube  Total Lab Automation - Reference site  Daily prep and maintenance overview for your cobas 8000 modular analyzer series Other  Automation in Clinical Chemistry  Northwell's Brand-New Automated Clinical Laboratory