Installation Guide - DIESSE Diagnostica Senese
Contents
1. VES eB Installation Guide Revision 3 0 09 09 10 English nICFCCE Diagnostica Senese S p A Ves Matic Cube 30 Installation guide rev 3 0 1 Before going into further details of the procedure for the instrument setup we should give a simple explanation on how the instrument reads the samples to determine the ESR value The basic principle is the tube scanning made by the instrument through a light beam The light intensity is such to have a maximum signal on the top of the tube light passes through plastic and label while blood shields the light beam so that the signal level drops to minimum levels then increasing again when the sensor reaches the bottom of the tube The instrument draws a graph of light absorption as the one shown in Figure 1 Figure 1 Graph of blood level reading inside the top lavender tube The sensor moves up and down its shaft through a stepper motor The instrument records both the number of steps run by the motor during the tube scanning and the intensity of light passing through the tube from the top down to the bottom of the tube Top of the tube Bottom of the tube The ESR value is calculated by comparing the graph obtained at time zero after sample mixing with the one obtained after 20 minutes of sedimentation The intensity of light in fact will pass through the plasma without any appreciable absorption see Figure 2 Time zero reading allows to determine the height of the blood2. type of labeling In this regards the table below reports the minimum and maximum volume limits of the most common types of top lavender tubes which can be found on the market TUBE MAX VOLUME MIN VOLUME VACUTAINER BD VACUETTE GREINER SARSTEDT RUBBER However it should be considered that in private laboratories can be found unusual types of top lavender tubes so mainly in these cases it is necessary to perform very accurate tests Regarding the labeling of tubes refer to paragraph 4 2 PREPARATION OF SAMPLES of the USER MANUAL The VES Matic Cube 30 is designed to work with a maximum of 2 labels applied to the sample to be tested reading through a maximum of 3 layers of paper along the reading axis It would be preferable to overlap the sample bar code label to the original one of the top lavender tube so that the back of the tube is free Check if it is possible to talk with the nurses who draw blood to suggest this method of labeling This is indeed the way of labeling that causes the fewest problems and also allows a visual assessment of blood volume in the tube and of the sedimentation level of the sample lt is very important the proper positioning of the tube in the rotor labels must face the LED see Figure 3 In this way the quota of light reaching the samples will be the same for all i White LED Receiver Figure 3 from left to right 1 label explaining the correct insertion of the tubes applied on th
3. This may happen in the case of little known brands of top lavender tubes manufactured with cheaper plastic materials often the walls of these tubes are opalescent and this could explain the phenomenon In this case you should decrease the intensity of light in order to alleviate the sliding effect In these situations it is advisable to convince the laboratory of the necessity of a proper labeling so that the labels have the minimum possible influence on the absorption of light The default level of light intensity in this case is too high this is the typical situation which happens with Greiner VACUETTE with the generation of a spike of light at the bottom of the tube By lowering the intensity of light the phenomenon may be eliminated VACUETTE SPIKE Figure 4 Examples of abnormal graphs Note the value of light which is set on the instrument is the one of the last performed reading test Ves Matic Cube 30 Installation guide rev 3 0 5 Graph analysis In the Graphs menu set up gt support password 000000 gt Graphs it will be possible to observe the graphs of the samples tested in the last cycle of analysis By pressing in sequence the Graph key you can view the graphs related to e First or reference reading Time 0 e Second reading Time 20 min e First and second reading for each sample To move from one sample to the next press the arrow keys for each sample it is displayed t
4. column before sedimentation To determine the point of the graph corresponding to this height the instrument uses two independent mathematical methods M1 and M2 Ves Matic Cube 30 Installation guide rev 3 0 2 Top of the Tube po Bottom of the tube Stan point of blood Top of the Tube Final Stan point of blood Bottom of the tube Initial blood level Final reading level Figure 2 examples of graphs at time 0 and after 20 minutes of sedimentation The graphs after processing with M1 filter green and after processing with M2 method blue are reported M1 method starting from the original curve in red in Figure 2 the graph is redrawn to make its analysis easier To do this it is necessary to apply a so called filter that is merely a mathematical process that eliminates the noise from the original reading in the lower part maximum light absorption of the graph In other words the minimum value of light absorption is recalculated by raising it in comparison to the real one thus eliminating the background noise green graph in Figure 2 Then the point beyond which were recorded 4 consecutive increasing readings is searched by moving from right to left along the green graph Basically it is searched from which point light intensity increases corresponding to the air blood interface The same method applied to the graph obtained after sedimentation allows to identify the point corresponding to the RBC plasma inte
5. e chassis 2 Tube position 3 reading sensor the labels must face the LED Ves Matic Cube 30 Installation guide rev 3 0 4 Using the laboratory tubes the first step to be performed is the calibration of light intensity the default value of setting of light intensity is 20 To change parameters Enter the set up Service password 000000 gt Motor test gt reading unit test gt reading test gt PWM duty cycle Insert one of the tubes after thorough mixing in position 1 of the rotor and perform an initial scan with the default light value and check the reading graph to perform this operation the lid must be closed If you get a reading curve like the one in Figure 1 with no spikes anywhere the default value can be kept This test should be run on 3 4 different samples verifying that the reading curve is clean for all samples In case of abnormal curves you must modify the intensity of light trying to get a clean graph see Figure 4 The default level of light intensity in this case is too low the labels shield the light and do not allow a clear distinction of the air blood interface By increasing the light intensity it is possible to reduce the influence of the label infact the label or labels will be crossed by the light beam while blood will not The default level of light intensity in this case is too high light reaches the receiver by sliding along the walls of the tube making it blind
6. he corresponding position in the sample holder plate not the patient bar code SAMPLE POSITION POINT FOUND BY M KIND OF GRAPH 165 58 A Reference reading M1 103 M2 104 27 0 09 ESC BLOOD LEVEL FOUND BY M1 and M2 Figure 5 Graph display first reading In the first and second reading graphs see Figure 5 are shown the blood levels found with the two main calculation methods M1 and M2 in addition to the graph related to the specific reading Below the graph it is shown the numeric value related to blood height expressed in number of steps the higher is the number the lower will be the level of blood which is also displayed in the graph E represents the point related to the x axis where M2 method found blood level O represents the point where M1 method found blood level in the above reported figure this symbol can not be seen as M1 and M2 are identical so it is not possible to distinguish them Ves Matic Cube 30 Installation guide rev 3 0 6 Les Reference amp final reading 01 radi 1 21 2 19 3 20 2710 09 Gs aj Wie In the first and second reading graph which shows the overlapping graphs instead of the number representing the blood levels of single readings found by M1 and M2 is shown the difference in mm h sedimentation between the levels of the two readings found by various methods Figure 6 Figure 6 Overlapping graphs of first and second reading Check of M1 filte
7. r In Figure 7 there are two examples one of clean curves and another with problematic curves due to a reading spike VACUETTE Greiner type In the first case there is no need to change any parameters because the instrument read the level of sedimentation without problems In the second case where the true ESR value was 22 the M2 method correctly calculated ESR while the M1 method because of the spike gave an incorrect result By raising the M1 filter level PERCFILTERMINABS Percentage value that controls the filter height in Method 1 Accessible through Service Set Change values entry the base line of the graph raises Clean curve No parameters to be changed 2 REF READ DIFF ESR M1 45 52 7 7 M2 45 53 8 15 58 Reference amp final reading 2 1 7 2 8 3 9 27 510 09 esc sceen A CW ox Problematic curve In this case the M1 filter should be raised to prevent M1 being influenced by the spike 1 REF READ DIFF ESR M1 71 75 4 4 15 58 Reference amp final reading 01 esc com La W M2 64 80 16 22 M3 78 80 2 2 Figure 7 graph examples Ves Matic Cube 30 Installation guide rev 3 0
8. rface plasma does not appreciably absorb light The difference between these two points is used to calculate the ESR value M2 Method in this case the graph derivative is calculated The derivative changes its sign in the points where the graph changes slope blue graph in Figure 2 the leftward point of changing slope corresponds to the air blood interface in the case of the first reading and to the RBC plasma interface in the case of the reading after sedimentation Again the difference between these two points is used to calculate ESR value The software compares ESR values obtained by the two different methods and if they do not differ by more than 20 points it provides the average of these two values as the result otherwise it provides a starred result M1 Ves Matic Cube 30 Installation guide rev 3 0 3 Now we can start the description of the instrument setting procedure The two main parameters to be checked and modified if needed are e light intensity Duty Cycle PWM e percentage of filter PERCFILTERMINABS these parameters can be accessed from the service menu Since in the laboratories are used different test tubes blood volumes and labels it is necessary to customize the instrument to fit to the drawing and sample management system of each laboratory First of all it is necessary to have some labeled tubes containing samples from the routine to observe their characteristics brand sample volume
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