Yes we do intra-operative PTH in our laboratory. We use the Elecsys with
specimen collected in EDTA, with a short spin time. It has completely
changed the way the surgeons operate. They still do frozen sections but not
as many and usually believe the lab before the frozen section. We work as a
team, with them contacting us with the OR list, and giving us warning when
they take the sample. If the PTH is still high they will explore the second
side of the neck no matter what the frozen section says and if it drops they
will close up the patient. We keep the analyzer in the lab. If you want to
contact the technologist for the actual funtioning of the tech and ensuring
that the machine does not go into a standby mode, let me know and I will
give you her e-mail or phone number.
Elizabeth Mac Namara
SMBD Jewish General Hospital
Montreal
Quebec
-----Original Message-----
From: This list is an open discussion list for the academic community
workingin [mailto:[log in to unmask]]On Behalf Of Sena,
Salvador, Ph.D.
Sent: January 8, 2002 6:41 PM
To: [log in to unmask]
Subject: Intraoperative PTH
We would like to offer an intraoperative PTH assay on plasma and I'm looking
for input from those who are already performing this test. I am aware of
two FDA-approved rapid PTH assays - the Nichols Quick-Pak and DPC Immulite
Turbo PTH. We currently do not have either of these instrument systems in
our laboratory, but we do have a Roche Elecsys 2010 that we use for our
routine PTH assay. Questions:
1. Has anyone tried using the Elecsys PTH assay for this application? If
so, did you find it to be fast enough to satisfy your surgeons? The assay
time is a little long (19 minutes), so the shortest achievable turnaround
time would probably be around 22-24 minutes (allowing for 60 second "quick
spin", transit time in the pneumatic tube system, phoning results, etc.).
2. What are the pros and cons of the Nichols vs. DPC systems? [Nichols
assay is faster, instrumentation looks smaller and more portable, but not as
totally automated as Immulite and reagent cost per test appears to be
higher?]
3. Does anyone take either of these instruments up to the OR to perform the
PTH measurements or do you do the test in the central lab?
4. Have you seen a decrease in the number of frozen sections per parathyroid
surgery since you started offering this test?
Please reply privately or to the list as you see fit. Apologies for the
multiple posting to those who are subscribers on more than one of these
lists. Thanks in advance.
Salvador F. Sena, Ph.D., DABCC
Associate Medical Director, Clinical Chemistry
Danbury Hospital
Danbury, CT 06810 USA
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