Effect of Pneumatic Tube System vs. Personnel Transport on Hemolysis Index in Emergency Department Blood Samples: A Randomized, Within-Patient Matched Trial (PTS-HEMO-ED)
5 août 2026 mis à jour par: Emir Ünal, Marmara University Pendik Training and Research Hospital
Comparison of the Effect of Pneumatic Tube System and Personnel Transport on Hemolysis Index in Blood Samples From the Emergency Department: A Randomized, Within-Patient Matched, Single-Blind, Prospective Study
Hemolysis is the most common pre-analytical error in emergency department (ED) laboratory specimens and can lead to false elevation of intracellular analytes (potassium, LDH, AST, hemoglobin), resulting in misdiagnosis and unnecessary testing.
Blood samples in the ED are transported to the laboratory either by pneumatic tube systems (PTS) or manually by personnel.
Although PTS shortens turnaround time, the forces generated during transport may damage erythrocyte membranes and promote hemolysis.
Evidence on whether PTS increases hemolysis compared with personnel transport is inconsistent, partly because existing studies use parallel-group designs that cannot control for between-subject biological variability, and partly because findings differ across PTS brands and configurations.
The Sumetzberger Power Control PTS installed at Marmara University Pendik Training and Research Hospital (speed 4-5 m/s, 120 m, cushioned capsule) has not been prospectively validated for hemolysis risk.
This study uses a randomized, within-patient matched, single-blind design in which two simultaneously drawn yellow-cap tubes from the same patient are randomly allocated-one to PTS and one to personnel transport-thereby eliminating between-patient variability.
The primary outcome is the Hemolysis Index (HI) category (ordinal scale 0-5 corresponding to free hemoglobin thresholds of <50, 50-99, 100-199, 200-299, 300-500, and >500 mg/dL).
Secondary outcomes include the rate of clinically significant hemolysis (HI ≥ 1 / free Hb ≥ 50 mg/dL) and the correlation between transport time and HI.
Aperçu de l'étude
Statut
Pas encore de recrutement
Les conditions
Intervention / Traitement
Description détaillée
Detailed Description:
PNEUMATIC TUBE SYSTEM TECHNICAL SPECIFICATIONS:
The installed pneumatic tube system is a Sumetzberger Power Control system (Sumetzberger, Austria). The transit line length between the Emergency Department phlebotomy station and the central clinical laboratory is approximately 120 meters. System operating speed is set at 4-5 m/s. Transport capsules are cushioned with internal foam padding to minimize mechanical impact forces. Average transit duration ranges between 50 and 90 seconds.
BLINDING AND OPERATIONAL STANDARDIZATION (CONSORT 2025 Item 12b):
Blood collection is performed by trained emergency department phlebotomists using standard venipuncture technique. Two yellow-cap serum separator tubes (SST) are drawn sequentially during the same venipuncture procedure. Tubes are labeled with standardized participant study identifiers and tube sequence numbers (Tube #1 and Tube #2) without indicating transport allocation. Laboratory technicians operating the automated analyzer and assessing the Hemolysis Index remain fully blinded to transport allocation.
PATIENT AND PUBLIC INVOLVEMENT (PPI) STATEMENT (CONSORT 2025 Item 8):
Patients or members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research. PPI was deemed non-applicable given the technical, pre-analytical nature of this laboratory quality evaluation study.
DATA SHARING STATEMENT (CONSORT 2025 Item 4):
De-identified individual participant data collected during the trial will be made available upon reasonable request to the corresponding investigator following publication.
Type d'étude
Interventionnel
Inscription (Estimé)
166
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: Emir Ünal, Assistant Professor
- Numéro de téléphone: +905327766010
- E-mail: emirunal@gmail.com
Sauvegarde des contacts de l'étude
- Nom: Emir Unal, Assistant Professor
- E-mail: emirunal@gmail.com
Lieux d'étude
-
-
Pendik
-
Istanbul, Pendik, Turquie (Türkiye), 34899
- Marmara University Pendik Training and Research Hospital
-
Contact:
- Emir ünal
- Numéro de téléphone: 05327766010
- E-mail: emirunal@gmail.com
-
-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Non
La description
Inclusion Criteria:
- Adults aged 18 years or older
- Presenting to the emergency department of Marmara University Pendik Training and Research Hospital
- Venous blood draw required for routine clinical care needing two or more yellow-cap (serum separator) tubes
- Written informed consent provided by the participant
Exclusion Criteria:
- Known underlying hemolytic disorder (e.g., hemolytic anemia, sickle cell disease, G6PD deficiency, autoimmune hemolytic anemia, or TTP/HUS)
- Macroscopic hemolysis visible in the sample tube immediately after phlebotomy
- Age younger than 18 years
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation croisée
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: PTS-First Sequence
Participants from whom two yellow-cap serum separator blood tubes are drawn simultaneously.
Tube #1 (first drawn) is transported via the pneumatic tube system (PTS), and Tube #2 (second drawn) is transported by manual personnel.
Both tubes are dispatched simultaneously.
|
Blood sample transport using the Sumetzberger Power Control pneumatic tube system (Sumetzberger, Austria).
The system operates at a speed of 4-5 m/s over a distance of approximately 120 meters using cushioned capsules.
Transport duration ranges between 50 and 90 seconds.
Blood sample transport performed manually by emergency department staff carrying the tube on foot from the phlebotomy area to the central clinical laboratory.
Transport is dispatched simultaneously with the paired pneumatic tube sample.
|
|
Comparateur actif: Personnel-First Sequence
Participants from whom two yellow-cap serum separator blood tubes are drawn simultaneously.
Tube #1 (first drawn) is transported by manual personnel, and Tube #2 (second drawn) is transported via the pneumatic tube system (PTS).
Both tubes are dispatched simultaneously.
|
Blood sample transport using the Sumetzberger Power Control pneumatic tube system (Sumetzberger, Austria).
The system operates at a speed of 4-5 m/s over a distance of approximately 120 meters using cushioned capsules.
Transport duration ranges between 50 and 90 seconds.
Blood sample transport performed manually by emergency department staff carrying the tube on foot from the phlebotomy area to the central clinical laboratory.
Transport is dispatched simultaneously with the paired pneumatic tube sample.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Hemolysis Index (HI) Category in PTS-Transported vs. Personnel-Transported Tubes
Délai: At laboratory analysis (within 30 minutes of blood draw)
|
Ordinal 6-category HI scale (0=<50, 1=50-99, 2=100-199, 3=200-299, 4=300-500, 5=>500 mg/dL free hemoglobin) as reported by the automated analyser.
Higher category indicates more hemolysis.
Compared between PTS and personnel tube from the same patient (paired).
|
At laboratory analysis (within 30 minutes of blood draw)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Rate of Clinically Significant Hemolysis (HI ≥ 1) in PTS-Transported vs. Personnel-Transported Tubes
Délai: At laboratory analysis (within 30 minutes of blood draw)
|
Proportion of tubes with HI category ≥ 1 (free haemoglobin ≥ 50 mg/dL), the threshold at which samples are typically flagged for rejection by the laboratory.
Dichotomous outcome (0 vs ≥1) compared between matched tube pairs.
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At laboratory analysis (within 30 minutes of blood draw)
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Spearman Correlation Between Tube Transport Time and HI Category
Délai: At laboratory analysis (within 30 minutes of blood draw)
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Spearman rank correlation coefficient (ρ) between recorded PTS transport time (seconds, 50-90 s range) and the HI category of the PTS tube.
Exploratory analysis.
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At laboratory analysis (within 30 minutes of blood draw)
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Les enquêteurs
- Chercheur principal: Emir Ünal, Marmara University
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Estimé)
1 août 2026
Achèvement primaire (Estimé)
1 novembre 2026
Achèvement de l'étude (Estimé)
1 janvier 2027
Dates d'inscription aux études
Première soumission
5 août 2026
Première soumission répondant aux critères de contrôle qualité
5 août 2026
Première publication (Réel)
10 août 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
10 août 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
5 août 2026
Dernière vérification
1 août 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- MU-KAEK-2026-09.2029.26-0645
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
OUI
Description du régime IPD
De-identified individual participant data collected during the trial that underlie the published results will be made available upon reasonable request to qualified scientific researchers.
Délai de partage IPD
Data will become available beginning 3 months following publication and ending 36 months following article publication.
Critères d'accès au partage IPD
Proposals should be submitted to the corresponding investigator via email (emirunal@gmail.com).
Requestors must provide a methodologically sound research proposal and sign a data use agreement.
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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