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ACL Elite / Elite Pro System

Operator's Manual • P/N 181121-11 • Rev. 0 December 2005

Manufacturer EU Authorized Representative


Instrumentation Laboratory Company Instrumentation Laboratory SpA
101 Hartwell Avenue - P.O. Box 9113 Viale Monza 338 - 20128 Milan, Italy
Lexington, MA 02421-3125 U.S.A. Telephone: 39-2-25221
Telephone: (781) 861-0710

Instrumentation Laboratory
ACL Elite/Elite Pro Operator’s Manual Text Part No. 181121-11 Rev. 0 December 2005

This publication and any and all materials (including software) concerning the products of IL
ACL Elite / Elite Pro Systems are of proprietary nature and are communicated on a strictly
confidential basis; they may not be reproduced, recorded, stored in a retrieval system,
transmitted or disclosed in any way and by any means whatsoever, whether electronic,
mechanical through photocopying or otherwise, without IL’s prior written consent.
Information contained herein is believed by IL to be accurate: in any event, no responsibility,
whether express or implied, is assumed hereby by IL for or in connection with the use thereof,
or for infringement of any third party rights which might arise therefrom, or from any
representation or omissions contained therein.
Information is subject to change and/or updating without notice.

Sarstedt, Epson and Hewlett Packard are registered Trademarks.


Contents

1 General Information
1.0 Introduction 1.1
1.1 Product Use 1.2
1.2 Measured Parameters 1.2
1.3 Presentation of Results 1.3
1.4 Instrument Description and Operation 1.3
1.4.1 Summary 1.3
1.4.2 Main Hardware Components 1.4
1.4.3 Sample Tray 1.5
1.4.4 Reagent Area 1.8
1.4.5 Rinse/Waste Area 1.9
1.4.6 Sampling/Dispensing System 1.9
1.4.7 Loading and Analysis Area 1.12
1.4.8 Microprocessor and Electronics 1.17
1.4.9 Liquid Crystal Display (LCD) 1.18
1.4.10 Keyboard 1.18
1.4.11 Interface Connectors 1.19
1.4.12 Internal Cooling System 1.20
1.4.13 On-board Barcode Reader 1.20
1.4.14 External Barcode Scanner (Optional) 1.21
1.4.15 External Printer (Optional) 1.22
1.4.16 Floppy disk drive 1.23
1.5 Additional Features 1.24
1.5.1 Standby Status 1.24
1.5.2 End of the Cycle 1.24
1.5.3 Power Loss 1.24
1.5.4 Setup and Utility Programs 1.25
1.5.5 Fault Detection 1.25
1.5.6 Video Display - Colors and Symbols 1.25
1.6 Procedural Limitations 1.25
1.7 Certifications 1.26
1.8 Instrument Disposal 1.28
1.9 Symbols Chart 1.29

2 Installation
2.0 Introduction 2.1
2.1 Installation Requirements 2.1
2.1.1 Ambient Conditions 2.1
2.1.2 Space Requirements 2.2
2.1.3 Electrical Requirements 2.2
2.2 Instrument Delivery and Unpacking 2.5
2.3 Mounting Instrument Parts 2.6
2.4 Turning the System ON 2.10
2.5 ACL - Host Interconnect Cable 2.13

Instrumentation Laboratory I
3 Analytical Operations
3.0 Introduction 3.1
3.1 Components and Use of the Operator Interface 3.1
3.1.1 Touch Screen 3.1
3.1.2 Numerical Keypad 3.2
3.1.3 Standard PC Keyboard 3.3
3.1.4 External Barcode Reader 3.4
3.1.5 Mouse Port 2 3.4
3.1.6 Menus 3.4
3.1.7 Windows and Boxes 3.4
3.1.8 Key Screen Elements 3.5
3.1.9 A Special Window for Alarms and Errors 3.9
3.1.10 Screen Saver 3.9
3.1.11 The ACL Elite/Elite Pro Software Tree 3.9
3.2 Sample Analysis 3.11
3.2.1 Sample Analysis Procedures - Summarized 3.11
3.2.2 Sample Analysis Modes 3.14
3.2.3 Material Map 3.23
3.2.4 Analysis: Loadlist 3.25
3.2.5 Analysis: Session Report 3.30
3.2.6 Session Pause Conditions 3.33
3.2.7 Analysis: Pause / STAT Functions 3.34
3.2.8 Results list 3.37
3.2.8.1 Extract Icon 3.39
3.2.8.2 Sample Detail Icon 3.40
3.2.8.3 New Sample (Tubes in folder) Icon 3.43
3.2.8.4 Delete (Trash Can) Icon 3.44
3.2.8.5 Printing Results 3.45
3.2.8.6 Sending Results to Host Computer 3.46
3.3 Quality Control 3.48
3.3.1 Analysing QC Materials using a Loadlist 3.48
3.3.2 Quality Control Setup 3.49
3.3.3 QC Result Review 3.52
3.3.4 QC – Plot and Statistics 3.53
3.3.5 QC – Cumulative Results 3.55
3.3.6 QC – Host Communication 3.59
3.3.7 QC – Extract Results 3.60
3.4 Calibration 3.62
3.4.1 General Calibration Procedure - Summary 3.63
3.4.2 Saving a Calibration - Summary 3.64
3.4.3 Dedicated Calibrations - Details 3.64
3.4.4 Calibration - Review Calibration 3.65
3.4.5 Factor Assays Calibration 3.71
3.4.6 Factor Assay Calibration – Parallelism Tests 3.78
3.4.7 Factor Assay Parallelism Results 3.79
3.5 Analytical Reference 3.81

Instrumentation Laboratory II
3 Analytical Operations (continued)

3.5.1 Analytical Reference: Setup 3.81


3.5.2 Analytical Reference: Plot and Statistics 3.83
3.5.3 Analytical Reference: Cumulative Results 3.84
3.5.4 Analytical Reference: Host Communication 3.86
3.5.5 Analytical Reference: Extract Data 3.87

4 Setup and Utility


4.0 Introduction 4.1
4.1 Setup 4.1
4.1.1 Setup Submenu 4.1
4.1.2 Setup - Tests – View/Define 4.2
4.1.3 Setup - Tests - Sort 4.4
4.1.4 Setup - Tests –Interference Table 4.6
4.1.5 Setup - Tests – Default Tests 4.8
4.1.6 Setup - Tests –Reflex Tests 4.9
4.1.7 Setup - Multi-Tests Profile 4.13
4.1.8 Setup - Multi-Tests – Test Groups 4.17
4.1.9 Setup - Multi-Tests – Test Group Profiles 4.22
4.1.10 Setup - Multi-Tests – Sort Multi-Tests 4.26
4.1.11 Setup - Default Multi-Tests 4.27
4.1.12 Setup - Liquids 4.27
4.1.13 Setup - Interfaces - Host 4.36
4.1.14 Setup - Interfaces - Printer 4.38
4.1.15 Setup - Interfaces - Internal Barcode 4.40
4.1.16 Setup - Interfaces - External Barcode 4.42
4.1.17 Setup - Interfaces - Keyboard 4.43
4.1.18 Setup - Interfaces - Network 4.43
4.1.19 Setup - Interfaces - Modem 4.44
4.1.20 Setup - System Configuration 4.44
4.1.21 Setup - Security 4.46
4.1.22 Setup - Audible Alarms 4.51
4.1.23 Setup - Date/Time 4.52
4.1.24 Setup - Units (Temperature) 4.53
4.2 Setup - Tests - Define 4.54
4.2.1 Copy Test 4.56
4.2.2 Setup - Tests Details 4.57
4.2.3 Analysis: Loading Setup 4.62
4.2.4 Calibration: Loading Setup 4.72
4.2.5 Acquisition Setup 4.82
4.2.6 Calculation Setup 4.84
4.3 Utility 4.113
4.3.1 Utility Submenu 4.113
4.3.2 Utility - Upgrade IL Library 4.113
4.3.3 Utility - Backup/Restore 4.114
4.3.4 Utility - Archive 4.115

Instrumentation Laboratory III


4 Setup and Utility (continued)
4.3.5 Utility - Software - Software Identification 4.117
4.3.6 Utility - Software - Software Upgrade/Upload 4.117
4.3.7 Utility - Save Rotor Map 4.119
4.3.8 Utility - Save Trace 4.120
4.3.9 Utility – Test/Material – Backup and Upload 4.121

5 Diagnostics and Maintenance


5.0 Introduction 5.1
5.1 The Diagnostic Submenu 5.1
5.1.1 Priming 5.2
5.1.2 Cleaning 5.4
5.1.3 Maintenance 5.7
5.1.4 Temperature Control 5.8
5.1.5 Needles Position 5.10
5.1.6 Session Error History 5.11
5.1.7 File Error History 5.12
5.1.8 Logbook 5.14
5.1.9 Service (dimmed) 5.15
5.2 Maintenance Procedures 5.16
5.2.1 Introduction 5.16
5.2.2 Daily Preventive Maintenance 5.16
5.2.3 Weekly Preventive Maintenance 5.19
5.2.4 Bi-weekly Preventive Maintenance 5.20
5.2.5 Monthly Preventive Maintenance 5.21
5.2.6 As-needed Maintenance 5.22
5.2.7 Decontamination Procedure 5.28
5.3 Maintenance Table 5.30

6 Troubleshooting
6.0 Introduction 6.1
6.1 Failures, Alarms and Warnings 6.1
6.1.1 System Anomalies 6.2
6.1.2 REM (Rotor Exchange Module) Anomalies 6.7
6.1.3 Temperature Anomalies 6.9
6.1.4 Mechanical Anomalies 6.12
6.1.5 Acquisition Station Anomalies 6.14
6.1.6 Liquids Anomalies 6.15
6.1.7 Optics Anomalies 6.18
6.1.8 Operative Anomalies 6.18
6.1.9 Parsing and Loading Anomalies 6.19
6.1.10 Database Anomalies 6.20
6.2 Data Transmission Failure 6.20
6.3 Data Reduction Error Codes 6.20
6.3.1 Session Error Codes 6.21
6.3.2 Reaction Curve Error Codes 6.22
6.3.3 Calibration Error Codes 6.25

Instrumentation Laboratory IV
6 Troubleshooting (continued)

6.3.4 Analytical Reference Error Codes 6.29


6.3.5 QC Error Codes 6.33
6.3.6 Double Test Error Codes 6.34
6.3.7 Ratio and INR Error Codes 6.35
6.3.8 DMS Errors 6.36
6.3.9 Other Miscellaneous Errors 6.37
6.4 Coag Errors (Data Reduction) 6.37
6.5 Sample ID Errors 6.38
6.6 Data Reduction Diagram for PT, APTT and TT 6.39

7 Assay and Instrument Specifications


7.0 Introduction 7.1
7.1 Measured Parameters 7.3
7.2 Calculation of Results 7.5
7.2.1 Coagulometric Tests 7.7
7.2.2 Chromogenic Tests 7.14
7.3 Samples/Reagents Configuration and Specifications 7.18
7.3.1 Sample Requirements and Positions 7.18
7.3.2 Sample Position in the Rotor 7.20
7.3.3 Coagulometric Test Volumes 7.22
7.3.4 Chromogenic Test Volumes 7.24
7.3.5 Special Tests Volumes 7.25
7.4 Data Processing Features, Parameters and Analytical
Specifications 7.26
7.4.1 Flagging Limits 7.26
7.4.2 Results Format: VDU and Printer 7.29
7.4.3 Dealing with Results Messages 7.29
7.4.4 Calibration Curve Slope (m) 7.32
7.4.5 Calibration Curve Intercept (q) 7.32
7.4.6 Ranges for Calibration Plasma Values 7.33
7.4.7 Reaction Times 7.33
7.4.8 Test Algorithms 7.36
7.5 Assay Performance Characteristics 7.37
7.5.1 Assay Precision Performance, Linearity and
Method Comparison Studies 7.37
7.5.2 Assay Calibration Stability 7.41
7.6 Analytical Limitations 7.42
7.6.1 Carryover 7.42
7.6.2 Cephalin: Needle Self-conditioning 7.43
7.6.3 Lipemic Samples 7.43
7.7 Container Specifications 7.43
7.7.1 Primary Tubes 7.43
7.7.2 Cups and Reagent Containers 7.44
7.8 Instrument Specifications 7.45
7.8.1 Hardware and Operational Specifications 7.45

Instrumentation Laboratory V
7 Assay and Instrument Specifications (continued)

7.8.2 Dimensions 7.46


7.8.3 Data Bases Specifications 7.46
7.9 Ambient Specifications 7.48
7.10 Electrical Specifications 7.48
7.11 Hazards 7.49
7.11.1 General Warning 7.49
7.11.2 Shock Hazard 7.49
7.11.3 Electrical Hazards 7.49
7.11.4 Biohazards 7.50
7.11.5 Mechanical Hazards 7.50
Addendum: Method Comparison Studies 7.51

8 Sample Collection and Storage


8.0 Introduction 8.1
8.1 Sample Collection 8.1
8.2 Plasma Handling 8.2
8.2.1 Plasma Separation 8.2
8.2.2 Plasma Transport 8.2
8.2.3 Plasma Storage 8.2
8.3 Calibration Plasma 8.2
8.3.1 Description 8.2
8.3.2 Preparation 8.3
8.3.3 Value Assignment 8.3

9 Parts and Expendables


9.0 Introduction 9.1
9.1 Startup kit 9.1
9.2 Order Information for Expendables 9.4

10 Warranty
10.0 General Warranty Conditions 10.1
10.1 Disclaimer Regarding Non-IL Brand Product 10.2

11 IL Worldwide Locations

Appendix A Host Communication Protocol


Appendix B Bar Code Label Specification
Appendix C Special Tests Procedures
Appendix D ACL Elite/Elite Pro Printout Examples

Index

Instrumentation Laboratory VI
ACL Elite/Elite Pro Operator’s Manual

INDEX
Calibration Plasma, 8.2
A Calibration Replicates, 3.71, 4.73
Calibration Stability, 7.41
Abort Test, 4.71, 4.81 Calibration Target Values, 4.31, 8.3
Absorbance channel, 1.15 Carryover, 4.6
Absorbance Tests, 1.2 Carryover - User Defined Tests, 4.7
Acquisition Anomalies, 6.14 Carryover Specification, 7.42
Acquisition Delay, 4.83 Check Mark, 3.29
Acquisition Setup, 4.82 Chromogenic Tests, 7.4, 7.14
Acquisition time, 7.33 Chromogenic Test Volumes, 7.24
Adapters, 1.9, 2.7, 9.4 Cleaning -Test Setup, 4.68, 4.78, 5.2
Add QC, 3.18 Cleaning Air Filter, 5.21
Alarms, 6.1, 6.4 Clock, 3.33
Algorithm, 4.87 Clock Symbol, 3.31
Ambient Conditions, 2.1 Clot/Reaction Curve, 3.42
Ambient Specifications, 7.48 Coagulometric tests, 7.3, 7.7
Analytical Reference, 3.82 Coagulometric Tests, 1.2
Analytical Reference Cumulative Results, 3.85 Color codes, 3.17, 3.39
Analytical Reference Data Extract, 3.88 Complete Possible and Signal, 4.71, 4.81
Analytical Reference Error Codes, 6.29 Connectors, 2.4
Analytical Reference Host Transmit, 3.87 Copy Tests, 4.56
Analytical Reference Plots, 3.84 Correct Ratio with 100% Std., 4.109
APCR, 7.8 Correct with AR, 4.108
APTT, 7.8 Cuvettes, 1.18
Archive, 4.115
Assay Performance Characteristics, 7.37 D
Assigned Liquid Volume, 4.29
Audible Alarms, 4.51 Database Anomalies, 6.20
Autolist, 3.27 Database Configuration, 4.44
Database Specifications, 7.46
B Data Reduction Diagram, 6.39
Data Reduction Error, 6.37
Backup, 4.114 Data Reduction Error Codes, 6.20
Backup Test and Material, 4.121 Data Transmission Failure, 6.20
Barcode, External, 1.21 Date/Time, 4.52
Barcode, On-board, 1.20 D Dimer, 7.16
Biohazards, 7.50 Dead Volume- Vials and Cups, 7.44
Decimal places- Result Formats, 7.29
C Decontamination, 5.16, 5.28
Dedicated Calibration, 3.64
Cal Low F, 3.72 Default Liquid Position, 4.34
Calculation of Results, 7.5 Default Multi-Tests, 4.27
Calculation Setup, 4.84 Default Tests, 4.8
Calibration, 3.63 Default Screen, 4.45
Calibration Curve Flagging Limits, 7.27 Delay at Completion, 4.67, 4.77
Calibration Curve Review, 3.66 Delete Icon, 3.44
Calibration Curve limits, 7.30 Delta Algorithm, 4.101
Calibration Curve Setup, 4.107 Dilutor, 2.8
Calibration Error Codes, 6.25 Dimensions of Analyzer, 7.46
Calibration - Factors - Non Parallelism, 3.72 Display, 1.18
Calibration - Factors - with Parallelism, 3.79 DMS Errors, 6.41
Calibration Loading Setup, 4.72 Dots displayed - Multi Tests, 3.15
Calibration Modes, 4.58 Double Test Error Codes, 6.36

Instrumentation Laboratory 1
ACL Elite/Elite Pro Operator’s Manual

E INR Setup, 4.60, 4.30


INR Errors, 6.35
Electrical Hazards, 7.49 Installation Requirements, 2.1
Electrical Requirements, 2.2 Instrument Cleaning, 5.19
Electrical Specifications, 7.48 Instrument Description, 1.3
Electronics, 1.17 Instrument Specifications, 7.45
Empty Cups - Analysis, 4.63, 4.66 Instrument Status, 3.5
Error 10, 7.30 Interface Connectors, 1.19
Error 13, 6.38 Interfaces - Setup, 4.36
Error 6, 6.37, 7.30 Interference Table, 4.6
Error 7, 6.38, 7.30 Intermediate Rinse, 4.66, 4.76
Expiration Date, 3.24 Internal Barcode, 4.40
External Barcode Setup, 4.42 Inter-ramp Interval, 4.68, 4.82
External Barcode Reader, 3.24 ISI, 4.30, 4.86
Extract Samples, 3.39 ISI Limits, 4.32, 4.34
Extrapolated Result, 4.109
K
F
Keyboard, 1.18, 3.3, 4.43
Factor assay calibration, 3.72
Factors, 7.9
Failure Status, 3.5, 6.1
L
Fibrinogen - PT based, 7.4, 7.14 Language Setup, 4.44
File Error History, 5.12 Latex tests, 7.4
Filter, 2.11 Letter Code Meaning - 3.17
Filter Cleaning, 5.21 Library Identification, 4.118
First Derivative Algorithm, 3.43, 4.96 Line Frequency, 2.3
Flagging Limits for Results, 7.26 Linearity, 7.39
Floppy Disk Drive, 1.23 Lipemic Samples, 7.43
Flush/Optic Channel Error, 6.21 Liquid Accessing Needle, 4.34
Free Protein S, 7.17 Liquid Anomalies, 6.15
Fuse, 2.3 Liquid ID, 4.28
Liquid Sensor, 4.45
H Liquid Setup, 4.27
Liquid Waste, 5.17
Halogen Lamp, 1.16, 5.27 Loading and Analysis Area, 1.12
hardware components, 1.4 Loading Setup - Analysis, 4.62
Hazards, 7.49 Loading Setup - Calibration, 4.72
Header volumes - Reagent and Sample, 7.22 Loadlist, 3.25
Heparin, 7.16 Loadlist Time Interval, 3.27
Hepatocomplex, 7.12 Logbook, 5.14
High curve (Factor Assay), 3.74 Low curve (Factor Assay) , 3.75
Host, 2.13, 3.46, 4.36
Hourglass, 3.31
M
I Magnetic Stirrer Part Number, 9.4
Maintenance - As Needed, 5.22
Icons, 3.6 Maintenance - Bi-Weekly, 5.20
Immunological Tests, 1.2 Maintenance - Daily, 5.16
Import Calibration Data, 4.58 Maintenance - Monthly, 5.21
Import ISI, 4.86 Maintenance - Weekly, 5.19
Import Raw Data, 4.58 Maintenance menu, 5.7
Import Ref Value, 4.86 Maintenance Overdue Warning, 5.8
In Cup Dilution, 4.65, 4.74 Maintenance Table/Checklist, 5.30
In Line Dilution, 4.65, 4.74 Make Loadlist, 3.25
In Session Calibration, 3.67 Mark Samples - Loadlist, 3.27

Instrumentation Laboratory 2
ACL Elite/Elite Pro Operator’s Manual

Materials Check, 4.70, 4.80 Primary Unit Correction, 4.91, 4.95, 4.96, 4.99
Materials Map, 3.23 Priming, 2.11, 5.2, 5.17
Material Map - Profiles, 4.16 Priming in standby, 5.3
Mean of Results, 4.105 Printer, 1.22, 4.38
Measured Parameters, 1.2 Printer Fail, 6.6
Mechanical Anomalies, 6.12 Printing Results, 3.45
Mechanical Hazards, 7.50 Printout Setup, 4.38
Method Comparison Studies, 7.40, 7.51 Pro Clot, 7.13
Microprocessor, 1.17 Product Use, 1.2
Middle curve (Factor Assay), 3.76 Profiles, 4.13
Miscellaneous Errors, 6.37 Profiles Details screen, 4.15
Mixing Cuvette Contents, 4.68, 4.78 Program Sample, 3.20, 3.35
Mouse, 3.4 Pro IL Complex, 7.11
Multi-Tests, 3.14, 4.13 PT, 7.7

N Q
Needle Alignment, 5.10 QC Error Codes, 6.37
Needle Cleaning, 5.14 QC Cumulative Results, 3.55
Needle Replacement, 5.23, 9.4 QC Data Extract, 3.60
Nephelometric channel, 1.15 QC Host Transmission, 3.59
New Liquid Setup, 4.34 QC Icon/Review Results, 3.52
New Sample - Program, 3.20 QC Plots, 3.53
New User Definition, 4.49 QC Setup, 3.49
Noise Checks- Data Reduction, 4.94 Quality Control, 3.48
Normal Range, 1.25, 3.39, 4.59 Q Prime Checkbox, 4.109
Normalization, 4.85
Numerical Keypad, 3.2, 4.43 R
O r2 check - Parallelism, 3.81
Ramp, 4.82
Omit Calibration Replicate, 3.68 Ratio, 4.60, 4.85, 4.105
On Board Stability- Reagents, 3.24, 4.29 Ratio Errors, 6.33
Operative Anomalies, 6.18 Raw Data - Save to Disk, 4.119
Optical Measuring System, 1.15 Reaction Curve Error Codes, 6.22
Optical Path, 1.15 Reaction Times, 7.33
Optical Path Cleaning, 5.21 Reagent Area, 1.8
Optical Reference, 4.74 Reagent Barcode Setup, 4.42
Optics Anomalies, 6.18 Reagent Priming, 4.65, 4.76
Reagent Vials, 7.44
P Reagents positions, 1.7, 7.18
Reference Value, 4.60
Parallelism - Calibration, 3.79 Reflex Testing Status, 4.44
Parallelism Results, 3.80 Reflex Tests Setup, 4.9
Parsing Anomalies, 6.19 REM Enable, 4.45
Part/Expendable list, 9.4 REM Anomalies, 6.7
Passwords - Security, 4.46 Rerun Tests Setup, 4.9
Patient Demographic Details, 3.21 Restore Configuration, 4.114
Pause System During Run, 3.34 Results, 3.37, 7.26, 7.29
Pause Reagent Timer, 3.25 Result Units - IL Coagulometric Tests, 7.5
Perform Sequentially, 4.69 Results - Units with/without Calibration, 7.6
Piston block and Electrovalves, 1.10 Review Calibrations, 3.66
Plasma Handling, 8.2 Rinse Reservoir Cleaning, 5.17
Power Consumption, 2.2 Rinse/Waste, 1.9
Precision Performance, 7.38 Rotor, 1.12
Presentation of Results, 1.3 Rotor Arm, 1.13

Instrumentation Laboratory 3
ACL Elite/Elite Pro Operator’s Manual

Rotor Holder, 1.15 Stirrers, 1.9, 2.7


Rotor Part Number, 9.4 Symbols Chart, 1.26
Rotor Stack, 1.13 System Anomalies, 6.2
Rotor Transport, 1.13 System Configuration, 4.44
Rotor Waste, 5.18
Rotor Waste Area, 1.16 T
Runner Icon - Main Screen - Setup 4.27
Target Values, 4.29
S Temperature - Limits, 2.12
Temperature Anomalies, 6.9
Sample Analysis Procedures, 3.11 Temperature Display - Real Time, 5.8
Sample Barcode Setup, 4.40 Temperature Units, 4.53
Sample Collection, 8.1 Test Code, 4.57
Sample Cups, 744, 9.4 Test Group ID/Code, 4.20
sample Database, 3.37 Test Group List, 4.22
Sample Details, 3.40 Test Group Profiles, 4.22
Sample ID Errors, 6.38 Test Groups, 4.17
Sample Requirement and Positions, 7.18 Test Group - User Defined, 4.19
Sample Spillage Cleaning, 5.19 Test ID, 4.57
Sample Status, 3.22, 3.31 Test Range, 1.25, 3.39, 4.59
Sample Tubes, 7.43 Test - Save Individual, 4.121
Sampling Rate - Data Acquisition, 4.83 Test volumes, 7.22
Sampling/Dispensing Arm Assembly, 1.10 Tests Details, 4.57
Save Rotor Map, 4.119 Tests Display/Print - Setup, 4.4
Save Trace, 4.120 Tests Execution Status, 3.31
Scale Range, 1.25, 3.39, 4.60 Tests Setup, 4.54
Scope, 4.64, 4.74, 4.82 Thermal Fail, 6.6
Second Derivative, 3.43, 4.98 Threshold, 3.43, 4.86
Security - Setup, 4.46 Threshold/Second Derivative, 3.43, 4.92
Sensors, 1.10 Time/Date Setup, 4.52
Service Menu, 5.15 Timing Constraint, 4.66, 4.77
Session Error Codes, 6.21 Touch Screen, 1.17, 3.1
Session Error History, 5.11 Trace File, 4.120
Session History, 3.32 Trend Algorithm, 4.88
Session Report, 3.31 TT, 7.8
Set Timer, 4.67, 4.77
Set Volume, Reagents, 3.24 U
Setup Tests, 4.2
Shock Hazards, 7.49 Unit Correction, 4.60
Silica Clotting Time, 7.13 Units, 1.3, 4.59
Single Test, 3.14 Upgrade IL Library, 4.113
Slope Check-Parallelism, 3.80 USB Ports, 2.4
Software Identification, 4.117 Used Rotor, 5.118
Software Tree, 3.10 User - Security Setup, 4.50
Software Upgrade, 4.117
Sort Multi-Tests, 4.26 W
Sort Tests, 4.4
Space Requirements, 2.2 Wait Until Timer Expires, 4.67, 4.77
Special Tests, 1.2 Warnings, 6.1, 6.5
Special Test Volumes, 7.25 Wash-R Part Number,9.4
Standby, 1.24, 3.5 Wash R. Checkbox, 4.74, 4.66
Start Reagent Timer, 3.24 Wash-Reference Emulsion, 1.9, 2.8
STAT, 3.34 Waste Line Cleaning Procedure, 5.22
Step Length, 4.66, 4.77 Waste Tube, 2.6

Instrumentation Laboratory 4
ACL Elite/Elite Pro Operator’s Manual

Instrumentation Laboratory 5
General Information
1.0 Introduction
This Operator’s Manual contains the information necessary to operate, maintain and
troubleshoot the Instrumentation Laboratory ACL Elite and Elite Pro. Personnel
responsible for operating and maintaining the instrument should read and understand
the material included here prior to using the system. This Manual should be kept near
the instrument or in a suitable location for reference as required.
This Section of the Manual contains general information about the ACL Elite/Elite Pro
systems, including use and measured parameters, description of the hardware
modules as well as their function and operation, methodology, additional features and
procedural limitations. The description and use of the ACL Elite/Elite Pro Operator’s
Interface is addressed in separate Sections of this Manual.

ACL Elite Pro system

Instrumentation Laboratory 1.1


General Information

1.1 Product Use


The IL ACL Elite/Elite Pro system is a fully automated, high productivity analyzer
designed specifically for clinical use in the hemostasis laboratory, for coagulation
and/or fibrinolysis testing. The system provides results for both direct hemostasis
measurements and calculated parameters.

1.2 Measured Parameters


The ACL Elite/Elite Pro system is used to perform the following tests:
Coagulometric Tests
• PT-FIB (Prothrombin Time and PT-Based Fibrinogen concentration)
• APTT (Activated Partial Thromboplastin Time)
• TT (Thrombin Time)
• Single Factors (VII, X, V, II, XII, XI, IX, VIII)

Absorbance Tests
• Antithrombin
• Heparin
• Protein C
• Plasmin Inhibitor
• Plasminogen
• Fibrinogen-C (Clauss method)

Immunological Tests
• D-Dimer
• von Willebrand Factor – Activity and Antigen
• Free Protein S

Special Tests
• ProClot (clotting Protein C)
• Protein S
• Factor V Leiden
• LAC Screen and Confirm
• Pro-IL-Complex *
• Hepatocomplex *

NOTE:
An (*) indicates that the test is not available in the United States.

Single Test or Multi-Tests


The user may program single or multiple tests on patient samples to be performed on
a random access basis. Refer to Section 4 for additional information on this subject.

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Tests Groups
Some tests can be run together as a group, thus saving time when the number of
samples to be analyzed is relatively small. Following are some examples:
PT-FIB/APTT
PT-FIB/APTT/TT
Fib-C/ AT/D-Dimer
Double Tests (Duplicate Testing)
The ACL Elite/Elite Pro offers the user the capability to set up double tests. Chapter
4.0 contains information that allows you to set up double tests on the system.

1.3 Presentation of Results


The ACL system offers the following choices to display and print results of testing:

• s (seconds)
• R (Ratio)
• NR (Normalized Ratio)
• INR (International Normalized Ratio)
• % (Percent activity)
• U/mL (units/mL)
• mg/dL (for example for Fibrinogen)
• mg/L
• g/L (for example for Fibrinogen)
• ng/mL (for example for D-Dimer)
• microg/mL
• microg/L (for example for D-Dimer)
• micromol/L
• IU/mL (International Unit)
• User configurable unit

1.4 Instrument Description and Operation

1.4.1 Summary
The ACL is a family of fully automated computer-controlled, microcentrifugal
analyzers. The ACL Elite/Elite Pro system incorporates a Liquid Crystal
Display (LCD) unit that shows the status of the instrument, permits the user
to select desired procedures, and through the use of menus and options
guides the operator through these procedures. Information and instructions
are entered into the system either via a Touch Screen device or through a
standard PC keyboard or mouse.
When sample testing is initiated, the samples and reagents are sequentially
pipetted into a 20-cuvette polystyrene rotor (loading process). A centrifugation
process then mixes sample and reagents. The mixing is carried out by a

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General Information

combination of rapid acceleration and braking actions, which are effective in


thoroughly mixing the liquids. Reaction measurements (data acquisition) via
the photometer are made while the rotor is spinning.
The ACL measures the parameters at 37 oC ± 1 oC (98.6 oF ± 1.8 oF), at an
ambient temperature from 15 oC to 32 oC (59 oF to 89 oF). However, if the
ACL is in a temperature-controlled environment where the ambient
temperature is held constant, the measurements are made within a narrower
temperature range: 37 oC ± 0.25 oC.
The results are displayed on the LCD and optionally printed by the external
printer, and/or sent to a host computer. The ACL performs automatic
calibration, offers a series of utility programs for the operator and manages a
complete quality control program.

1.4.2 Main hardware components


The ACL Elite/Elite Pro analyzer includes several hardware components and
modules, which interact with each other to carry out the analytical process.
This section contains descriptions of those components and their functions as
well as the operations that take place during the analytical process.
The figure below highlights some of the main components of the ACL
Elite/Elite Pro, as viewed from the front of the system.

System – Components (ACL Elite does not have Rotor Transport and Rotor Arm)

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5
6
ACL Elite/Elite Pro Operator’s Manual

1. Wash-R Emulsion 6. Floppy Disk Drive 11. Rotor Waste Area


2. Dilutors 7. LCD 12. Keyboard
3. Sample Tray 8. Rotor Stack Area 13. Adapters Area
4. Reagent Area 9. Rotor Holder Cover 14. Liquid Waste Outlet
5. Sampling Arm 10. Rotor Transport / Arm* *Not Available on ACL Elite

8
9 & 10

11

12
14 13

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General Information

The following items will be addressed in the Sections below:


• Sample Tray (Section 1.4.3)
• Reagent Area (Section 1.4.4)
• Rinse/Waste Area (Section 1.4.5)
• Sampling/Dispensing System (Section 1.4.6)
- wash-reference emulsion
- piston block and electrovalves
- Sampling arm assembly
- Sensors
• Loading and Analysis Area (Section 1.4.7)
- Rotors (reaction cuvettes)
- Rotor housing and rotor transport*
- Rotor holder and rotor loading
- Optical measuring system (photometric and nephelometric)
- Rotor waste area
• Microprocessor and Electronics (Section 1.4.8)
• Liquid Crystal Display (LCD) (Section 1.4.9)
• Keyboard (Section 1.4.10)
• Interface Connectors (Section 1.4.11)
• Internal Cooling System (Section 1.4.12)
• On-board Barcode Reader (Section 1.4.13)
• External Barcode Scanner (Section 1.4.14)
• External printer (Section 1.4.15)
• Floppy disk drive (Section 1.4.16)
*Rotor Transport system is not available on the ACL Elite

1.4.3 Sample Tray


The ACL autosampler system includes a rotating sample tray which contains:
- 40 x 14.2 mm diameter positions for cups and primary tubes and
- 10 x 23 mm diameter positions to hold accessory materials such as
calibrators, diluents, reagents vials, etc.
Optical sensors located around the tray verify that the tray is correctly
positioned, and also detect the presence of cups, tubes and vials.
Three different sample trays can be used (with the ACL system) depending
on the instrument configuration. Each is appropriate for a different size of
primary tubes: 3 mL, 5 mL and S11.5; all of them can be used for 0.5, 2 or 4
mL cups.

Short (3 mL) Primary tube (13x75 mm)


Tall (5 mL) Primary tube (13x75 mm and/or 13x100 mm)
Tall (S 11.5) Sarstedt primary tube (11.5x66 mm) and/or (11.5x92 mm)
The dimensions mentioned above are all nominal values.

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Sample Tray

Sample Tray Location on the ACL

Press Button to Remove Tray

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General Information

§ Additional Reagents positions


The ten internal positions of the sample tray - A1 to A10 - are used to place
materials such as calibrators, diluents or reagents in a choice of containers
such as 23 mm vials (10 mL fill volume), 18 mm vials (4 mL fill volume) or
cups. Adapters are needed for the 4 mL vials and cups as seen in the picture
below.
Normally, position A1 is reserved for a cup containing calibration plasma
(normal pool) and position A2 is reserved for a cup containing IL Factor
Diluent, for use in the calibration procedure.

Adapters for internal positions in the Sample Tray

Vial Adapter

Cup Adapter

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1.4.4 Reagent Area


The ACL Elite reagent area consists of 8 reservoirs labeled R1 to R8
designed to hold reagent containers. The ACL Elite Pro has 4 additional non-
stirred cooled positions labeled R9 to R12. An area alongside the vial holes is
designed to hold the vial caps while the vials are in use.
Positions R1 to R4 (all models) and R9 to R12 (ACL Elite Pro only) are
maintained between 10 - 16 oC by a Peltier-effect regulator. Positions R1 to
R4 are equipped with a stirring mechanism.
Positions R5 to R8 are used for reagents at room temperature; these
positions do not have a stirring mechanism.
The reagents in positions R1 to R6 and R9 to R12 are aspirated with the
internal (Reagent) needle while the reagents placed in positions R7 and R8
are aspirated with the external (Sample) needle.

Reagent Area - ACL Elite

All reagent positions can hold 28 mm vials (16 mL fill volume). Smaller
diameter vials require the use of color-coded adapters.

Vial Adapters

Gray: for 10 mL vials requiring magnetic stirrer

Pink: for 10 mL vials not requiring magnetic stirrer

Green: for 4 mL vials not requiring magnetic stirrer

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1.4.5 Rinse/Waste Area


The rinse/waste system of the ACL consists of a removable rinse cup
reservoir positioned between reagents positions R4 and R5, a plastic tube
connected to the cup reservoir drains the waste from the cup, and a waste
container outside the analyzer (left side) collects the waste.
The cup, which is always filled with Wash-R Emulsion, is used as a wash
basin for the dispensing needles between cycles; the liquid waste is then
drained and collected in the waste container on the outside of the analyzer
for proper disposal.

Rinse/Waste System

Rinse Waste Reservoir under Needles External Waste Container


(left side, front of unit)

1.4.6 Sampling/Dispensing System


The sampling/dispensing system of the ACL Elite/Elite Pro includes the
following components:

Wash-Reference Emulsion bottle


This is a plastic bottle containing 1000 mL of silicon emulsion, which is
employed as a wash solution and serves as the optical reference for the
nephelometric channel. A sensor located inside the bottle alerts the user
when the liquid level falls below acceptable values. The cap on the bottle is
removed by lifting it up off the bottle.

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Piston block and Electrovalves


Set against the back wall of the analyzer is an acrylic block with two cylinders
each of which has a stainless steel piston. Two electrovalves are connected
to the pistons. The electrovalves are electronically controlled and connect the
pistons to the Wash-Reference Emulsion bottle as well as to the two needles
mounted on the sampling/dispensing arm.
Sampling/Dispensing Arm Assembly
Two stainless steel needles, external (Sample) and internal (Reagent), are
mounted on the distal end of an arm, which is actuated radially by a stepper
motor. Another stepper motor moves the arm in the vertical plane through a
worm screw. The combination of these two movements allow the following
operations:

- Aspiration of sample and/or reagent from their respective locations.


- Dispensing of sample and reagent into the inner and outer
compartments of the reaction cuvettes within the rotor.
- Washing of the needles in the waste/rinse station.

Sampling Dispensing System

Sensors
Two liquid level sensors connected to the needle block are used to detect the
presence of samples and reagents in the needles.
Through the liquid level sensors, the system monitors the presence of
samples and liquid materials (calibrators, deficient plasma, diluents, etc.) in

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General Information

the sample tray and reagents in the original reagent vials located in the
reagent area.
These liquid sensors are integrated into the ACL analytical cycles in such a
way that their operation does not affect the throughput of the system. For all
analytical cycles the verification by the sensors is done “in-line” during the
loading phase. The sampling arm stops when the needle is just below the
liquid surface to allow proper aspiration of the programmed amount of liquid.
The liquid sensors become active at the start of each analytical cycle. The
sequence of sensor operations during a cycle is as follows:
- self-check
- liquid test
- washing
- final sensor self-check
- if applicable, reports sensor failures to be displayed in the LCD.

If Operators are warned of sample/reagent sensor failures: results of a


sample for which the system detected insufficient volume will appear with a
warning. For Example, if the failure was due to insufficient sample in a cup,
the warning message will display “low level”. If all sample containers in the
sample tray are empty, the cycle will be aborted after the final self-check. No
other warnings appear on the video or on the printer.

Sampling Arm with sensor

Sample line is on top

External
Internal (Sample)
(Reagent)

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Any sensor failure warning due to self-check or to insufficient reagent will:


- disappear at the beginning of the loading phase
- appear during incubation/acquisition in case of self-check error or
insufficient reagent
- remain up to the next loading phase in the following cycle.
Although the sensor test terminates as soon as an error is detected during
the initial self-check, the analytical cycle continues. In this case, the test
results are given and a warning appears in the status line indicating the
sensor failure. No indications will be given about the absence of samples
and/or reagents.
The operator may view the warning condition by pressing the Warning icon.
An equivalent message will be printed out with the results.

Note: No additional amount of liquid (sample or reagent) is aspirated for the


sensor check.

1.4.7 Loading and Analysis Area


The area of the analyzer where the reaction cuvettes are loaded and the
analysis takes place is located under the rotor holder cover in the center of
the instrument, on the right side of the reagent area. This area includes the
reaction cuvettes (rotors) storage system and mechanisms involved in the
transport of these rotors, the plate where the rotor is placed during loading
and analysis (rotor holder), the hardware components responsible for
ensuring proper mixing of reagents and samples in the cuvettes and the
optical system used to make the analytical measurements. The rotor holder
cover can be opened by pressing the rotor cover icon.

Rotor
Inner Well

Outer Well

Caution: Avoid touching


the area of the rotor where
the optical reading occurs.
This includes the top, side
and bottom of the outer
portion on the rotor.

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General Information

Rotor (reaction cuvettes)


The disposable reaction cuvettes, precision made of UV-transparent
polystyrene, are radially arranged in groups of 20. The 20-cuvette unit is
called a rotor. Optical readings occur in the outer portion of the rotor.
Each wedge-shaped cuvette contains two compartments, an inner one near
the center to hold the sample and/or reagent and an outer one that holds
reagents only. A partial dam between the compartments maintains the
contents separately during the loading process; as centrifugal action starts,
the sample/reagent in the inside compartment flows over the dam to mix with
the contents in the outer compartment. The reaction and analysis take place
within the large, outside compartment while the rotor is spinning.

Rotor Stack, Rotor Transport and Rotor Arm


Rotor stack - Before their use, rotors are stored in a stack that holds up to 12
rotors. The rotor stack compartment, which may be accessed from the top of
the analyzer on the right side, can be filled at any time (continuous rotor
loading) either manually (one rotor at a time) or using a rotor refill tool (up to
10 rotors at a time). The rotor stack area is thermostatically controlled in
order to keep the rotors in a temperature range between 36 and 39 oC; the
rotor stack is insulated to help thermal-regulation. The instrument informs the
Operator when the Rotor Stack is empty on the ACL Elite Pro.

Use of Rotor Refill Tool

Depress center button to


load and unload rotors

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Feeding the Rotor Stack

Rotor Transport* - Below the rotor stack, a rotor transport slide mechanism
moves the bottom rotor out to make it available to the rotor arm mechanism.

Rotor Arm* - The robotic arm takes the rotor and inserts it into the rotor
holder. This is the area where the rotor will remain during the loading and
analysis process. Once analysis is completed, if the rotor is fully utilized (or if
requested by the user), the rotor arm discards the rotor into the rotor waste
container.

Rotor Transport and Arm – (Not Applicable on the ACL Elite)*

On the ACL Elite rotors must be manually loaded from the storage area into
the analysis compartment. Press the “Open Lid” icon to raise/lower the
analysis compartment cover. Press the button on the center of the hub in the
analysis compartment to properly seat and remove the rotor. The analyzer
will alert the operator when a rotor exchange is needed.

Instrumentation Laboratory 1.15


General Information

Rotor Holder and Rotor Loading


The rotor holder is an aluminum disk that holds the rotor in place during
loading and analysis. The rotor holder is thermostatically controlled to a
temperature of 38.5 ± 0.5 oC to insure 37 oC inside the cuvette.

Rotor Holder Area

Press this
button to
manually
place and
remove
rotors

Rotor loading: as indicated above, the loading of sample and reagents into
the reaction cuvettes involves the action of the sampling/dispensing arm and
needles.

Optical Measuring System


The Loading and Analysis area also houses the optical system for analysis
on two channels: nephelometric and absorbance.

Nephelometric channel: the light source for this channel is a light emitting
diode (LED); the light (λ = 660 nm) is directed to the reaction cuvettes in the
rotor by a fiber optic system. The scattered light is read at a 90o angle with
respect to the incident beam using a solid state detector located below the
rotor holder.
Absorbance channel: the light source is a halogen lamp, from which the
radiation is directed to the reaction cuvettes in the rotor via a quartz optic
fiber and a focusing system. The selection of the wavelength for analysis is
effected by a narrow-band interference filter centered at λ = 405 nm.
The optical detector is mounted in the cover of the loading/analysis area;
therefore the readings are made at a 180o angle from the light beam.
The optical path width for the absorbance channel is 0.5 cm (cuvette height).
The absorbance values provided by the analyzer are normalized to 1 cm.
These values are generally twice those ones obtained on other ACL models,

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for which the absorbance values are not normalized and are thus exactly the
ones obtained for the 0.5 cm cuvette path.
The halogen lamp can be replaced by accessing the area through a
removable cover inside the rotor waste area in the center of the instrument by
an IL Service engineer.

Nephelometric and Absorbance Detection Systems

Clot channel Absorbance Channel

Sensor
405 nm filter
LED Rotor
Lenses

Optical Fiber Sensor

Quartz
Quartz optical fiber

Halogen Lamp

Rotor Waste Area


The used rotors are automatically dropped into a waste container on the ACL
Elite Pro system. On the ACL Elite system rotors may be manually moved
into the waste bin or discarded immediately into a designated biohazard
container per laboratory protocol. This container is accessed from a door on
the right front area of the analyzer for removal and disposal of the used
rotors, as seen in the figure below. The instrument informs the user when the
Rotor Waste is full.
Warning: Cuvettes within the rotor are intended for use one time only.
IL does not recommend or support the re-use of previously used-
washed cuvettes in a rotor.

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General Information

Rotor Waste Access and Removal

In the waste area a switch (sensor) verifies the presence of the waste
container.

1.4.8 Microprocessor and Electronics


This ACL analyzer unit is built around three computer microprocessors.
These microprocessors control all actions of the analyzer: mechanical
movements, aspiration and dispensing of samples and fluids, acquisition and
processing of data and operator interface with input (keyboard) and output
(video/printer) devices.
The electronics consist of printed circuit boards held together by a frame
mounted behind the front panel of the analyzer. Three of these boards are
assigned to the microprocessor and logic sections while the other three are
used for the interface modules and the various activation controls. These
circuits and the sub-assemblies of the instrument are supported by a
switching power supply directly connected to the main power

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1.4.9 Liquid Crystal Display (LCD)


This module consists of a Liquid Crystal Display, 12-inch active matrix (LCD),
which is fitted with a Touch Screen function, allowing most operations to be
carried out using the LCD.
The LCD guides the operator during the analytical process and displays
calibrator data and patient results. It is also used to display calibration curves
and to perform several utility programs, which are easily accessible through
this input device.
The LCD screen system reproduces 256 colors, and shows numeric and
alphanumeric characters. The interaction with the operator is also made user
friendly by the availability of graphics and icons. The screen is divided into
three areas:
- The upper section displays the submenus
- The central section displays menus, results, graph plots and instructional
guidelines
- The lower section displays instruction icons.

1.4.10 Keyboard
The ACL Elite/Elite Pro has a standard computer keyboard with mechanical
keys that allow the user to access the various operating modes of the
instrument.
Although the instrument is equipped with and supports the English (US & UK)
keyboard layout, the ACL software itself also supports the following
languages: German, French, Spanish, Japanese (Kanji) and Italian.

Keyboard

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General Information

1.4.11 Interface Connectors


RS-232 C Interface for Host (port 1)
The ACL Elite/Elite Pro contains an RS-232C interface (DTE Standard) for
the output of data to a central computer (Host) or a personal computer.
Communication to a host computer is via ASTM protocol.
RS-232 C Interface for a serial mouse (port 2)
USB ports (4 receptors)
The USB ports can be used for a mouse, printer or the optional external
reagent barcode reader.
Modem (port 4) not supported in this software release.
External Printer Output (port 5)
The ACL Elite/Elite Pro has an output for an optional external printer. Two
emulation protocols are available for printers: ESC/P2 (Epson like printers)
and HP-PCL (for HP like Laser Printers).

Standard PC keyboard (port 6)

Rear Panel and Fuse

1 2 3 6

1. RS232C 1 (Host - Optional)


2. RS232C 2 (Mouse)
3. USB (4 ports) Mouse, Printer, External barcode
4. Modem (NS)
5. Parallel Printer (Optional)
6. Keyboard

NS = Not Supported in this software release

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ACL Elite/Elite Pro Operator’s Manual

1.4.12 Internal Cooling System


The cooling of the system is insured by the presence of fans mounted on the
internal right side of the analyzer. An air filter prevents dust from entering the
system (see Maintenance section).
A two-level alarm warns the user when the internal temperature of the
instrument rises above damaging levels. The first level alerts the operator of
the temperature rise and displays a warning. The second level switches off
the instrument.

1.4.13 On-board Barcode Reader


The on-board barcode reader, a standard feature of the ACL Elite/Elite Pro, is
located in the sampling area as indicated in the figure below. A small window
indicates its position. For additional information on the use of the on-board
barcode reader, refer to Section 3, Section 7 and appendix B of this Manual.
The numeric and alpha-numeric readable codes are:

- Codabar
- Code 39
- Code 128
- Interleaved 2 of 5

When using barcoded sample tubes, it is important to position them in the


sample tray such that the labels are facing towards the outside of the sample
tray. This will allow correct reading of the labels by the on-board barcode
reader.

On-Board Barcode Reader

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General Information

1.4.14 External Barcode Scanner (optional)


The external barcode scanner is a standard item on the Elite Pro and an
optional feature of the ACL Elite. This barcode scanner is able to read the
alphanumeric information on the HemosIL reagent vials when the material
map is displayed. The vial label includes the following information used by
the ACL Elite/Elite Pro:

- Last 4 digits of the lot number


- Lot number expiration date
- Material ID

The scanner is attached to one of the USB ports located on the backside of
the analyzer. Connect the scanner with the analyzer off and reboot the
system. The scanner will become active.
The scanner is automatically activated when the material map is displayed.

External Barcode Scanner

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1.4.15 External Printer (optional)


An external 80-column printer can be interfaced to the ACL Elite/Elite Pro.
Two emulation protocols can be used : ESC P2 or HP-PCL.
The ESC P2 is a typical Epson like protocol while the HP-PCL is a typical
Hewlett Packard like protocol for Inkjet and Laser printers.
The printer can use either a USB or Parallel connector. If the USB
connection is used the printer must be connected and turned on prior to the
system being booted up. If the printer is turned off while the instrument is on,
the analyzer must be rebooted in order for printing to occur.

External Printer

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General Information

1.4.16 Floppy Disk Drive


A floppy disk drive is mounted in the upper right area on the ACL Elite/Elite
Pro.
This device is used for some of the utility programs (refer to section 4).

The floppy disk is accessible from the cover by pushing both sides of it to
open.
3.5” Double sided High Density IBM preformatted disks should be used in the
drive.

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1.5 Additional Features

1.5.1 Standby Status


If the ACL Elite/Elite Pro is left ON for a period longer than 30 minutes
without any operator action, the system moves into the Standby status. The
LCD screen is “Switched off”. Pressing the Touch Screen reactivates the
display and allows the system to resume normal operation.
When the system enters the Standby status, the database is saved, all
motors are deactivated to reduce power consumption and the LED source is
switched off. While the instrument is in Standby an automatic priming cycle is
performed every 30 minutes.

1.5.2 End of the Cycle


At the end of each analytical cycle, a beep signal notifies the operator that
the cycle has been completed.

1.5.3 Power loss


The ACL contains a non-volatile memory to retain the database in the event
of a power interruption. The instrument performs an automatic save of the
database with every entry in standby or when exiting from the main program
to power off. Failure to log off before shutting the system down may result in
the loss of some results that have not been saved to the database.
The instrument has an internal clock that keeps track of the date and time.
When power returns after an interruption, the instrument performs self-
checks and displays the “login” screen. Entering the main screen, two
situations are possible:
1. The rotor holder temperature was within the acceptable range during the
check. The system is ready.
2. The rotor holder temperature was out of range. On the Main menu, the
Warning icon on the lower part of the screen is activated indicating that one
or more temperatures are out of range.

Note: Selecting the “WARNING” icon a message may be displayed if


temperatures of the reagent cooling system, the rotor holder, the rotor
transport and/or the rotor stack are out of range.

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General Information

1.5.4 Setup and Utility Programs


The instrument incorporates several utility programs that allow certain
functions to be changed or set according to the user’s needs. These
programs also help in troubleshooting.
For additional information, refer to Section 4 and Section 6 of this Manual.

1.5.5 Fault Detection


The system automatically monitors faults to ensure accuracy of sample data
and proper system performance. Fault monitoring includes display of alarms
and warnings.
For additional information, refer to Section 6 of this Manual.

1.5.6 Video Display Colors and Symbols


Certain situations concerning results and calibration parameters are
displayed as follows:

− Black = Result within Normal range


− Violet = out of Normal range
− Red = out of Test range
− *** = result out of the Scale range, high, for the assay
− --- = result out of the Scale range, low, for the assay
− ? = No result is available for this ordered test
− * = More than one result is available for this test
For additional information, refer to Section 3.2.2 and Section 7 of this
Manual.
Defined normal, test and scale range limits can be obtained by detailing the
individual test definitions in the system. Normal ranges must be entered by
user.

1.6 Procedural Limitations


The operating range of the ACL Elite/Elite Pro is 15 to 32 oC (59 to 89 oF) and at up to
85% Relative Humidity (not condensing). The system has been tested according to
EN61010-1 to ensure no safety hazards occur in the temperature range 5 - 40 oC (41
to 104 oF) and functional performance characteristics are resumed when the
instrument re-enters the range of 15 to 32 oC (59 to 89 oF).

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1.7 Certification

CE Certification
The CE label on the back of the instrument indicates that the ACL Elite/Elite Pro conforms
to the European Directives as stated in IL Declaration of Conformity,

EU Directive:

IVD - 98/79/EC (27/10/1998) , Annex I and III

Applicable standards:

• EN 61326-1: 1998/A2 2001 (Class A)

• EN 61010-2-04 Safety requirements for electrical equipment for measurement,


control and laboratory use. Part 1: General Requirements

• EN 61010-2-101 Part 2: Particular requirements for in-vitro diagnostic laboratory


equipment

• EN 61010-2-081 Part 2: Particular requirements for automatic and semi-automatic


laboratory equipment for analysis and other purposes.

CSA Certification
The CSA label on the back of the instrument indicates that the Canadian Standards
Association (CSA) has certified the ACL Elite/Elite Pro to the applicable standards.

Applicable standards:

• CAN/CSA C22.2 No. 1010.1-92

• UL Std. No. 61010-1, 2nd Edition

LOPD (Data Protection Organic Law)


Directive 95/46/CE of the European Parliament and the Council Directive of October 24th,
1995.

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General Information

European regulation on data protection, concerning:

Luxembourg Ireland Greece

United Kingdom Belgium Portugal

Austria Germany Italy

Denmark France Netherlands

Sweden Finland Spain

European parliament and council directives and regulations on data protection.

Spanish Constitution of 1978.

Organic Law 15 of December 13th, 1999, on Personal Data Protection (LOPD).

Royal Decree 994/1999 on Security Measures. Royal Decree 1332/1994.

Regulation of the Computerized Processing of Personal Data.

Spanish Data Protection Agency instructions.

Other Certification
The ACL Elite/Elite Pro meet CEI/IEC 61010-1, 2001 Mod, Second Edition, for the
following:

• External Surface Temperature

• Flame Resistance

• Fluid Resistance

• Internal Air Flow and Temperature

• Audible Noise

• Product Labeling

The ACL Elite/Elite Pro shipping package, US or overseas, complies with the International
Safe Transit Packaging Testing Procedure ISTA 1B (June, 1999) and ASTM 999.

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1.8 Instrument Disposal


European Union Directive 2002/96/EC on Waste Electrical and Electrical
Equipment (WEEE)

Instrumentation Laboratory is committed to meeting or exceeding the conditions of


the WEEE Directive, and being a good environmental partner. In compliance with the
Directive, beginning with product shipped after August 13, 2005, all instruments will
be labeled with the wheelie bin symbol.

Please call your local Instrumentation Laboratory distributor for information regarding
the disposal of any end-of-life instruments.

Instrumentation Laboratory 1.29


General Information

1.9 Symbols Chart


The following chart displays the various symbols that may be associated with the ACL
Elite/Elite Pro system

Temperature Use By Manufacturer Batch Code


CE Mark Limitation

ATTENTION: CAUTION: NOTE: ATTENTION:


Biological Risk See Risk of electric Important user Consult
Instructions Shock Information Documents
For use

In Vitro Authorized Contains


Catalog Number Serial Number Diagnostic Representative sufficient for
Device <n> tests

Earth Off (supply) On (supply) End of Life


Protective Disposal
Conductor (WEEE)
terminal -Earth

1.30 Instrumentation Laboratory


Installation
2.0 Introduction
This section contains all the information necessary for installing and setting up the
ACL Elite/Elite Pro system.

Warning: The ACL Elite/Elite Pro system must only be installed by IL personnel or
IL authorized persons.

Before attempting the installation of the ACL Elite/Elite Pro system in the laboratory,
inspect the site with laboratory personnel to identify the desired location for the
system and to insure that the environment meets all the requirements for its
successful installation.

2.1 Installation Requirements


The following sections detail the specific installation requirements for the ACL
Elite/Elite Pro system.

2.1.1 Ambient Conditions


The instrument will function correctly in an ambient temperature of 15-32 oC
(59 oF to 89 oF) with a relative humidity of up to 85% (non-condensing).

In accordance with the IEC regulations no instrument failures will occur in


presence of short term ambient temperature as low as 5°C or as high as
40°C.

The instrument should be positioned in an area free from dust, fumes,


vibrations and excessive variations of temperature.

Instrumentation Laboratory 2.1


Installation

2.1.2 Space Requirements


External dimensions of the analyzer are:
- Height at display level 60 cm 23.6 inches
- Height of analysis surface 27 cm 10.6 inches

- Width (including LCD) 100 cm 39.4 inches


- Depth 60 cm 23.6 inches
- Weight 63 Kg 139 lbs.
The heat generated by the instrument during normal operation is exhausted
from the bottom, on the front-right and left side of the unit.
Sufficient space must be allowed around the instrument to permit circulation
of air for cooling. The instrument must be positioned so that a waste tube can
be easily connected to its left side.
If the operator wishes to work from a sitting position in front of the system,
leg-space should be provided under the front of the instrument.

2.1.3 Electrical Requirements


The instrument has been designed to operate correctly with variations of
±10% on the nominal line voltage and with line frequencies between 50-60
Hz.
The instrument has a power supply that can operate from 100 to 240 V and it
automatically switches to the line voltage required.

Warning: Check that the nominal line voltage in the laboratory is


compatible with the label on the rear of the instrument as shown in the
table below. The electrical installation of the room should comply with
local, state or national requirements (including a power supply circuit
with independent grounding).

Value as shown on the label Values of line voltage for


normal function
100 – 240 V 100, 110, 115, 120, 125 Vac ±10%
220, 230, 240 Vac ±10%

Power Consumption
Check that the line is capable of supplying 350 VA.

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ACL Elite/Elite Pro Operator’s Manual

Warning: The average power consumption is about 350 VA, but peak
loads or current surges may exceed this value when turning the
instrument on.

Line Frequency
The instrument will function at any frequency between 50-60 Hz.
The power cord provided with the system is specifically designed for use with
the ACL Elite/Elite Pro. No other cord should be substituted. The cord plugs
into the socket as shown in the figure below. The fuses are enclosed in the
compartment to the right of the socket. The power entry module and the
ON/OFF switch are included.

Power Socket and Fuse

Instrumentation Laboratory 2.3


Installation

Connectors
The instrument is provided with several connectors located on the back side.

Connectors

1 2 3 4 5 6

1. RS232C 1 (Host - Optional)


2. RS232C 2 (Serial Mouse)
3. USB Ports (4): Mouse, Printer or External Barcode reader
4. Modem (NS)
5. Parallel Printer (Optional)
6. Keyboard

NS = Not Supported in this software release

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ACL Elite/Elite Pro Operator’s Manual

2.2 Instrument Delivery and Unpacking


An IL-certified representative should unpack the boxes containing the ACL and
accessories, visually inspect them to verify that there has been no damage during
shipping and handling. IL is not responsible for damages resulting from any non IL-
certified representative opening the boxes.
In case of damage notify the carrier and IL immediately.
Remove the box containing the rotors and the startup kit. Using the startup kit list
included in the box, confirm that all the shipping list components are present.
Remove the instrument and place it on the working surface.
Remove the adhesive tape used for transport from the various parts (covers, fan
cover, etc.).

Caution: Two persons should lift the instrument using the space below the unit
at the front and at the back as shown on the figure below.

Instrument carrying points

Instrumentation Laboratory 2.5


Installation

2.3 Mounting Instrument Parts


Waste tube
Connect the waste tube to the fitting on the bottom left hand side of the instrument.
Cut the tube to suitable length to fit into the waste container which must be situated
below the instrument waste outlet port, as shown in the figures below.

Caution: The horizontal section of the tube should be kept as short as possible
and the free end should not be immersed in the liquid waste container.

Warning
The liquid waste from the instrument is to be considered contaminated and
should be disposed of according to the waste management procedures of the
laboratory and in compliance with local regulations (see also CLSI GP25-A, Vol.
13 No. 22: Clinical Laboratory Waste Management, Dec. 1993).

Waste tube connection and waste container position

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ACL Elite/Elite Pro Operator’s Manual

Rinse, Sample and Reagent Accessories


• Verify that the waste-rinse reservoir is placed in its appropriate position.

• Fit the appropriate sample tray on its corresponding support.


• Fit the reagent adapters in their appropriate positions (if needed), as shown in the
figure below. Three color-coded reagent adapters are available for reagent
positions R1 to R8 (ACL Elite) and R1 to R12 (ACL Elite Pro ) :

Gray for 10 mL vials requiring magnetic stirrer (R1 to R4 only)

Pink for 10 mL vials not requiring magnetic stirrer

Green for 4 mL vials not requiring magnetic stirrer

Different blue vial adapters are used for the additional positions on the sample
tray.

• Place the magnetic stirrers inside the reagent vials in reagent positions R1 to R4,
if needed.

Reagent Adapters for the R1-R8 (ACL Elite) and R1-R12(ACL Elite Pro) positions

Instrumentation Laboratory 2.7


Installation

Reagent Adapters for the Sample Tray A1-A10 positions

Cup Adaptor Vial Adaptor

Wash-Reference Emulsion
Place a 1-liter bottle of Wash-Reference Emulsion in the appropriate position at the
back of the dilutor block. Insert the aspiration tube. Make sure that the aspiration
tube connector is properly connected to the level-sensing device.

Positioning of the Wash-Reference emulsion bottle

Electrovalve-needle assembly
Verify that the two tubes from the dilutor/electrovalve assembly to the needle block
are tightly connected.

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ACL Elite/Elite Pro Operator’s Manual

NOTE: The tube from the left hand electrovalve fits into the lower needle
connector and the right hand tubes fits into the upper needle connector.

Electrovalve-needle assembly

Positioning the touch-screen LCD display


Connect the LCD display to the appropriate fitting on the right side of the instrument,
as shown in the figure below.

Position of the LCD display

Monitor can be adjusted for left/right and up/down viewing angle

Instrumentation Laboratory 2.9


Installation

2.4 Turning the System On


Before turning the instrument on, check that the line voltage setting of the laboratory
is in accordance with the instrument label. Connect the instrument to the power
supply and switch it on using the power switch on the back panel.
Check that the Warning message “INCUBATION TEMPERATURE OUT OF RANGE”
appears on the screen display by accessing the WARNING icon. Check that the
magnetic stirrers in the reagent vials R1 and R4 are rotating (if needed).

Date/Time
Select Setup from the Main screen menu bar and click the Date/Time option. Choose
the date format. Set date and time. Press Confirm/Cancel to accept or ignore the
changes (refer to Section 4 - Setup Date/Time).

NOTE: The message “INCUBATION TEMPERATURE OUT OF RANGE” in the


Warning list is displayed for approximately 15 minutes, until the rotor holder
has reached the operating temperature.

Needle Arm Assembly


Please refer to Section 5 for information about the Needles Position procedure.

Priming
Select Diagnostic from the main screen menu bar and click the Priming option.

The Priming screen is displayed during the priming cycle:

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ACL Elite/Elite Pro Operator’s Manual

Priming screen
During priming, check that the number of bubbles in the dilutor chambers are reduced
to a minimum. If necessary, pinch the chamber outlet tubes with your fingers while
the piston is descending and release them before the piston reaches bottom dead
center. Repeat the priming cycle if necessary.
Check that there are no blockages or leaks in the fluid path and that the liquid is
flowing smoothly from the bottle to the dilutors and from the dilutors to the needles.

Check that the discharge of liquid from the rinse cup to the instrument outlet and then
to the waste container is not impaired.

Warning: If the message “SENSOR FAIL” in the Warning area is displayed, the
priming cycle must be repeated.

Air Cooling System Check


Locate the ventilation filter holder on the right side of the instrument. Verify that the
filter is clean and that the two fans are operating properly.

Instrumentation Laboratory 2.11


Installation

Temperature Check
Wait until the INCUBATION TEMPERATURE OUT OF RANGE warning has
disappeared and the Main menu is displayed. Click the Diagnostic button in the
menu bar and select the Temperature Control option, which will open the
Temperature Control screen. For details refer to Section 5.

Temperature Control screen


The temperature should be within the following ranges for each area:

• Rotor Holder 38 to 39 oC

• Peltier* 10 to 16 oC

• Rotor Transport 34 to 40 oC (N/A ACL Elite)


• Rotor Stack 34 to 40 oC
*ACL Elite Pro will display two Peltiers for R1 – R4 and R9 – R12.
The temperature display is constantly refreshed showing a blinking effect on the
display.
.

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ACL Elite/Elite Pro Operator’s Manual

On-Board Barcode Reader


This is a standard feature for the ACL Elite/Elite Pro. Set up the On-Board Barcode
Reader according to the procedure described in Section 4 of this Manual.
For additional information on the On-Board Barcode Reader, refer to Appendix B.

Manufacturer’s Responsibility
The manufacturer is responsible for the defects having an impact on safety, reliability
and performance of the equipment only if:
- assembly operations, extensions, re-adjustments, modifications or repairs are
carried out by manufacturer’s authorized personnel; and

- the electrical installation complies with national requirements; and

- the equipment is used in accordance with these operating instructions.

2.5 ACL - HOST Interconnect Cable


The following table provides information regarding the wiring of the interconnection
cable between the ACL and a PC (Host).

ACL Side PC Side


Interface Type: DTE Interface Type: DTE
9 Pin Female Delta Connector 9 Pin Female Delta Connector

PIN DESCRIPTION PIN DESCRIPTION


1 N.C 1 N.C.
2 TXD 2 TXD
3 RXD 3 RXD
4 DTR 4 DTR
5 Signal GND 5 Signal GND
6 DSR 6 DSR
7 RTS 7 RTS
8 CTS 8 CTS
9 N.C. 9 N.C.

Instrumentation Laboratory 2.13


Analytical Operations
3.0 Introduction
This Section describes the different procedures associated with sample analysis,
calibration and Quality Control (Q.C.) on the ACL Elite/Elite Pro System. Since these
procedures require an interaction between the operator and the ACL, this Section
begins with some general information about the System’s Operator Interface (OI) for
easy referral, as need arises.

3.1 Components and Use of the Operator Interface


The following sub-sections are intended to familiarize the operator with the Operator
Interface (OI) items used during the process of requesting and performing analytical
operations, such as the data input devices, menu items, buttons and icons. The ACL
Elite/Elite Pro software tree is also included.

3.1.1 Touch Screen


The basic interaction with the ACL is done through menus that allow access
to sets of related functions (analysis, calibration, QC, set-up, diagnostics,
etc.) and through the use of dialogue or message boxes to input or retrieve
information.

The main information input device for the user is the touch screen. To start
an “enter” or “edit” action, the operator touches the area to be edited. If the
information to be entered is strictly numerical, the editing is done directly on
the keyboard or popup keypad (optional system configuration). If the
information requires alphanumeric characters, the input is done through the
external keyboard.
The editing action may be closed by pressing the "Confirm" √ or the
"Cancel" Χ buttons.
Once confirmation is complete, the system performs an automatic check on
the entered value; if an erroneous entry is detected, the user is notified by
means of dialogue boxes and the editing action is reactivated. The touch
screen supports auto-repeat functions in order to make lists easier to scroll
(e.g. sample lists, test lists, increase/decrease order).

The Main Database screen is divided into 3 main areas:


1. Status area: upper part of the screen which contains:
Instrument status Date and Time
Current user Software revision
IL logo

Instrumentation Laboratory 3.1


Analytical Operations

2. Working area: central area of the screen, which displays windows that
contain data or messages.
3. Toolbar area: bottom part of the screen, which contains a series of
buttons for immediate access to particular functions and easy access to
specific commands. The status of the buttons is dependent on the instrument
status, but independent from the type of information displayed in the working
area.

NOTE: On the touch screen, any disabled object (menu, check-box,


icon, button) is dimmed out and cannot be selected.

3.1.2 Numerical Keypad


The numerical keypad allows the operator to edit numerical data without
using the standard PC keyboard. The numerical keypad can be configured to
automatically display when the user starts an edit action (refer to section
4.1.17). The keypad allows the operator to visualize the edited string while
editing is in progress. The keypad automatically disappears when the
"Confirm” √ or "Cancel" Χ. buttons are selected or the editing action is
implicitly closed.
The keypad displays the name of the field being edited as a window caption,
and information on the accepted range values; it also supports the date
format.
When the numerical keypad is opened, the values shown in the fields are
either the default or the values previously entered. Use the arrow buttons to
select the field to be edited.

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ACL Elite/Elite Pro Operator’s Manual

3.1.3 Standard PC Keyboard


The main function of the PC keyboard is to enter and edit data in the
alphanumeric fields. The keyboard input is case sensitive.
To start the editing action, select the field to be edited. This is done by
moving the cursor from the current object (it may be the default object if the
window was just opened) to the chosen object by pressing [TAB] or [Shift] +
[TAB].
To close the editing action, of the present text box, press [Enter] or select
another active object or move the cursor by pressing the [TAB] or [Shift]
+[TAB] keys. In all cases, closing the editing action causes the system to
activate checks on the entered data and the user is notified of any error
condition by means of a dialogue box. If the editing action has been closed
(touching a different area of the screen), the entered value will be changed to
the pre-existing one.
The editing action, of the present text box, may also be closed by pressing
the [ESC] key without activating any change; in this case the value returns to
the pre-existing one.
Main and secondary menus may be selected using the keyboard. The menus
are opened by pressing [ALT]+underlined Character; selections within the
menus are done using the specific underlined character. Pressing the
[ENTER] key allows access to the secondary menus.
The keyboard function keys (F1 – F10) may also be used to activate the
functions on the bottom row of icons. Use [Ctrl] + F4 for keyboard log off.

Instrumentation Laboratory 3.3


Analytical Operations

3.1.4 External Barcode Reader (optional on ACL Elite)


The USB ports allow for the connection of an external hand held barcode
reader. This device can be used to identify reagents and indicate the
placement of them onboard the system. Please refer to section 4.1.16

3.1.5 Mouse - Port 2


A serial mouse may be used as a pointing device in place of touching the
screen. The USB ports also provide the capability to connect a USB mouse
to the analyzer.

3.1.6 Menus
A menu may be opened by selecting the appropriate area of the screen
(touch or click with the mouse) or using the keyboard: [ALT] + underlined
letter.
The selection of menus to be opened may be done in all directions: up and
down or right and left.
The displayed items, which have a secondary menu, are identified with a
marker (Ø).
Selecting a menu item, touching an external area, or pressing [ESC] from the
standard keyboard closes a menu.

NOTE: In any menu, an inactive item is dimmed out. Selecting an


inactive item does not elicit a response; therefore, this method cannot
be used to exit the menu.

3.1.7 Windows and Boxes


Within the ACL screens, the data, information, or messages for the user are
grouped or contained in defined units of three different types:
• Standard window: usually a larger area which contains sets of related
data which can be edited by the user

• Dialogue box: a small area used to prompt the user to choose one of
several options (i.e. OK, Abort, Retry, Ignore, Cancel, Yes, No)
• Message box: an area used only to provide information

ICONS are often included in a message box. The table below lists all
possible icons with their corresponding meanings.

3.4 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Icon Meaning
ERROR. Calls attention to high priority failures and
fault messages.

WARNING. Delivers different kinds of messages, i.e. to


warn the user of a “not allowed/wrong” operation, or of
problems/errors detected by the instrument during or
after an operation.
QUESTION. Requests confirmation by the user before
starting an operation or before canceling an action

INFORMATION. Offers general information. In some


boxes, but not always, the message is followed by a
request for confirmation.

3.1.8 Key Screen Elements


Below are descriptions of the most significant items found within the ACL
screens.

• Instrument Status
Located in the upper part of the screen within the Status area, this item
identifies the current state of the instrument as one of the following:

INIT (BOOT/START-UP): indicates that the instrument is performing startup


operations (Initializing)

READY: indicates that there have been no errors detected, there are no
analytical operations in progress and the instrument is ready to start

OPERATING: indicates that either an analytical function is in progress (i.e.


calibration or sample analysis) or a diagnostic function is being performed

HOLD: identifies a system "pause" condition during an analytical session (i.e.


STAT request, no rotors, etc.)
FAILURE: indicates that the system detected an internal mechanical
malfunction (devices, temperature control, etc.)

STAND-BY: the status into which the instrument moves automatically after
30 minutes of inactivity. LCD display is switched off (screen saver); this
extends LCD life. An orange LED indicates that the instrument is ON.
Touching the screen or any key on the keyboard will cause the instrument to
exit from standby.

NOTE: when the instrument is in standby operation, every 30 minutes an


automatic priming cycle is performed. The consumption of Wash-R Emulsion
is approximately 0.9 mL (3 strokes per single piston dilutor – total of 6
strokes; each single stroke of 0.15 mL).

Instrumentation Laboratory 3.5


Analytical Operations

SERVICE: the status assumed when the Service functions are in use.
• Check Boxes, Buttons and Icons

Buttons allow the user to select options, cause actions and get from one part
of the software to another. The buttons are positioned in different areas
depending on the screen. Buttons are identified with text that is self -
explanatory of the action. Icons, which illustrates an action, are defined
below.
Check boxes allow the user to “mark” an item.
If a check box or button is in mutual exclusion with another check box or
button, there is a frame wrapping the two, along with “graphic” information.

• ICONS
Icons can be found either in the middle Working Area of the screen or lining
up in the Toolbar Area at the bottom of the screen.
Below are two lists grouping the standard icons used throughout the ACL
Elite/Elite Pro, along with their associated commands. The first one includes
the Window Icons found in the screen’s Working Area, and the second one
includes the Toolbar Icons found in the screen’s Toolbar Area.

NOTES:
1. The same icon may have slightly different meaning depending on the
screen where it is found.
2. One or more of these may be disabled on a specific screen, indicated
by a dimmed representation. Its selection is ignored.
3. “Active” toolbar buttons for each specific screen and their actions
are described at the end of each appropriate section of this Manual.

3.6 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Table - Window Icons


Window Icons Command / Action

Confirm (dimmed if Edit action not


close3d.ico allowed)

Cancel
cancel3d.ico

Print
print.ico

(Host) Transmit

Delete

Add item to the list

Remove an item from the list

Transfer an item from one list to


another

Details

Information in different languages


earth.ico

New Sample

Extract Sample Data


sort.ico

Note

Patient Name

Patient Details

Save information to floppy disk


save.ico

Instrumentation Laboratory 3.7


Analytical Operations

Table - Toolbar icons


T Toolbar Icons C Commands / I Instrument Status
Actions (Icon active)
STAT/Pause O Operating
Pauses the system for Hold
stat or sample entry

R . H
I Instrument Status O Operating
Status of the operation inH Ready
progress. Displays Hold
material map in Ready

Close/Open cover Ready


. Hold

STOP R Ready
Confirmation is required. Operating
stop.ico Hold

Reagent Map
Color changes dependingO Operating
upon the reagent map
status
Q QC R Ready Hold
Press to view the most Operating
recent QC data. Red ! Failure
indicates a QC failure
Database View Ready
Return to the database Operating
dbview.ico view or “Main” screen. Hold

Host Status Ready Hold


Host communication in Operating
host-d.ico process Failure

Warning Ready Hold


This icon indicates Operating
Warnings exist. Press to Failure
open “Warning List”.
Log Out Ready
Allows the operator to Failure
Exit the screen.
A Confirmation is required

Start or Resume Run Ready Hold

3.8 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

3.1.9 A Special Window for Alarms and Errors


If an abnormal situation develops and causes an interruption during the
progress of an operation, the operator is informed through an alarm message
in a specific message box. This message box is displayed in front of all the
other windows present in the working area. After the operator confirms the
message, the information about the alarm can be viewed in this warning
window.
Error conditions that do not affect the in-progress analytical session may be
reviewed accessing the "Session Error History". The operator is able to view
a list of all the warnings and error messages, sorted by time, which pertain to
the last analytical session or to the one in progress. The Session Error
History is saved at the conclusion of each analytical session so the errors can
be checked between analytical sessions.
The "File Error History" window contains a list, sorted by time, of the last 100
alarms or error conditions. The “Session Error History” and “File Error File
History” windows are dynamically updated when opened and must be closed
before starting a new operation.

3.1.10 Screen Saver


A screen blank is activated after 30 minutes of system inactivity, provided the
ACL system is in the READY status. The operator cannot modify this time.
Any action performed on the touch screen, through the keyboard or the bar
code reader will reactivate the system.

3.1.11 The ACL Elite/Elite Pro Software Tree


The next page shows the structure of the ACL Elite/Elite Pro Operator’s
Interface - or system Software Tree - including main menu, first and second-
level sub-menus.

Instrumentation Laboratory 3.9


Analytical Operations

ACL Elite/Elite Pro Software Tree

Menu First-Level Submenu Second-Level Submenu

ANALYSIS Multi Test Session


Single Test Session
Loadlist
Session History

QC QC Review

CALIBRATION Calibrate
Review Calibrations
Analytical Reference

DIAGNOSTIC Priming
Cleaning
Maintenance
Temperature Control
Needles Position
Session Error History
File Error History
Logbook
Service (dimmed)

SET-UP Tests View/Define


Sort Tests
Test Group
Interference Table
Default Tests
Reflex Tests

Multi-Tests Profiles
Test Groups
Test Group Profiles
Sort Multi -Tests
Default Multi-Test
Liquids
Interfaces Host
Printer
Internal Barcode
External Barcode
Keyboard
Network (dimmed)
Modem (dimmed)
System Configuration
Security
Audible Alarms
Date/Time
Units

3.10 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

UTILITY Upgrade IL Library


Back-up/Restore
Archive
Software SW Identification
SW Upgrade (#)
Save Last Rotor Map
Save Trace
Test/Material Backup
Upload
Debug (dimmed)
Testing (dimmed)

(#) SW Upgrade is divided in SW Master, SW Slave and SW REM.

3.2 Sample Analysis


Section 3.2.1 and those that follow it contain detailed descriptions of the screens,
options and steps involved in the sample analysis process on the ACL Elite/Elite Pro.

The ACL provides 2 modes for running samples: Single Test and Multi-Tests. Within
each of these a “session” is considered to be the total of all the individual test “runs”.
For example, you are using the PT-APTT profile and have 20 samples to process.
Each sample contains both tests. The “Session” would therefore be composed of 4
test “Runs”; 2 runs for PT and 2 runs for APTT since the maximum number of
samples per run is 19 for the PT and APTT tests.

The ACL allows a variety of choices to enter the sample ID information into the
system before analysis, depending on the laboratory’s procedures and system setup.
For those users who are already familiar with the ACL Operator Interface, Section
3.2.1 includes summarized sample analysis protocols to be followed depending on
the mode of sample ID entry.

3.2.1 Sample Analysis Procedures - Summarized

Manual Sample ID Entry - Loadlist created before Analysis


1. Select Analysis.
2. Select Loadlist.
3. Select the desired (empty) Loadlist, click the details icon.
4. Click the Enter/Edit Sample ID button.
5. Type the Sample ID, use the ? to move to the next position or Confirm
when all sample IDs have been entered.
6. If Default Tests are desired for the list, do not program tests for individual
samples. Click on the “Set Default Test” button.
7. Click the Program Test button
8. Program Tests/Multi-Tests on the sample by clicking the desired test
selection in the Test matrix. The selection will display in the
Programmed test list. Corrections can be made clicking the test
selection again to deselect if the desired tests/profiles were the same as
the previous sample, click the Prev Prog button. Press the ? to move to
the next loadlist position or Confirm when complete.

Instrumentation Laboratory 3.11


Analytical Operations

9. Click the Confirm button: Date and Time is associated to the Loadlist
Number and the system switches to the Loadlist screen.
10. Click the Confirm button: the system switches to the Main screen. The
inserted samples are displayed in the database.
11. Select Analysis; then chose either: Multi-Tests or Single Test.
12. Click the Loadlist No. box and enter the loadlist number.
13. If tests were not previously ordered on the sample (step 6) or default
tests are not desired, click the Program Sample button. Select the test
to be run and press the ? to move to the next sample on the Loadlist or
Confirm when complete.
14. Verify that the current test selection is the one of choice confirm the
materials map and click the Runner icon.
15. During Analysis the Session Report screen is shown. Test sequence is
indicated. From this screen the Material Map and the Error History are
available.
Manual Sample ID Entry – Loadlist created during Analysis
1. Select Analysis.
2. Select Multi-Tests Session or Single Test.
3. With cursor on the first tray position of the Loadlist, click the Program
Sample button. QC can be added by clicking on the Add QC button.
4. In the Sample Entry screen enter the Sample ID and select the Tests to
be run.
5. Click the “New Sample” icon to enter the next position and enter the
next Sample ID.
6. If tests to be run are the same as before, click the Prev. Prog. button; if
they are different, select a new Test.
7. Repeat steps 6 and 7 until all samples and tests are entered.
8. Click the Confirm button to accept the changes; the system switches to
the Single Test Pre-Analysis screen (if a single test was selected) or to
the Multi-Tests Pre-Analysis screen (if a Multi-Tests was selected).
9. The tray positions will be displayed in dark blue with the letter P
(Pending).
10. Press the Store Loadlist button and enter in a loadlist number.
11. Once the samples are in the sample tray, confirm materials, click the
Runner.

Manual sample ID Entry –Loadlist created from Database menu

1. Click the New Sample icon.


2. Enter the Sample ID.
3. Select the Test to be programmed.
4. Repeat steps 1, 2 and 3 until all samples are entered.
5. After programming the last sample, click the Confirm button. The
system switches back to the Main screen. The inserted samples are
displayed and marked with a P (for Pending); in the “Test Request”
area the tests requested are marked with a ?.
6. Select Analysis.
7. Select Loadlist.
8. Click the Make Loadlist button.
9. Enter the Loadlist Number to start with (1-20), default is 1, and the
Number of samples per Loadlist (1-40), default is 40.
10. Click the Pending button (‘All’ or ‘Test’ selection). You may then select
a certain “Date and Time” range along with a “Sample ID” range.
11. An alternate method is to click on Mark Samples and select the
Sample IDs from the database of samples.

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12. Click the Confirm button. The system switches back to the Loadlist
screen showing the Date and Time when the loadlist was saved.
13. Click the Confirm button. The system switches back to the Main
screen.
14. Select Analysis.
15. Select Multi-Tests Session or Single Test.
16. Click the Loadlist No. box and enter a valid Loadlist number.
17. Once the samples are in the sample tray, confirm materials, press the
Runner.

Sample ID entry by barcodes - no connection to a host computer


1. Select Analysis.
2. Select Multi-Tests Session or Single Test.
3. Place the samples on the sample tray
4. Select Read Bar-codes and the instrument will create the loadlist using
the barcode reader.
5. Click on the Program Sample and select the Test to be run.
6. Click the “>” button to move to the next position sample ID.
7. If tests to be run are the same as before, click the Prev.Prog. button; if
they are different, select a new Test. Repeat step 6 or when complete
click the Confirm button.
8. Confirm Materials Map and press the Runner icon.
9. During Analysis the Session Report screen is shown. Test sequence is
indicated. From this screen the Material Map and the Error History are
available.
Sample ID entry by barcodes - connection to a host computer (Host
Query mode)
1. Select Analysis; select the desired Multi-Tests or Single test.
2. Confirm the reagent map and Click the Runner icon (instrument will
perform the Host Query and proceed to the analysis).
3. During Analysis the Session Report screen is shown. Test sequence is
indicated. From this screen the Material Map and the Error History are
available.

Sample ID entry by barcodes – connection to a host computer (Host


Query mode) – Default Multi-tests

1. Place barcoded samples on sample tray. From the main database


screen click the Runner icon. (Instrument will perform Host Query and
proceed to the analysis).
Note: It is important to ensure the Reagent positions onboard the
analyzer are setup with the correct reagents placed for this option.
Failure to do so may result in tests running with an inappropriate reagent.
Refer to the Profile Setup screen to view the material map for the default
profile.

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Analytical Operations

The ACL Elite/Elite Pro can process up to 40 samples in a single session


(including Reflex tests) programmed with a number of tests while optimizing
cuvette positions within the rotors. As positions on the sample tray become
complete, new samples may be substituted into these positions. This is
accomplished using the Stat/Pause Icon. Reagents and samples (from cups
or original containers) are automatically aspirated and dispensed by the
needle arm. Rotors are loaded and discharged automatically providing a
complete walk-away system for the ACL Elite Pro. The ACL Elite will prompt
the user when a new rotor for analysis is required.

3.2.2 Sample Analysis Modes


The sample analysis process is started from the Main screen by selecting
Analysis on the menu bar. The 2 options given on the Analysis screen for
processing samples are MULTI-TESTS and SINGLE TEST. In addition, the
“Runner” icon on the main database will start a run using the default Multi-
tests setup.

• Multi-Tests: This option allows you to process multiple tests in a


random access fashion on the samples in the tray. The tests groupings
are user defined and configured under the Setup menu. The multi-tests
grouping can be composed of one or more single tests (profile) or one or
more tests groups (test group profile)

• Single Test: This option will configure the system to only process the
single test selected for analysis. If the samples on the tray have multiple
tests programmed on them, only the selected test will be analyzed and
the un-processed tests will remain pending on a sample.

SINGLE TEST ANALYSIS Screen

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MULTI-TESTS ANALYSIS Screen

Notes:
§ The Current Multi-Test drop down menu will list the available
profiles, test groups and test group profiles in the order selected by
the sort multi-tests function
These 2 analysis screens contain multiple windows and associated buttons:

1. Top left area: the Current Multi-Tests or Single Test window displays the
selection to be run in the current analytical session. The selection can be
changed by pressing the (>) button on the right of the window and browsing
though the displayed list; the decision must be confirmed by pressing the
same button again. The main objective of this screen is to activate the
Materials map, since the programming of the map is dependent on the
Current selection displayed.

The ( …) displayed prior to the test groups names have the following
meaning.

… Single Test Group

Multi - Tests session composed of single tests


• • Multi – Tests session composed of Test Groups


• •

The Deselect Tests button (available when in the Multi-Tests Analysis


Screen only) may be clicked to open the Multi-Tests Details window. This

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Analytical Operations

screen allows the operator to deselect running one (or more) of the tests, on
all samples, included in the Multi-Tests.
Clicking the Material List button at the bottom left of the screen opens the list
of materials required for the analysis.
Clicking the Materials Map button opens the Pre-Analysis: Material Status
window as shown below (for details refer to Section 3.2.3).

2. Middle area: the two windows in the middle of the Selected Pre-Analysis
screen (refer to screen on pages 3.14 and 3.15) contain the sample
programming information. The round circle on the left divided into 4
quadrants is used to select a region on the sample tray. The current
selected quadrant is displayed in yellow and highlighted. The window to
the right displays the status of the 10 samples within the selected
quadrant. The color of the circle provides information on the status of the
sample. In addition to the color, the circle may contain a letter or symbol
that provides further details about the sample type. The following table
contains details about the colors and sample type letters.

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Color Status Letter/Symbol Status

Empty

Gray
Available
+ Stat

No tests Programmed

Light Blue
Programmed
P Onboard

Programmed Complete
but will not
be run in this
C
Dark Blue
session

Sample has Not

Lavender
test that
match
N Programmed

current run

Completed in Quality Control


prior or
current
QC
Green
session

Pending, but Empty cup in


will be position
Orange processed in
session

Sample ID (Hourglass)
Warning or
Sample
Error
Yellow processing

Sample Not
? Identified

The circles will be colored and also will contain a symbol. Examples include:

1-2: Programmed Stats


3-4: Programmed Routine
5: Completed Sample
6: Tests Not Programmed
7: Sample Not Identified
8: QC Sample
9: Empty Position
10: 0.5 Cup in Position

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Analytical Operations

Clicking on a position circle will display the information about that sample.

#: Sample tray position


+: Sample Priority – Stat indicated by !
S: Status of Tests (P, C or N)
• P - Pending: One or more tests is missing a result

• C - Complete: All tests programmed on the sample


have been analyzed

• N - No Test: Sample ID has no tests ordered

F: Flags associated with that sample


Samples that are detected as short will be flagged in yellow with L. No
further testing will be performed on this sample position during this
session. If the sample is replenished, the sample must be moved to a
different position on the tray if processing is desired in the current
session.

The small window on the top left Sample Tray Map enables the Read
Bar Code button to be displayed. The Loadlist No. window allows the
operator to either create a new loadlist or select a stored one. To create
a new one enter the Loadlist number (1-20) not currently defined for
samples. Refer to section 3.2.4 for loadlist details. If you modify a
loadlist, press the Store Loadlist button to save the changes.
The operator chooses how to program samples according to the desired
sample ID entry mode (refer to section 3.2.1):
- Manual Entry into the “Analysis” menu
- Manual Entry in the “Loadlist” menu
- Manual Entry in the “Database” menu
- Use of barcoded samples, no connection with Host Computer
- Use of barcoded samples, connected, Host Query mode
• Clicking the Read Bar Codes button activates rotation of the sample
tray. During the rotation the barcode reader and sample cup/tube
position reader identify a cup/tube placed on the tray along with sample
identification by reading the bar codes. If barcoded samples are present
and barcodes are readable, their corresponding Sample IDs are
displayed in the large window. If a cup or tube is identified to be in place
and the system is unable to read the barcode label a warning of “Error in
Sample Identification” is presented to the operator. If this occurs, check
the tube position to ensure the barcode label was properly oriented, then

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click on the Read Bar Code button again. Bar Code read flags:
(No_R) - Sample ID missing, (Dpl) - duplicate Sample ID, (No_C) -
truncated Sample ID, (Inv) - invalid Sample ID. A label ID that cannot be
read by the reader may be entered manually by selecting the Loadlist
position and pressing the Edit Sample ID button. Refer to section 6.5 for
barcode troubleshooting information.
• The Loadlist button will display the status of the 20 Loadlists.

• The Store Loadlist button will save the changes to the current list.
• Clicking on the ADD QC button on the bottom of the screen will open the
QC screen. Scroll down the list and select the desired QC liquid to be
processed in the current cup position. Press the Confirm (v) to accept.

• Clicking the Edit Sample ID button displays a window that allows the
operator to type the sample identification. Up to 16 alpha-numeric digits
can be entered via the standard keyboard or up to 16 numeric digits
using the screen keypad. Use the ? to enter additional IDs in
subsequent positions on the sample tray.

• Once all the ID numbers have been typed, clicking the Confirm button
accepts all the IDs and returns to the Selected Pre-Analysis Screen. To
return to the Pre-Analysis Screen without accepting the changes, click
the Cancel button. The system does not allow the same SampIe ID to
be loaded twice; if this is attempted, a warning appears: Duplicated
Sample ID.
• Clicking the Clear ID button deletes the selected Sample ID, leaving the
space blank to enter another Sample ID. No confirmation is requested.

• Clicking the Program Sample button opens the window that allows you
to program a new sample.

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Analytical Operations

1. Program Sample for NEW SAMPLE

Within this screen the operator types the Sample ID (required field), and
enters the Patient Demographic information (optional) on the top half of the
screen. If the sample is a Stat sample, the Stat icon should be checked.
The Test or the Multi-Tests (shown when in Multi-Tests analysis mode) to
run on the sample is ordered by clicking on the desired selection. If you make
a mistake, the scissors icon can be used to delete the test or Multi-Tests from
this sample or you can uncheck a selection box. Use the New Sample (tubes
in folder) icon to save this request and present a new (blank) order entry
screen for your next sample. If the current sample has the same test or
profile as the previous one, you can use the Prev. Prog. Button. This
sequence is repeated for all new samples.
After programming the last sample, click the Confirm (v) button. The system
switches back to the Single test/Multi-Tests or Test group Pre-analysis
screen.
The samples entered are displayed and marked with a P (Pending).

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2. Details for SAMPLE with Previous tests

Patient demographics: the upper portion of this window displays the patient
demographic information. The displayed fields that are editable fields include:
Patient ID, Patient Name, Department Name or Number (Dept.), Birth Date
and Sex. Note: The sample ID field cannot be changed once it has been
confirmed (v).

Loadlist and Position fields display the current Loadlist and position within
the list for the displayed sample.

Patient Details: clicking this icon allows access to additional fields, such as
the Operator Notes, the Physician’s name and the Entry Date. (see screen
below)

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Analytical Operations

If the sample is a Stat sample, the Stat icon should be checked.


Status: the "status” associated with each sample is displayed in the Sample
Data Screen:
o Trans. T = Transmitted and L = Local (Not Transmitted)
o Sample Status: (No test ordered [N]; Pending for at least
one test [P]; Completed [C]).
The tests programmed on the sample will be displayed in the center portion
of the screen. Pending tests will be indicated with a (?). Results for
completed tests will be displayed. Press the Detail Icon to view detailed
information about the test (i.e. clot curve). To delete a test that is either
pending or completed on a sample, move the cursor to the test and press the
Trash (Delete) Icon.
Additional or repeat Tests to be run on the sample are ordered by clicking
the Program Test button. Use the New Sample (tubes in folder) icon to
save this request and present a new (blank) order entry screen for your next
sample. This screen would be the one displayed in option 1 above.
To move to the next sample ID in the list use the (? ? ) to move down or up
in the list. Samples can be printed by pressing the Printer icon.
After programming the last sample, click the Confirm (v) button. The system
switches back to the Single test/Multi-Tests or Test group Pre-analysis
screen.
The samples entered are displayed and marked with a P (Pending).

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3.2.3 Materials Map

Pressing the Materials Map Button will display the Liquids necessary to do
the testing for this session.

The Materials map displays in a graphical format the liquid positions on the
analyzer. The Map shown above applies to the ACL Elite Pro. The ACL Elite
does not have positions (R9-R12), which are shown.

This screen displays the status of the reagents currently on-board the
system, along with other information. The color of the position circles can be:
Green: Volume of liquid in position is greater than warning limit

Orange: Volume of liquid in position is less than warning limit or either


onboard or lot number stability has expired.
Red: Analyzer detected a reagent shortage in this position.

Note: When you start a run, the materials map is not checked for
volume status. The analyzer will proceed with the testing regardless of
the color of the reagent position. The colors are only alerts to the user.
The operator is able to assess the situation of the ten Sample Tray positions
and the Reagent Tray positions. Clicking on one of the colored liquid
positions will display details about that liquid. This information includes:

• Liquid ID: The Name of the liquid assigned to this position


• Lot Number: Current lot number entered for the liquid in this position
• Liquid Level: The remaining volume of liquid in this position. This level
is retained from the last session for which this liquid was used. The
system tracks the level by counting down the volume during the testing.

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Analytical Operations

The operator must enter the initial “start” volume. This is generally done
when a new bottle is placed on board or by the optional barcode reader.
• Expiration Date: The lot number expiration date for this liquid. If this
liquid is used beyond the expiration date, the operator will be alerted with
a warning in the Session Error History list. The Expiration date is
predefined in the Liquids screen.
• On Board Stability: The remaining time left for this liquid on board the
analyzer. The system tracks the time the bottle is on board the analyzer.
The operator must start the clock using the “Start Timer” button when a
new bottle is placed on the analyzer. The “Start Timer All” button will
start the clock for all of the liquids displayed on the current materials
map. If a bottle is removed from the analyzer, the timer countdown may
be paused by pressing the “Pause Timer” button. When the bottle is
returned back to the analyzer the clock may be resumed by pressing the
“Pause Timer” button. If this liquid is used beyond the on board stability
time, the operator will be alerted with the warning “Material on board
stability expired in position XX” in the Session Error History list. The On
Board Stability time is predefined in the Liquids screen. Expired stability
will be displayed in orange on the Materials Map.

Note: The use of the Liquid Level, Expiration Date and On Board
Stability tracking is optional. The operator can track these items offline
and does not have to use the features on board.
Three operations can be carried out on the Liquid Level settings:

§ Set Volume will allow the volume update of the specific reagent position
to a customized value (using the keyboard or the keypad on the screen)

§ Reset single will update the volume of the selected reagent position to
its default value (predefined in the Liquids screen).

§ Reset All will update all volumes of all reagent positions displayed on
the current map to the default values (predefined in the Liquids screen).
When the screen is activated, the system also checks and displays
information about the status of the rotor station, status of the waste, number
of available cuvettes in the rotor and the current volume of the Wash-
Reference Emulsion. To start the session with an unused rotor, the operator
must check the Start with a New Rotor box.
Press the Confirm (v) to Accept the changes and return to the Pre-Analytical
screen. Pressing the Cancel (X) will discard any changes you made. Press
the Runner icon and the run will begin.

Liquid Details: This button will display the liquid setup screen for the current
liquid position selected. Refer to section 4.1.13 for further details
The optional External Barcode Reader can be used to identify reagent
placement and validate the lot number and expiration date. When the
material map is displayed, read the vial label using the reader. The lot
number information and expiration is checked and the position to place the

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reagent onboard the analyzer will blink. Place the vial in the designated
location. If the lot number or expiration dates are invalid the system will
display a warning box on the screen. You can configure the external
barcode reader to automatically reset the default volume and onboard
stability for the vial when a label is read.
If the “Pause Timer” is checked for a reagent vial, when this vial is read with
the external barcode reader the “Pause Timer” will become unchecked. If the
vial is then read a second time at this point the volume and timer will be reset
if these options are enabled under the external barcode setup.
Refer to section 4.1.16 for information on enabling the external barcode
reader.

3.2.4 Analysis: Loadlist


The Loadlist screen below can be accessed selecting Analysis from the
Main screen menu bar, and then the Loadlist option from the Analysis menu.

This screen gives the operator access to the information on the stored
loadlists, by being either blank or defined. Each of the defined stored loadlists
(20 maximum) is identified with a number, status and date/time.
Several options are available:
• Clear Single clears current highlighted single Loadlist. Clearing a
Loadlist has no impact on the samples in the database. The samples
that were on the loadlist can still be viewed and printed after a Loadlist is
cleared.

Instrumentation Laboratory 3.25


Analytical Operations

• Clear All clears all defined Loadlists.


• Make Loadlist opens the loadlist creation screen.
• Clicking the Clear Single button in the Loadlist screen, displays a
confirmation window: Do you really want to clear the selected loadlist?
OK clears the single selected loadlist; Cancel will cancel the operation.
• Clicking the Clear All button on the bottom right of the screen, displays a
confirmation window Do you really want to clear all loadlists? OK clears
all of the stored loadlists; Cancel will cancel the operation.
• Clicking the Make Loadlist button opens the Make Loadlist screen (see
details below).

Loadlist can be created 4 ways:


1. Time Interval (Date/Time sample was entered into database)
2. Sample ID range
3. Marking or selecting Individual samples
4. Automatic List creation using a predefined Sample ID Prefix or Suffix
Once one of the four list criteria is chosen you then select which tests to
include on the loadlist. Clicking the Pending (all) button will search the
database for all pending tests for the group of samples chosen. Clicking the
Pending (test selection) button will allow you to scroll down the displayed
test list and select the desired tests by pressing Select. If you make a
mistake you can remove a test by clicking on the Deselect button. The
notation in the Select column will then be removed.

Loadlist Creation Process


The first item to define at the top of the screen is the Loadlist Number to
Start with. You must enter in a value between 1-20 in this field. To the right

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of this field is the entry location for the Number of Samples per loadlist.
Enter in a value between 1-40.
You then select one of the 4 ways listed above to use for creating the loadlist.
1. Time Interval – Clicking All Time Interval will create the loadlist without
respect to the time that the samples were entered into the database. If
you click on From To you must enter in a Start Date/Time and End
Date/Time.
2. Sample ID Range – Clicking All Samples will select all samples with no
respect to the Sample ID attached to it. If you click on From/To you must
enter in a Starting Sample ID and Ending Sample ID to include in the
loadlist. Only samples within this range will be placed on the loadlist.
3. If you click the Mark Samples button the following screen will appear

This screen will display all the samples along with their current status in the
database. You can scroll down the list and press Select to mark the current
individual sample. If you make a mistake, press the Deselect Single to
remove the notation in the mark column. Pressing Deselect All will remove
the notation in the mark column for all samples. When you are finished press
the Confirm (v) or Cancel (X) to return to the previous screen.
4. Click the Autolist button to display the automatic loadlist creation screen.
This screen will allow you to create one or more loadlists. You can
create the sample IDs for the loadlist using a prefix or suffix.

Instrumentation Laboratory 3.27


Analytical Operations

On this screen you must enter in the number of loadlist you want to prepare.
You can create up to 20 loadlists; each loadlist will contain up to 40 samples.
In the Fixed String field, enter in a character string to attach to each sample
ID. If you want to use the fixed string as a prefix, click on the Use as a prefix
button. If you do not click on this field, then the fixed string will be appended
as a suffix to the ID.
The Variable string field will determine the maximum number of sample IDs
to create. If you select a variable string of 2, the maximum number of
samples will be 99, if you select 3 the maximum number will be 999. The
starting number field will vary in length depending upon the variable string
field entry. The number you enter into the Starting Number field will be used
for the first sample. The remaining sample IDs will then index by one after
this value.

When you are finished press the Confirm (v) or Cancel (X) to return to the
previous screen.

Note: On this screen you determine the number of loadlist to prepare.


On the previous screen you entered in the loadlist number to start with
along with the number of sample IDs each loadlist will contain.

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Once the Loadlist/Autoloadlist is created you then program tests for the
sample IDs on the list. Select the Loadlist and then press the Detail Icon.

The sample IDs on this loadlist will be displayed in the left hand column. You
can change the Sample IDs on the list by selecting a particular sample and
pressing Edit Sample ID. If you need to delete samples from the list you can
use the Delete Sample ID or Delete All Sample ID buttons.
To program or change the requested tests, select either a particular sample
ID or the first one on the list.
To program tests for the selected sample, Press the Program Sample
button.

Instrumentation Laboratory 3.29


Analytical Operations

Click on the Prev. Prog to All button to program the previous tests request to
ALL samples on the loadlist. If you press the Prev. Prog button the previous
tests will just be ordered on the current highlighted sample only.
Click on the Set Default tests button to program the Default tests to all
samples on the loadlist.
Highlight a sample and click on the Detail button to view the current sample.
This will display the demographics along with the tests ordered and any
completed results for the sample.
To print a loadlist, click on the Printer Icon.
• Confirm or Cancel exits the screen; the system goes back to the
previous screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.2.5 Analysis: Session Report


This screen is automatically displayed during a run.

This screen displays information about the status of the tests and samples for
the analytical runs performed on the system.
The top line displays the current test being analyzed and the current phase
for the test (i.e. loading, waiting, acquisition…)

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The middle of the screen displays the 4 sample ring quadrants on the left and
the 10 sample cups included within the quadrant. Please refer to section
3.2.2 for details on the color codes and symbols used for the sample
positions.
The details (results) of a sample can be displayed by selecting the sample
ring quadrant on the left then selecting the desired cup position and clicking
the Details button. If a sample is complete the results will be displayed.
The Materials Map button will display the current reagent map for the
session. Please refer to section 3.2.3 for details on the Materials Map.
The Session Status button will display the Analysis Session report screen
for all samples in the current session.

The Test Execution Status box displays information on the tests in the
session. It displays the tests that may be analyzed in this session along with
the number of samples programmed, number of reflex tests to be processed,
and the number of samples completed. Test groups are considered to be
individual tests and display that way in the box.
The Sample Status for the Session box on the right displays the samples to
be processed in this session. This box is divided into 5 columns:
• # Column: position on sample tray
• +: an ! in this column indicates the sample is designated a stat
sample.
• Status: Displays the current status of this sample. The status
can be indicated by the following symbols
- Hourglass symbol: Sample is in process
- Clock symbol: Sample is in a waiting status

- Check Mark (v): Sample is finished being processed

Instrumentation Laboratory 3.31


Analytical Operations

• Short: This column will display a “low” indicator when a sample


has been detected to be short. A sample found to be low would
stop all further testing on that sample.
• The sample ID column displays the sample IDs on the loadlist.
The Materials Map button will display the current reagent map for the
session.
Note: The bottom row of Icons on the main screen contains one of a reagent
bottle. The color of the bottle indicates the status of the reagents in the map.
If all the reagents have levels above the warning volume the icon will be
displayed in green. While testing is in process if a reagent becomes low the
bottle icon will turn orange. If a reagent runs out during analysis the bottle
icon turns red. Pressing the bottle icon will display the current reagent map.

When a reagent runs short during analysis the system will continue
processing all other tests. When testing is complete the system will display a
message box with the following:

One or more reagents are insufficient to complete all samples. Do you want
to Refill?
Press Yes to refill and then restart.
Press No to close the session.
If the Yes option is selected the operator should replenish the reagents that
are short and press the runner icon to restart the run.

If “No” is selected the system will end the current analytical session. The
run can be restarted later by selecting Analysis à Session History

The Restart this Session button will start the analysis again to process
those samples with a status of “Pending”. This can be useful if a reagent
runs short during analysis.

The Session History Button will normally be dimmed out during analysis. If
an error condition occurs during the analysis the button will illuminate. The
operator should make note of the button status. When the button illuminates,
the operator should press the button to display the Session History List.

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The list will display the Date and Time along with the Error that occurred.
The Printing option will print the Session Error History Report followed by a
confirmation window Do you really want to print? Yes allows the operator to
print the Session Error History Report; No will cancel the operation.
Press the Confirm (v) button to return to the previous screen.

If the session has completed, you can return back to the Session History
screen by selecting Analysis from the Main screen menu bar and Session
History from the Analysis menu. This opens the Analysis: Session Report
screen.

• ACTIVE BUTTONS on the bottom of this screen are :

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.2.6 Session Pause Conditions


The following conditions will place the ACL Elite/Elite Pro into a pause status
during analysis. If this occurs, the condition noted should be corrected. The
run can then be resumed by pressing the runner icon

ROTOR WASTE FULL (Elite Pro Only)


When the rotor waste is full the instrument will beep and automatically pause.

Instrumentation Laboratory 3.33


Analytical Operations

To proceed the operator has to empty the rotor waste container and press
the “runner” icon.
ROTOR STACK EMPTY (Elite Pro Only)
When the rotor stack is empty, the instrument will beep and automatically
pause.
To proceed the operator has to refill the rotor stack and press the “runner”
icon.
REAGENT SHORT
A reagent shortage detected during analysis will place the system in the Hold
condition at the end of the session. At this time the operator has the option to
refill the reagents and resume the session.

3.2.7 Analysis: Pause / STAT Functions


During a run the session status is presented showing the number of tests
executed and which test phase is in progress.

It is possible to pause the system during an analytical session using the


Stat/Pause “Ambulance” icon on the bottom left side of the screen.
When this icon is activated a message saying, “Do you really want to hold the
session” will be presented.
Pressing “NO” the session will proceed.
Pressing “YES” the session will pause at an appropriate time in the current
session. You will be notified when it is safe to proceed.
Stat samples cannot be executed during Automatic Host Transmission.
During the Hold state, you can perform the following on the system:

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• Add Samples, both STAT and Routine

• Change Priority of a Sample from Routine to Stat


• Add Tests to a sample on the sample tray
• Add QC samples to the session

• Access the Materials Map to Refill reagents


• Substitute Samples on the sample tray. Completed samples
indicated by a green cup position circle (also noted by a C in “S”
column) can be removed and replaced with a new sample.

The “Add Samples/Stats” screen displays the status of the samples on the
tray.

The Status of the samples is displayed using colors and letters/symbols for
the cup positions (refer to section 3.2.2 for details on the colors and
symbols). The sample tray is divided into 4 quadrants of 10 sample positions
each. To change to a different quadrant simply click on the desired segment
in the circle on the left.
Barcode stat samples

Read Barcodes: This button will activate the sample bar code reader and
read the sample IDs on the tray. It will then display the samples IDs. No
host query is performed during this action. Non-barcoded sample IDs (except
QC cups) will be deleted from the list for samples that are currently not active
on the rotor being analyzed. If you are not bi-directionally interfaced, after
reading the barcodes click on the desired sample position to display the
sample-programming screen. Enter the optional demographic information.
To designate the sample as a stat, click the Stat icon. Select the tests by
clicking on the desired test box. To remove a test from the programmed tests

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list click on the test name a second time. Use the down arrow to proceed to
the next sample position. When complete press the Confirm button.
Restart with BCR: This button can be selected if you are using host query
and barcoded samples. Click this button then press the resume icon. The
system will read the sample IDs and query the host for the tests to process.
This option is not recommended to be used when a mix of barcoded and
non-barcoded samples are present on the sample tray.

Non-Barcoded stat samples


Programming Non-Barcoded Samples: Click on the desired sample
position to display the sample-programming screen.

To program your samples enter the Sample ID along with any of the other
optional demographic information. To designate the sample as a stat, click
the Stat icon. Select the tests by clicking on the desired test box. To remove
a test from the programmed tests list click on the test name a second time. If
you have additional samples to program click on the New Sample icon. If
you are finished programming samples click on the Confirm button. Press
the Runner run icon to start the analysis.
Enter/Edit Sample ID: This button allows you to manually enter an ID or edit
one that is displayed. Positions that cannot be edited will dim the button.
Clear ID: This button will clear an ID from a position on the sample tray. The
position can then be used to program a new sample onto the tray. This button
will be dimmed if the sample tray does not have positions in which the
sample is complete. Completed samples will be designated as a green cup
position circle with the letter C. Samples with pending tests to be completed
will be designated as an orange cup position circle with the letter P.
Positions that cannot have the ID cleared will dim the button.

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Program Sample: Opens the tests order screen. Refer to information in


section 3.2.2 for details on this function.
Add QC Liquids: Displays the QC liquid list. Select the desired liquid and
click on the Confirm button to accept. The QC liquid will then be added to
the samples on the tray. Note: Do not click on the Restart with BCR button
when QC is added to a list. Press the Runner icon only to start the run.

Once the Stats/New Samples have been programmed and added to the
sample tray, the run is restarted using the Runner icon.
Notes:
• When the stat/pause icon is pressed, the system will display a
message indicating when it is safe to add/remove samples from the
tray. Please wait for this message to appear. This is an indication
that the sample arm will not move toward the sample tray.
• If a test is added but not contained in the Multi-Tests or Single Test
presently running the test will only be programmed.

• Default tests will be added to a sample when the next test in the run
is started. Prior to this the circle will be displayed in light blue with
the status of N. After the next test in the run is started the default
tests will be added to the samples and circle will become purple
when processing occurs.

• If a test is contained in the Multi-Tests or Single Test presently


running the test will either interrupt the current session or be
executed in a session after the current one. The current session will
be interrupted if the samples have not been pipetted. If the stat
interrupt occurs during a session whereby the reagent only is being
pipetted, the system will abort the run to process the stat. If you do
not want to abort the current run, wait until the unit begins pipetting
sample before requesting the stat interrupt.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

- Confirm exits the screen; the system goes back to the previous screen.

3.2.8 Results list


The main screen of the ACL Elite/Elite Pro is the database or results list. Up
to 1000 sample IDs can be contained in the sample database. The database
is handled in a first in first out (fifo) manner for completed samples. When the

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database reaches 1000 samples, the oldest samples with a status of


“Complete” will be permanently deleted. Each sample ID can reference up
to 30 tests. Tests processed in duplicate occupy a minimum of 3 test
positions (first result, second result and mean).

The “Database View” at the top of the screen indicates whether you are
viewing “All Samples” or a “Subset” of the samples. A subset of the
samples in the database is obtained by Extracting results. If you are viewing
a subset of the results and you wish to view all, you must extract again and
select the “All Samples” option.
The numeric values on the right of the screen (i.e. 147/540) indicate how
many samples are currently displayed in the database. If you extract, the first
value indicates how many samples were extracted and the second value
indicates the total number of samples in the entire database. When you are
viewing “All Samples” the two values will be identical.
The results list has several columns:

- + indicates if the sample was run with a (STAT) priority attribute


- S Column indicates the status of the sample ID
• N means no tests are programmed on that sample ID
• P means one or more tests are missing a result
• C means that all tests have been run on the sample and it is
considered complete
- E Column indicates errors are present on at least one test for the
sample ID (refer to section 6.3 for further details)
- Sample ID column (max 16 characters). Each of the 1000 samples in
the database must have a unique Sample ID. Duplicate IDs are not

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allowed. If you need to re-use a sample ID, you must delete the original
one first. Highlight ID and click the “trash can” icon to delete.
- Patient Name column (max 25 characters). Using the “Identity Card”
icon this column can be hidden. This will allow more tests to be
displayed across the database screen.
- Test and Unit columns are defined (customized) in the sort test
submenu in the Test Set-up. Please refer to the Test Setup Section
(chapter 4). If a test has a ? in a column, then the result is pending for
the sample. As the test is completed, the ? will be replaced with the
result. If the result is displayed along with a “Snowflake” symbol, then
there is more than one result available for that particular test. Tests with
errors will be noted instead of a result on the screen. Highlight the
sample and press the “detail” icon to view all the results
A result presented in “black” color means it is within the normal range.
A result presented in “violet” color means it is outside the normal range.
A result presented in “red” color means it is outside the test range.

A result presented as “***” means it is outside the scale range high.


A result presented as “---” means it is outside the scale range low.
The Instrument status line also displays the current User logged into the
system and the current revision of the software on the analyzer.
Several functions are available from the test results list:
Extract Results Detail Sample Icon

New Sample Delete Samples

Print Samples Transmit to Host

3.2.8.1 Extract Icon

• Using the Extract icon (Hand in File Drawer) it is possible to filter the
database for desired samples based on several criteria. See screen
below

- Single Sample ID
- Sample ID From … To … (Use the Same number of Characters
when defining the From/To range that you normally have for the
Sample ID)
- Patient ID

- Patient Name

- Loadlist Number

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- All samples

- Entry Date From … To …


- Department

It is possible to combine the above Sample ID criteria with the result criteria
checkbox selections on the lower part of the screen.
- Completed / Pending

- Stat / Non Stat


- Transmitted / Not Transmitted
- Flagged / Not Flagged

Note: If you extract into a subset of the database, you must re-extract using
the “All Samples” checkbox to return the database to display all samples.
New samples entered into the database while you are in a subset may not be
shown on the database.

3.2.8.2 Sample Detail Icon


• Using the Details function (magnifying glass) additional information on
the Sample and Tests can be displayed. This information would include
Demographic data, Results, Errors and Reaction curves.

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From the Sample Data screen the patient detail icon displays additional
demographic information.

From the Sample Data screen it is possible to view the reaction curve.
Highlight the desired test and press the detail icon to view the curve.

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Warnings associated with the test results are displayed in the warning
list. Please review these and take appropriate action if necessary before
reporting the results.
The “Floppy Disk” icon allows you to save the “normalized data
readings” for the curve. The data can then be viewed using another
software program (i.e. Microsoft Excel). The curve as it is presented can
be printed using the print icon. Warnings associated with the results are
displayed in the warning list.

The Clot/Reaction Curve displays the normalized data points recorded


during the acquisition phase. The “Y” axis displays the total reaction
change divided into 5 points. The reaction change is rounded to 2
decimal places; therefore samples with a small amount of change may
display duplicate points within the 5 that are displayed. Curves for
clotting assays typically will be presented in a “S” pattern. The curve is
generally composed of 4 sections: Baseline, Acceleration, Deceleration
and Endpoint.

Endpoint

Deceleration

Optical
Readings Delta

Acceleration
Baseline

Acquisition Time

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The Baseline readings start after any acquisition delay settings in the
test definition. During the baseline the sample and reagents are
mixing and this continues until the clot has begun to form. In the
acceleration phase the clot continues to form resulting in an increase
in the optical readings. The deceleration phase is the time when the
clot formation begins to slow down. For a clotting based assay, once
all the fibrinogen has been converted to fibrin the endpoint has been
reached and the reading stablizes
Various algorithms are used by the system to select the actual
clotting time. Some examples of these include:
- First Derivative: time at which the maximum speed of clot
formation is noted.

- Second Derivative: time at which the maximum change in


speed (maximum acceleration) of clot formation is noted.

- Threshold: time when a pre-set optical density value is reached.

- Threshold- 2nd Derivative: If the threshold reading is not met,


then the system will use the 2 nd Derivative value.
When viewing clot curves some items you should make note of
include:

- Shape of the curve (Flat curves may indicate no clotting)

- Long baselines indicate a prolonged clotting time

- Range of the “Y” axis. A tight range may indicate no clotting or


a low fibrinogen value. Compare the questionable sample’s “Y”
axis with one from a normal sample. A wide range on the “Y”
axis may indicate a high fibrinogen value.

- Continual rise in the Acceleration phase with no endpoint


indicates the sample did not clot within the acquisition time.

- A drop in the endpoint may indicate an unstable clot formation

3.2.8.3 New Sample Icon (Tubes in Folder)


• Using the New Sample Icon it is possible to add a new sample to the
database and manually program tests on it. Please refer to page 3.20 for
details.

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3.2.8.4 Delete Icon (Trash Can )


• Using the Delete Icon it is possible to delete results using the following
criteria.

- Single Sample ID

- Sample ID From … To …(Use the Same number of Characters


when defining the From/To range that you normally have for the
Sample ID)

- Patient ID

- Patient Name

- Loadlist Number
- All samples

- Entry Date From … To …


- Department
It is possible to combine the above Sample ID criteria with the test criteria
checkbox selections on the lower part of the screen.
- Completed / Pending
- Stat / Non Stat

- Transmitted / Not Transmitted


- Flagged / Not Flagged

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3.2.8.5 Printing results


Using the Print Icon it is possible to Print results (two types of reports can be
generated: Cumulative and Sample Reports) using the following criteria.

- Single Sample ID

- Sample ID From … To ……(Use the Same number of Characters


when defining the From/To range that you normally have for the
Sample ID)

- Patient ID

- Loadlist Number

- All samples
- Patient Name
- Entry Date From … To …

- Department

It is possible to combine the above Sample ID criteria with the test checkbox
selections in the lower part of the screen.
- Completed / Pending
- Stat / Non Stat

- Transmitted / Not Transmitted


- Flagged / Not Flagged

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3.2.8.6 Sending results to Host Computer


Using the Host Icon it is possible to download test requests or transmit
results using the following criteria.

- Single Sample ID

- Sample ID From … To ……(Use the Same number of Characters


when defining the From/To range that you normally have for the
Sample ID)

- Patient ID

- Loadlist Number (1 through 20)

- All samples
- Patient Name

- Entry Date From … To …

- Department
It is possible to combine the above Sample ID criteria with the test checkbox
selections on the lower part of the screen.

- Completed / Pending
- Stat / Non Stat
- Transmitted / Not Transmitted

- Flagged / Not Flagged

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Note: If the liquid and/or Wash-R sensors are disabled, the system will not
automatically transmit the results to the host. At the end of each run, a
warning message will appear, instructing the operator to check the material
and sample levels to ensure there is sufficient residual volume in the
containers. Once the check is performed then the results can be manually
transmitted to the host. When the sensors are re-enabled, the auto
transmission will resume.

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3.3 Quality Control


This Section contains all the information needed to perform analysis of quality control
materials and satisfy your laboratory’s quality control program requirements on the
ACL Elite/Elite Pro System. The first subsection presents a summarized procedure
for those users already familiar with the ACL Elite/Elite Pro system. Specific details
about the screens, options, etc. are described later in the step-by-step procedures.

• The QC Materials must be pre-defined in the Liquid Setup screen; refer


to the pertinent information in Section 4 – Setup.
• The QC Material target values must be pre-defined in the QC Setup
screen; refer to the pertinent information in Section 4 – Setup.
• The QC Materials may be run with patient samples during normal routine
testing or alone as a separate run. In the first case, refer to the
“Analysis” section 3.2.1; in the second case, follow the steps below.

3.3.1 Analyzing QC materials using a loadlist


This procedure will describe how to run QC on a loadlist without patient samples.
The loadlist can be saved and recalled each time that you need to run QC. Several
different loadlists can be configured on the system. Each loadlist could contain
different QC materials

• Select Analysis.

• Select Multi-Tests or Single Test.

• Click on the Loadlist No. box. Enter a loadlist number (1-20). If you do
not know which loadlists are available, click on the “Loadlist” button to
display the status of the 20 loadlists.

• Position the cursor on the desired cup position on the sample tray. Click
the Add QC Liquid button.
• Choose the control and click the Confirm (v) button.

• Repeat the last two actions until all materials have been entered.
• Click on the Store Loadlist button to save the loadlist.
• Place the QC sample cups on the sample tray in the respective
positions. Press the Runner icon to begin the analysis.
Note: At the completion of the run, the completed loadlist will still be stored
in memory. If you do not delete it you can recall it the next time you need to
run QC. In this case you would not need to reprogram the sample tray
positions.

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3.3.2 Quality Control Setup


The quality control process is started from the Main screen by selecting QC
on the menu bar, and selecting QC Setup/Review. This will open the QC
Review screen shown.

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Under the heading LIQUID ID, the window on the left side of this screen lists
all control materials that are configured in the Setup Liquids menu, while the
Configured Test window in the middle of the screen lists the tests that are
associated with each material.
The QC statistics are reported on the right side of the screen:
- Unit
- Actual Mean
- Target Mean
- Actual SD
- Target SD
- Actual CV
- Results in Statistics
- Results in Database (DB)
Clicking on the Show Enabled button will reduce the list of Liquids and
display just the Liquids that have been setup for QC analysis on the system.
This is a toggle type button. With the button not clicked you will always
display all liquids. With the button clicked you will display only the liquids
previously setup.
Clicking the Confirm (v) button exits the screen and the system goes back to
the Main screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

The QC configuration must be entered into the QC Setup screen shown


below. Select the QC liquid in the left box then press the Setup button under
the middle window.

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The top of the screen displays the selected QC material (Liquid ID) and
specific information about it such as Expiration Date, Lot Number, plus a
space for Notes.
The next step is to associate tests to the selected QC Liquid.
To do this, the operator highlights a test from the Enabled Tests list shown on
the left window then clicks on the Arrow icon under the window. This action
causes the selected test to move from the Enabled Tests list to the
Configured Tests list shown in the middle window. By repeating this
sequence, the control material is associated with up to 15 tests.

To remove a test from the Configured Tests list, click the Scissors icon
under the window. This action opens first a confirmation window: Removing
test removes all tests data…Do you really want to remove the selected test?
The Yes or No selection reminds the operator that removing a test means
removing all the results saved for that test.
Once the QC Liquid/Tests association is complete, the next step is to define
the units, target mean, target SD and the SD Range for all tests associated to
the QC material.
Unit: for each test, the selection of units includes only the ones that are
legitimate for that test. Modifying a previously selected unit will not cause a
change in Target Mean and SD values. These would need to be updated if
the unit type is changed.

Target Mean and Target SD: these fields accept any value, which is entered
by touching the field and using the external keyboard or the keypad on the
screen.

SD Range: choose 1, 2 or 3 SD. The typical SD ranges for IL reagents and


controls levels are reported in section 3.3.8. Labs may use these values as
guidelines, but they should establish their own SD.

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If the QC Range Check box is activated, the control will be checked and will
be flagged if found to be outside the defined range. Patient results will not be
flagged if only this box is checked.
The Flag Patient Results check box can be activated only after the
activation of the QC Range Check box. If this box is checked and QC is out
of range, then a flag will be noted on the patient samples processed on the
same run as the QC samples. Samples processed on subsequent runs that
do not have QC samples will not be flagged.
The QC Range Check and Flag Patient Results check boxes can be
activated by simple touch, causing a check sign to appear.
The Clear Statistics button deletes, after confirmation, all the results of a
particular Test – QC Material combination.
Warning: Changing the Lot number for a QC liquid under the Liquid
Setup menu will delete all previous QC results for that liquid.
Clicking the Printer icon, followed by a confirmation request Do you really
want to print? Yes allows the operator to print the test Setup; No will cancel
the operation.
Clicking the Confirm button allows the operator to leave this screen and the
system goes back to the QC Review screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View display the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.
When there is an active association between a QC material and tests, the
Plot and Statistics, Cumulative Results and Host icons are active.

3.3.3 QC Result Review


The Main Database screen has a QC Icon on the bottom row. This icon will
display a separate database of the last 100 QC results processed on the
system. A red exclamation point will be displayed across the icon if there is a
QC failure on the system. Results outside 2SD will display in blue, while
those outside 3SD will display in Red. Results within their range will be
displayed in black. The exclamation point will remain on the icon until the QC
failure is cleared from the list. If all QC liquids and tests have no QC outliers
the exclamation point will not be displayed.

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The database displays the following for the QC results: test, QC material,
result, unit for result, and any errors. The number of Results in the database
is displayed in the “Results” box on the top right. The Clear All and Clear
Single buttons will remove the results from the QC database, however they
will still be displayed under the QC Plot and Cumulative result options. The
results on the database can be printed using the Print All QC
o r Print Today QC.

3.3.4 QC - PLOT and STATISTICS


In order to open the QC Plot and Statistics window (shown below), press the
Plot and Statistics button located in the QC Review screen.
This screen displays both the Plot and the Statistics of a selected QC
Material and test pair, displayed at the top of the screen.
The window in the left side of the screen displays the following information,
which is not editable from this screen:
- Start Date
- End Date
- Unit
- Actual Mean
- Target Mean
- Actual SD
- Target SD
- Actual CV
- Results in Statistics
- Results in Database (DB)

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The QC plot for a test can be viewed in the window on the right side of the
screen. The chart indicates Days on the X-axis, the unit and target mean on
the left y-axis, and the SD on the right y-axis.
The display covers an interval of 30 days; the default window displays the
results for the last 30-day interval, but the operator may view earlier data and
move about using the scroll bar. The last 500 QC values per liquid and test
can be displayed on the plot. The system will retain the last 65,536 values
for statistical calculations.
QC values will be displayed as follows on the graph:
• Omitted values appear as a blue diamond symbol

• QC values out of SD range (1 or 2 SD) appear as a violet circle


• QC values out of 3 SD range appear as a red triangle
• Valid QC values appear as an asterisk

The statistical calculation is done using all results in database. To obtain the
Statistics and Plot for other selected intervals of time, click the Select
Interval button and enter the specific start and end date (dd.mm.yyyy or
according to the date format selected in the Date/Time configuration) in the
specific fields of the Select Interval screen:

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The new interval must be confirmed by clicking the Confirm button, which
results in the system going back to the QC Plot and Statistics screen, or not
confirmed by clicking the Cancel button (this applies only to the selected
interval). The statistical results will be updated based upon the selected
interval.
Clicking the Printer icon, followed by a confirmation window Do you really
want to print? Yes allows the operator to print the plot; No will cancel the
operation.
Clicking the Cumulative Results button opens the QC Cumulative Results
screen (refer to subsection below).
Clicking the Confirm button exits this screen and goes back to the QC
Review screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.

- Shutdown followed by a confirmation window Do you really want to


shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.3.5 QC - CUMULATIVE RESULTS


Clicking the Cumulative Results button located in both the QC Plot and
Statistics and the QC Review screens opens the QC Cumulative Results
screen:

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The top portion of the screen displays the following: the selected QC material
(Liquid ID), the selected test (test ID), the date range (dd.mm.yyyy) and the
time range (hh.mm). This information cannot be edited on this screen.

The larger part of the screen is used to display the results obtained for the
selected pair QC material-test.
“F” column flag – A Q will appear in this field if there is a QC alert.

“S” column indicates the transmission status (L is local, T is transmitted).


“O” column means omitted, designated by a check mark in this column .
Results are displayed using a list that can be scrolled vertically; the columns
show the numeric results in the configured unit and the date/time of the
analysis. Values out of programmed SD range (1 or 2 SD) will be displayed
in violet and those values out of 3 SD will be displayed in red.
There is also a column for notes, and columns for possible flags and
warnings.
Further details about a single result, are accessible by clicking the Details
icon, which opens the QC Single Result Details screen:

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On this screen, the identity of the Liquid ID/Test ID pair is displayed on the
first line of the screen.
The windows in the left side of the screen display the QC sample curve, the
measured units and the calculated units.
Additional information about the displayed result is also viewable on the right
side of the screen:
- Transmission status (T: Transmitted to Host or L: Local when result
has not been transmitted to Host)
- Omission status (Yes or No)
- Analysis date and time
- Notes (if any)
- Warning list.
Clicking the Disk icon allows the operator to save the result on a floppy disk
for future use. The action opens the Type File Name screen.
After typing the name of the file and confirming the operation, the Operation
in Progress screen opens and the information is saved on the disk.
The disk save routine saves the raw data point readings and not the actual
clot curve display to disk. The file must be named with a “crv” extension (i.e.
PTQC1.crv)

Clicking the Printer icon, followed by request for confirmation window Do you
really want to print? Yes allows the operator to print the single result; No will
cancel the operation.
Clicking the Confirm button causes the system to go back to the QC
Cumulative Results screen.
The operators may enter their own notes in the Insert Notes screen (shown
below) that is opened by clicking the Notes icon.

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The free text note field allows the operator to key in up to 30 alphanumeric
characters. Click the Confirm button after entering the note to save it.

Clicking the Omit Result button allows the operator to permanently omit the
selected result. Before omitting it, confirmation is requested Omitting
result…Do you really want to omit the selected result? Yes or No selections
are possible. When the result is omitted, a check will appear in the O column
beside the result and this result will not be included in the statistical
calculation. Omitted results will be displayed on the QC Plot as a blue
“diamond” symbol. You cannot Un-Omit a result once it has been omitted.
Clicking the Plot and Statistics button allows access to the QC Plot and
Statistics screen (refer to section 3.3.4 above).
Clicking the Host icon opens the QC Host Communication screen (refer to
section 3.3.6 below).
Clicking the Extract Results icon opens the QC Extract Data screen (refer to
section 3.3.7 below).
Clicking the Printer icon, followed by a confirmation window Do you really
want to print? Yes allows the operator to print the results; No will cancel the
operation.
Clicking the Confirm button saves any changes and returns back to the QC
Review screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.

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- Shutdown followed by a confirmation window Do you really want to


shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.3.6 QC - HOST COMMUNICATION


Clicking the Host icon found in both QC Cumulative Results and QC Review
screens opens the QC Host Communication screen:

The Host Communication configuration displayed on the screen is needed to


decide which type of QC results are to be sent and for what time interval.
The user first defines the date range, choosing between:

− “All range” (All range would include all results for the selected tests)

− “From…To…” (Specific Date range to send)


If the latter is selected, the starting date/time and the ending date/time must
be defined.
The user can then select if data for a specific test or all tests should be
transmitted by choosing between the following options:

- “Single Test”
- “All Tests”
Once the date range and tests are chosen the user can then narrow down
which results to send from the following choices:

- Valid Results
- Invalid Results
- Not Numeric Results
- Out of Scale Results
- Omitted Results
- “Transmitted” or “Not Transmitted”

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- “Flagged” or “Not Flagged”

Touching the check box area close to the option makes the selections; a
check mark appears next to the choice. These options allow the user to
group the transmitted results for ease of handling: i.e. Valid and Not Flagged
results. The second level options can also be combined with them to transmit
groups such as Valid and Not Flagged - but Omitted - results.
Once the transmission criteria are defined, the transmission begins by
clicking the Start Communication button.
Clicking the Cancel button rejects the changes; the system goes back to
either the QC Cumulative Results screen or to the QC Review screen
depending from which screen the Host icon was pressed.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.3.7 QC - EXTRACT DATA


Clicking the “Cumulative Results” button from the QC Review screen opens
the QC Cumulative Results screen.

Clicking the Extract Results icon will open the QC Extract Data screen
(shown below) that is almost identical to the QC Host Communication screen.

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The data configuration displayed on this screen is needed to decide which


type of QC results are to be extracted and at what time intervals. The Liquid
ID/Test ID association is visible on the upper part of the screen.
The user first defines the date range, choosing between:
− “All range” (All range would include all results for the selected tests)

− “From…To…” (Specific Date range to send)


If the latter is selected, the starting date/time and the ending date/time must
be defined.

Once the date range and tests are chosen the user can then narrow down
which results to view from the following choices:

- Valid Results
- Invalid Results
- Not Numeric Results
- Out of Scale Results
- Omitted Results
- “Transmitted” or “Not Transmitted”
- “Flagged” or “Not Flagged”

The selections are made by touching the check box area close to the option;
a check mark appears next to the choice. These options allow the user to
group the extracted results for ease of handling: i.e. Valid and Not Flagged
results. The second level options can also be combined with them to view
groups such as Valid and Not Flagged - but Omitted - results.
Once the extraction criteria are defined, the process begins by clicking the
Extract icon. The cumulative data for the selected interval will be displayed.
The statistical results are not updated based upon the selected data. The
statistics will be based upon the default interval data.

- Clicking the Cancel button rejects the changes.

• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

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3.4 Calibration
The ACL Elite/Elite Pro system requires that certain tests be calibrated either prior to
or simultaneously with sample analysis. If a test with a dedicated calibration is
requested, and no calibration curve exists in memory, a “missing calibration” warning
will be displayed during the pre-analytical check.
Although calibrations require the use of test-specific reagents and often other specific
materials, the calibration procedure is common to all tests.
This section contains all the information needed to calibrate assays on the ACL
Elite/Elite Pro, starting with a summarized procedure for those users already familiar
with the ACL Elite/Elite Pro system, followed by step-by-step procedures with specific
details about the screens, options, etc.
Calibration Table characteristics by test

Test Dedicated In Session Each Rotor

PT #
Fib-PT Based #
Fibrinogen-C #
Factors* #
Antithrombin #
Heparin #
Protein-C #
Plasminogen #
Plasmin-Inhibitor #
ProClot #
Factor VIII Chrom. #
Free Protein S #
Protein-S #
Pro S #
D-Dimer #
VWF (Ag & Activity) #

*Assays with Parallelism import the calibration from the same factor
assay with a dedicated calibration mode
Dedicated means a separate session is initiated to perform a calibration.
The session is initiated using the calibration menu. The analyser will

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store the last executed calibration curve. The curve is viewable under
the calibration review submenu.
In session means the calibration is executed the first time together with
samples and then saved. Subsequent runs for the test in the same
analytical session use the saved curve. For future analytical sessions, if
the calibrators are positioned on the sample tray the calibration will be
executed, if not, the previous calibration is used. The system will store
the last five In-session calibrations per test. The curves are visible using
the calibration review menu. The last curve performed is active and in
use.

Each Rotor means that every time a rotor is loaded with samples the
calibration is executed as well. The calibration material is required to be
placed on the sample tray for each run. If multiple rotors are processed
within an analytical session, a calibration will be performed on each rotor.

3.4.1 Dedicated Calibration Procedure-Summary


1. Select Calibration from the Main screen menu bar and select Calibrate from
the Calibration submenu.

2. Scroll through the list of tests displayed in the Test to Calibrate window on
the top right side of the screen, and select the test to be calibrated.
3. Look at the left side window or Materials Map and make sure that you have
on hand the materials listed to perform the calibration for the test.
4. Press Start to begin the Pre-Analysis phase. The ACL Elite/Elite Pro will
check the presence of the required materials; if all required materials are
present the calibration run will begin.

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3.4.2 Saving a Calibration - Summary


At the end of the cycle the Calibration can be viewed prior to being saved.
When the new calibration is accepted the previous calibration will be deleted.
For dedicated calibrations only it is possible to compare results of the new
calibration session with those of the previous calibration before deciding to
save it or not. For non-dedicated calibrations, the system retains the last 5
calibrations in memory. The oldest is automatically cancelled with any new
calibration run.

Note: Calibrations should be reviewed and accepted prior to the system


going into standby

3.4.3 Dedicated Calibration- Details


The calibration process is started from the Main screen by selecting
Calibration on the menu bar and selecting Calibrate from the Calibration
submenu. This will open the Calibration Pre-Analysis screen:

The screen is divided into several areas:

Top right area: The Test to Calibrate window allows the user to scroll through
the list of tests displayed and choose the test to be calibrated. The list
includes all the tests that require a dedicated calibration.

Top left area: A large window displays the list of materials needed to perform
the calibration for the test selected in the Test to Calibrate window. For
example, if a PT test is selected, the Calibration Plasma, Factor Diluent and
Thromboplastin will appear as required materials.

• If you are using a new lot of any of the materials press the Liquid
Details button at the bottom of the window and modify the appropriate
lot number.

• If you are using a new lot of Calibration Plasma, press the Liquid
Details button at the bottom of the window and enter the new assigned
value as shown on the Calibration Plasma package insert sheet.

Note: For the PT calibration, the value entered for the cal plasma is 100.
The window is divided into 4 columns with one row per Material. The
information displayed is the same as that entered when defining the
material’s configuration:

- # Number of the position assigned on the ACL Sample


Tray (A1-10) or Reagent Position (R#)
- Lot Number Number of the specific lot
- Value Assigned value for the FIRST Standard, as indicated
on the package insert sheet

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Clicking the Materials Map button at the bottom of the window opens the
Pre-Analysis: Material Status screen:

This screen displays the status of reagents currently on-board the system,
along with other analyser information. Refer to section 3.2.3 for details on
the Materials Map.

Clicking the Start button from the Materials Map starts the calibration run.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

3.4.4 Calibration - Review Calibrations


The Calibration Review (dedicated and in session calibration) process is
started from the Main screen by selecting Calibration on the menu bar, and
selecting Review Calibration from the Calibration submenu. This will open
the Calibration Review screen:

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This screen displays the recorded date and time of all the calibrations
performed for each enabled test.

• Dedicated Calibrations: The ACL will save the last calibration performed.

• In-Session Calibration: The ACL will save the last 5 calibrations. The
most recent one will be the active one in use.

Calibrations may be deleted by selecting the desired Test ID and Calibration


date/time, then clicking the Delete icon.
Clicking the Details icon at the bottom of the screen opens the Calibration
Data screen (shown below).

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This screen gives the user the ability to view at a glance the most important
information related to calibration runs:
- Name of the test (ID)
- Date and time when the calibration was performed
- Calibration curve
- Calibration Line Equation coefficients
- Errors (click the Error View button, see below)
- Warnings (click the Warning List button, see below)
- Mean value of the replicates, units of measure and CV%
Clicking the Details icon displays information about each single replicate.

This screen allows the operator to review the clot formation curve (or the
absorbance curve, depending on the test) for each single replicate, along
with the numeric value. For the clotting test curves, the clotting point is also
displayed.
Individual replicates can be omitted by pressing the Omit Replicate button.
The selected replicate will be removed from the calculation of the mean. It
will remain displayed and will have a check in the Omit Column. You may
omit multiple replicates, but must leave at least one for the curve calculation.

The mean value for a calibration is calculated by averaging all replicate


values. The replicate furthest from the mean is eliminated. The
remaining replicates are then averaged. This is the value used to
construct the curve
The raw data for the level and replicates displayed may be saved using
the floppy icon. The curve must be given a name. The .crv extension will
automatically be added to the name.
- ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.

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- Database View displays the Database View or Main Screen.


- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

- Confirm exits the screen; the system goes back to the Calibration
review screen.
Warning: Changing the target value of a calibrator in the Liquid Setup
screen after a calibration is performed results in the stored calibration
getting automatically updated to reflect the new value. A warning
message is presented informing the user the stored calibration will be
updated. Calibration should still be executed for the test if the
calibration was never performed using this lot of calibrator.
Clicking the Confirm button will allow the operator to exit the screen and the
system goes back to the Calibration Data screen.
Clicking the Printer icon the calibration curve and the calibration data are
printed. If the curve is composed of multiple segments, you must print each
segment individually. If the printer icon is pressed while viewing the replicate
curves, then the curve displayed will be printed.
Clicking the Error View button opens the Error View screen (shown below).

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Clicking the Warning List button opens the View Warnings screen:

Clicking the Confirm button exits the screens: the system goes back to the
Calibration Data screen.

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Table: Number of calibration points used per test.

Test Calibratio Total Number of Total


n Number of Replicates Number of
Standard Calibration for each Calibration
to be Points Point Points
positioned

PT 1 3 6 18

Fib-PT Based * * * *

Fib-C 1 3 4 12

Factors # 2 6 1 6

Factors $ 1 6 2 12

AT 1 3 4 12

HEP 2 3 4 12

P-C 1 3 1 3

PLG 1 3 1 3

FVIII Chr 1 3 1 3

P-I 1 3 1 3

ProClot 1 3 1 3

ProS 2 3 1 3

D-Dimer 1 3 4 12

VWF(Ag / Act) 1 4 4 16
* same number as the PT tests

# 2 standards are used for Non-Parallelism Factor Assays calibration: the


100% is the Calibration Plasma as it is (neat) and the Low Factor
Calibration Plasma is the same calibration plasma diluted 1+15 with
Factor Diluent (this dilution has to be prepared manually by the operator).
Factors with parallelism utilize Calibration plasma only.
$ Factors with Parallelism tests defined will import the calibration from the
same assay without the parallelism dilutions. The calibration for this test
will require 3 empty cups during the calibration cycle which will be used
to prepare the Low Factor Calibration Plasma dilution.

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3.4.5 Factor assay calibration for Non-Parallelism Tests


This information is valid for all 8 factor assays (VII, X, V, II, XII, XI, IX and
VIII*) when using the IL tests library. The calibration curve for factors is
divided into 3 segments:
1. High Curve: Prepared using Cal Plasma with levels at 100%, 50% and
25%.
2. Low Curve: Prepared using Low Cal F with levels ranging from 6.25%,
3.125% and 1.56%.
3. Middle segment connects the 25% from segment one and the 6.25%
from segment three.
*excludes Chromogenic Factor VIII

Preparation of the Calibration standards


For factor assay calibration it is necessary to prepare two calibration
standards:

100% is represented by the reconstituted Calibration Plasma; the specific


assigned value contained in the insert sheet of the calibration plasma needs
to be used as the assigned value for this material and the relative factor
being tested.

Cal Low F (6.25%) is represented by the Calibration Plasma diluted 1 + 15


using Factor Diluent. The assigned value is automatically calculated by the
ACL Elite/Elite Pro from the 100% value entered by the user. The standard is
prepared by pipetting 20 µL Calibration Plasma + 300 µL Factor Diluent into
0.5 mL cup. Mix well prior to use.

The 100% calibration plasma is required to obtain a valid calibration curve.

If the 100% calibration plasma material is not placed, a window will indicate
the missing materials. The options to abort or to continue are given. If the
user chooses to continue, sample analyses are performed although the
calibration cannot be executed. Sample results are calculated based on the
previous calibration. Response and activity (%) values are reported. If no
stored calibration curve exists, the results will only be displayed in seconds.
If the 100% material does not give a valid result, the entire calibration is
automatically rejected. When reviewing the calibration, an error message is
displayed. In addition, no calibration curve or statistics will be displayed.

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IL recommends that the 100% material be placed on the sample tray for each
Factor Analysis session.

The Cal Low F (6.25%) material is an optional material. It is used to obtain


the Low and Middle segments of the calibration curve.

Below is a summary of the 6 dilutions used by the ACL Elite/Elite Pro to


perform a Factor Assay calibration when all 3 segments are performed.

Dilution Ratio in % Preparation


100 Undiluted Calibration Plasma
50 Cal Plasma - Dilution done automatically by the
ACL Elite/Elite Pro
25 Cal Plasma - Dilution done automatically by the
ACL Elite/Elite Pro
6.25 Cal Low F - Manually prepared diluting the
Calibration Plasma 1+15 with Factor Diluent
3.12 Cal Low F - Dilution done automatically by the
ACL Elite/Elite Pro
1.56 Cal Low F - Dilution done automatically by the
ACL Elite/Elite Pro

3 Calibration segments: High, Middle and Low

The calibration curve for factor assays is composed by 3 segments:

High segment is obtained connecting the 100, 50 and 25 % points


Middle segment is obtained connecting the 25 and 6.25% points
Low segment is obtained connecting the 6.25, 3.12 and 1.56% points.

Factor Assay Calibration in the IL test library use the criteria of the in-session
calibration mode. If the undiluted calibration plasma is present on the ACL
Elite/Elite Pro sample tray, the High segment calibration is performed during
the analytical session.

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If the undiluted calibration plasma is not present, the previous High


calibration stored in memory is used for calculation and reporting of results.
Note: Do not place the Low Cal F cup onboard the analyser without
placing the Cal Plasma cup
An analytical session is defined as beginning with the start of analysis and
ending when the instrument returns to Ready.
Note: All results processed on a calibration curve with an error in one
segment will be flagged with a warning “Invalid adjacent segment”.
High curve

In case the operator needs only the High curve, it is possible to perform the
calibration only using the undiluted calibration plasma.

The ACL Elite/Elite Pro will perform only 3 calibration points: 100%, 50 and
25%.
Linearity varies from factor to factor but the instrument will always flag a
result less than 60% of the lowest calibration point.

In case the lowest calibration point is 25 %, all results below 15 % will be


flagged with a “C” in the Error column and tagged with “Extrapolated Result”
in the Test Details Warning List.

If a result is higher than 150 % of the highest calibration point value, a “C” will
be displayed in the Error column and “Extrapolated Result” will be shown in
the Test Details Warning List.

For example, if the highest point of the calibration is 100 %, all results above
150% will be flagged with a “C” and tagged with “Extrapolated Result”.
If the High curve is not valid (rejected), results on patients will be presented
only in seconds.

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If the High calibration curve is rejected but the 100% result is a valid result,
the Low curve and the Middle curve segments will be calculated.
If the 100% gives a non-valid result (i.e. error number xx), the High, Middle
and the Low curve will be rejected.

In both cases listed above the calibration should be repeated along with
Quality Control and patient samples.

It is possible that only two points (including the 100%) are valid and in this
case the instrument will present the "2 point cal” condition.

Low curve

If both High and Low segments are required, both segments must be
calibrated at the same time.

If the High curve is rejected due to a non-valid 100% result, the Low curve is
rejected.

If the Low curve is rejected (invalid, non monotonic, etc.), the High and the
Middle curve segments can be considered valid. The Middle segment curve
should be verified prior to reporting the patient results.

It is possible that only two points (including the 6.25%) are valid and in this
case the instrument will present the "2 point cal” condition.

Any result outside its specified Test Range as defined in the test setup will be
flagged with a “C” in the Error column and “Outside Test Range” will be
displayed in the Test Details Warning List.

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Middle curve

The Middle curve will be calculated when both High and Low curve segments
are calibrated at the same time and both 25% and 6.25% points have
produced valid results.

In case the High and Low segment do not produce a valid calibration (i.e.
slope out of range), if both results of the Middle curve segment are valid the
Middle curve segment is calculated. The Middle segment curve should be
verified prior to reporting the patient results.

Any result outside its specified Test Range as defined in the test setup will be
flagged with a “C” in the Error column and “Outside Test Range” will be
displayed in the Test Details Warning List.

Non monotonic check

Another check done on calibration is called “Monotonic”.


This check verifies that the results obtained in seconds are proceeding in the
same direction: low to high or high to low.
If one of the points in seconds is not “monotonic”, the entire segment of the
curve is flagged and rejected.

If the High curve segment is found “non monotonic”, sample results will be
calculated based on the Middle or the Low curve segments if valid.

If the Low curve segment is found “non monotonic”, sample results will be
calculated based on the Middle or the High curve segments if valid.

For the two conditions above, the curve should be verified prior to reporting
the patient results.

If only the 100% calibrator is present and the error “non monotonic” is shown,
the entire curve will be rejected. In this case sample results will be calculated
based on the previous calibration curve. If a previous calibration curve is not
present, only response values will be reported.

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Slope check

If the calibration slope exceeds the slope limit specifically defined for the
segment, the segment will be rejected with the Slope out of Range error
message.

Samples run in this condition will be flagged with a “C” together with the
message “Slope out of Range”.

r2 check

If the calibration r2 for a specific segment exceeds the r2 limit specifically


defined for the segment, the r2 will be presented in red and a “C” flag with the
message “r2 out of Range” will be presented together with patient sample
results.

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Flags on patient results

Several flags on patient results may be present and they are summarized in
the following table.

Flag Explanation

Out of Test Range = result is Result is outside the Test Range


displayed in violet for that specific test.

Extrapolated result When the result is greater than


150% of the highest calibration
point or less than 60% of the
lowest calibration point. Applies to
high curve or low curve.

Previous calibration Result is calculated using a


previously stored calibration.

Invalid Adjacent Segment Calibration curve has a segment


with an error.

Slope out of Range Result is calculated if at least the


High segment of the curve is valid.

R2 out of Range Result is calculated and an error


message is shown (r2 out of
Range).

Response “non monotonic” Result is calculated and an error


message is shown (response “non
monotonic”)

Recommendation:

If the Low segment fails and results are obtained <25%, repeat the
calibration, Quality Control, and patient samples.

Since calibration can be run simultaneously with patient samples or a


previously stored calibration can be used, the operator should verify that all
calibration segments are valid and no calibration flags are present before
validating any results.

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For good laboratory practice, at least two (2) levels of controls should be run
together with patient samples.

If a calibration displays any flags, good laboratory practice suggests


repeating the calibration, Quality Control and patient samples.

In case of Factor VIII and/or IX, patient therapeutic treatment may be


associated to sample results. Perform the Low curve calibration, at the same
time as the High curve calibration, to cover factor concentrations down to the
1.56 % level.

Stability of a stored calibration curve should be monitored by the use of at


least two levels of Quality Control materials each day of testing.

3.4.6 Factor assay calibration for Parallelism Tests

Factor assays for tests with parallelism import the calibration from the same
factor test defined without the parallelism dilutions. This master test is
calibrated using the dedicated calibration mode.

This information is valid for all factor assays with Parallelism when using the
IL tests library. The calibration curve for factors is divided into 3 segments:

o High Curve: Prepared using Cal Plasma with levels at 100%, 50% and
25%.

o Low Curve: Prepared using Low Cal F with levels ranging from 6.25%,
3.125% and 1.56%.

o Middle segment connects the 25% from segment one and the 6.25% from
segment three.
Calibration of the master test will require 3 empty cups on the sample tray
during the calibration cycle. These cups will be used to automatically prepare
the dilution of the Cal Plasma for use as the Low Cal F.
Samples that are processed with the Factor Parallelism will process the
samples at three dilution levels: 100%, 50% and 25%.

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3.4.7 Factor assay Parallelism Results

Introduction
Factor Parallelism is a technique used to determine the influence or effect
inhibitors have on a sample’s Factor Assay activity result. The possible
presence of an inhibitor and its effect may be determined by assaying the
Factor using a series of dilutions. The impact of the dilutions on the factor
activity can then be observed.
The purpose of the Parallelism function on the ACL Elite / Elite Pro is to
assist with the identification of an inhibitor in an easy, automated fashion. The
Parallelism test mode is a means to create operator definable dilutions. The
instrument will execute all dilutions, perform testing on the dilutions, and will
provide evaluation data on the results to assist in determining the presence of
an inhibitor.

The software provides multiple checks of the data generated and provides
the operator with valuable information to assist in identifying the presence of
an inhibitory pattern. Some of the checks include comparison to the original
undiluted result and precision data of the additional dilutions.

Performing Factor Parallelism is an optional feature and if executed will


provide an operator definable Flag to alert the operator if a limit has been
exceeded. If an inhibitor is suspected, confirmatory testing is suggested.

Results are obtained by running a series of dilutions of the sample similar to


performing a calibration. Samples run using factor parallelism will be
analyzed at the 100%, 50% and 25% levels. On the cumulative report the
results for all 3 dilutions will be reported as Dil 1 (100%), Dil 2 (50%) and Dil
3 (25%). Each of these levels may display the results in seconds, %
(Uncalculated) and Rec % (Recalculated). The recalculated results will be
the % uncalculated values multiplied by the dilution factor.

In addition to the individual results the system will perform calculations for the
following:

- AVeCR% - Average of the three Corrected Results in % activity.


- CV-CR% - CV% of the three Corrected Results % values. When this
value exceeds the limit in the test setup the results will be displayed in
red on the screen and an error will print on the report.

- Slope – The slope for the 3 parallelism values is calculated. This slope
should coincide with that for the factor test calibration. In the test setup
there is a user definable minimum and maximum allowable Slope limit.
When the recovered slope for the samples is outside the limits in the test
setup the results will be flagged in red and the error “Slope out of range”
will be printed.

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- Int – This value is the intercept for the line based upon the 3 factor
parallelism dilutions. In the test setup there is a user definable minimum
and maximum allowable Intercept limit. When the recovered value for
the samples is outside limits the results will be flagged in red and the
error “Intercept out of range” will be printed.
- R2 – This value is the correlation coefficient calculated using the
seconds and the 3 factor parallelism dilution % values (uncorrected). In
the test setup there is a user definable minimum and maximum
allowable R2 limit. When the recovered value for the samples is outside
the limits the results will be flagged in red and the error “R2 out of range”
will be printed.
Sample results with an error on any of the above units should be reviewed for
the presence of a possible factor inhibitor. Additional retesting including off-
line dilutions at higher levels may be required to confirm any questionable
results.

Example 1:
Laboratory Maximum Variance ± 10% of the mean
Concentrations: 100% 50% 25%
Values: 54.7% 51.5% 46.4%

In the above example the results of 54.7% and 51.5%, have a mean of 53.1
with a 10% agreement the range is 47.8% - 58.4%. If the results are outside
that range another dilution should be made, if they are within range they are
close enough to report. If all points are within 10% of their mean then the
100% concentration value should be reported as long as no other flags are
seen.
Parallelism’s sole purpose is to aide in the identification of inhibitors. In the
case of an inhibitor the answer reported should be the result obtained when 2
dilutions (CR’s) agree

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3.5 Analytical Reference


Analytical Reference (AR) is the name associated to a control material that is
intended for use as a general check of the system precision.
The AR results are handled just like the results for a Quality Control material.
The plot and cumulative list of results are both available for the AR. These
results may be transferred to a host computer, printed or archived to a floppy
disk.

3.5.1 Analytical Reference: SETUP


To Review the Analytical Reference results, from the Main screen select
Calibration on the menu bar, then select Analytical Reference from the
Calibration submenu. This will open the Analytical Reference Review screen:

This screen is similar to the QC Review screen.


The user may select the desired test from the list of enabled tests. The
following statistics are displayed, but cannot be edited, on the right side of the
screen:
- Unit
- Actual and Target Mean
- Actual and Target SD
- Actual CV
- Results in Statistics and in Database (DB)

If the AR Use box is checked then the system will check for the presence of
the Analytical Reference during the Pre-Analytical check for all assays.
Remove the check from the box to disable the use of the Analytical
Reference for all assays. Default value is for the box to be unchecked.

If the AR Use button is checked (enabled) and profiles are created the
material map for the profile will reflect the need for Cal Plasma. If the AR
Use button is later disabled the profiles that contain tests that use the AR will
need to be deleted and re-created.

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Clicking the Setup button opens the Analytical Reference Setup screen (see
details later in this Section).
Clicking the Plot and Statistics button opens the Analytical Reference Plot
and Statistics screen (see details later in this Section).
Clicking the Cumulative Results button opens the Analytical Reference Data
screen (see details later in this Section).
Clicking the Transfer to Host icon opens the AR Host Communication
screen (see details later in this Section).
Clicking the Confirm button exits the screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.
Clicking the Setup button in the Analytical Reference Review screen opens
the Analytical Reference Setup screen:

The selected test ID appears on the top of the screen; below it the operator
can view the following information:
- Unit
- Target Mean and SD
- Target SD
- SD Range
- Results in Database. 10, 100, 500, 1000 is selectable. Any change to
the number of results in the database will delete all AR results for this
test.
- Note

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Clicking the Clear Statistics button, followed by a confirmation window


Clearing Cumulative Results for this test? Yes clears the cumulative results;
No will cancel the operation.
Clicking the Confirm button saves the changes, while clicking the Cancel
button rejects the changes; in both cases the system goes back to the
Analytical Reference Review screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.5.2 Analytical Reference: PLOT and STATISTICS


Clicking the Plot and Statistics button in the Analytical Reference Review
screen opens the AR Plot and Statistics screen.

This screen displays both the Plot and the Statistics for the selected test.
The following information is viewable, but not editable, on the far left side of
the screen:
- Start and End Date
- Unit
- Actual and Target Mean
- Actual and Target SD
- Actual CV
- Results in Statistics and in the Database (DB), choices are 10, 100, 500
and 1000 viewable results.

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Analytical Operations

The AR plot is displayed on the far right side of the screen; the axes on the
chart indicate:
- X-axis = days
- left Y-axis = target mean and chosen units
- right y-axis = SD
The display covers an interval of 30 days; the default window displays the
results for the last 30-day interval, but the operator may view earlier data and
move about using the scroll bar.
The statistical calculation is done using all the results in the database. To
obtain the statistics for other selected intervals of time click the Select
Interval button and enter the specific start and end date (dd.mm.yyyy or
according to the date format selected in the Date and Time configuration) in
the specific fields of the Select Interval screen.
The new interval must be confirmed by clicking the Confirm button, which
results in the system going back to the AR Plot and Statistics screen, or not
confirmed by clicking the Cancel button (this applies only to the selected
interval).

Clicking the Printer icon, followed by a confirmation window Do you really


want to print? Yes allows the operator to print the test setup; No will cancel
the operation.

Clicking the Cumulative Results button opens the Analytical Reference Data
screen (refer to subsection below).
Clicking the Confirm button allows the operator to leave this screen and go
back to the AR Review screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to turn the
system off; No will cancel the operation.

3.5.3 Analytical Reference: CUMULATIVE


RESULTS
Clicking the Cumulative Results button in either the Analytical Reference
Review or the Analytical Reference Plot and Statistics screen opens the
Analytical Reference Data screen:

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In the upper part of the screen, the user views the selected Test ID. The
larger part of the screen is used to display the results obtained. Results can
be displayed using the list that can be scrolled vertically and horizontally; the
columns show the numeric results in all configured units and the date/time of
the analysis.
There is also space for notes, and columns for flags and warnings. The
operator may enter his own notes by clicking the Note icon that opens the
Insert Notes screen (similar to that on the QC screen).
Clicking the Confirm button allows the operator to save the entered or
modified note and to exit this screen, going back to the AR Data screen.

Clicking the Omit Result button allows the operator to permanently omit the
selected result. Before omitting it, confirmation is requested Omitting
result…Do you really want to omit the selected result? Yes or No selections
are possible. When the result is omitted, a check will appear in the O column
beside the result and this result will not be used in the statistical calculation.
Clicking the Plot and Statistics button allows the operator to have access to
the Analytical Reference Plot and Statistics screen (refer to subsection
above).
Clicking the Host icon opens the AR Host Communication screen (refer to
subsection below).
Clicking the Extract Results icon opens the AR Extract Data screen (refer to
subsection below).
Clicking the Printer icon opens the AR Result Report screen with the various
possibilities:
− ALL
− From … to
− Not numeric

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− Out of scale
− Omitted
− Transmitted
− Not transmitted
− Flagged
− Not flagged
Clicking the Confirm button exits this screen and goes back to the Analytical
Reference Review screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

3.5.4 Analytical Reference: HOST


COMMUNICATION
Clicking the Transfer to Host icon in the Analytical Reference Review screen
opens the AR Host Communication screen (similar to the QC functionality).

The Host Communication configuration displayed on this screen is needed to


decide which type of AR results are to be sent and at what time intervals they
should be transferred to the Host Computer.

The user first defines the date range, choosing between:

− “All range”

− “From…To…”
If the latter is selected, the starting date/time and the ending date/time must
be defined.
The user can select also if a specific test data or all tests data should be
transmitted between the following options:
- “Single Test”
- “All Tests”
The user then makes a second-level choice from each of the following
pairs:

- Not Numeric Results


- Out of Scale Results
- Omitted Results
Some second-level selections are also available:

- “Transmitted” or “Not Transmitted”


- “Flagged” or “Not Flagged”

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Touching the area close to the options makes the selections: a check mark
appears next to the choice. These options allow the user to group the
transmitted results for ease of handling, i.e. Not Numeric and Not Flagged
results. The second level options can also be combined with them to transmit
groups such as Not Numeric and Not Flagged - but Omitted - results. Once
the extraction criteria are defined, clicking the Start Communication button
may activate the transmission.
Clicking the Cancel button rejects the changes and exits the screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to turn the
system off; No will cancel the operation.

3.5.5 Analytical Reference: EXTRACT DATA


Selecting Analytical Reference from the Calibration menu, Cumulative
Results and then clicking the Extract Results icon in the Analytical
Reference Data screen opens the AR Extract Data screen (similar to the QC
functionality).
The data configuration displayed on this screen is needed to decide which
type of AR results are to be extracted and at what time intervals they are
extracted.
The user first defines the date range, choosing between:

− “All range”

− “From…To…”
If the latter is selected, the starting date/time and the ending date/time must
be defined.

The user then makes a second-level choice from each of the following
pairs

- Not Numeric Results


- Out of Scale Results
- Omitted Results
Some second-level selections are also available:
- “Transmitted” or “Not Transmitted”
- “Flagged” or “Not Flagged”
Touching the area close to the option makes the selections; a check mark
appears next to the choice. These options allow the user to group the
transmitted results for ease of handling, i.e. Not Numeric and Not Flagged
results. The second level options can also be combined with them to transmit

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Analytical Operations

groups such as Not Numeric and Not Flagged - but Omitted - results. Once
the extraction criteria are defined, clicking the Extract icon can activate the
extraction.
Clicking the Cancel button rejects the changes and exit the screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.

- Shutdown followed by a confirmation window Do you really want to


shutdown ACL? Yes closes the session, allowing the operator to turn the
system off; No will cancel the operation.

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Setup and Utility
4.0 Introduction
The intent of this Section is to familiarize the ACL Elite/Elite Pro user with the items
included in the Setup and Utility portions of the Operator Interface. The understanding of
the items and their proper use are key in order to prepare the system for its optimum
analytical operation, to handle data and to work with the system software.

4.1 SETUP
The Setup portion of the ACL Elite/Elite Pro software groups all functions related to
definition or configuration of features or items in order to adapt and optimize the use of
the system to the laboratory needs prior to performing the analytical operations.

4.1.1 SETUP Submenu


Clicking the SETUP button on the Main screen menu bar displays :
TESTS
- View/Define
- Sort Tests
- Interference Table
- Default Tests
- Reflex Tests
MULTI-TESTS
- Profiles
- Test Groups
- Test Group Profiles
- Sort Multi-Tests
- Default Multi-Tests
LIQUIDS
INTERFACES
- Host
- Printer
- Internal Barcode
- External Barcode
- Keyboard
- Network (dimmed) – Not Supported in this version
- Modem (dimmed) – Not supported in this version

SYSTEM CONFIGURATION
SECURITY
AUDIBLE ALARMS
DATE/TIME
UNITS

Instrumentation Laboratory 4.1


Setup and Utility

4.1.2 Setup - TESTS – View/Define


This area of the software is used to define and view individual tests. The default
setting for all tests is disabled. The test library can contain up to 300 tests; 200
reserved for IL applications and 100 reserved for customized applications; up to
100 tests can be enabled (active) at the same time independent of the mix.

Selecting Tests from the Setup submenu, and then choosing View/Define
opens the View Tests screen:

Above the test list a rectangular box will show the number of tests present in the
Library Application. The box will show two numbers; the enabled tests followed
by the total number of tests.
The large window on the left of the screen displays a table of all the configured
tests.
Each test is identified by an abbreviated name, Test ID, shown on the right side
column. The Test ID name can be customized in the test details screen. The
Test ID must be unique for each test.

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The two columns to the left of the test names contain checks indicating whether
each test is:
- currently Enabled and ready to be run on the ACL

- an IL pre-defined test application.

Note: IL pre-defined tests were developed and tested specifically for


use with IL Test reagents and new supplies (i.e. rotors and
wash-R) for use on the ACL™ Elite/Elite Pro. The proper
performance of other reagents and supplies including washed
rotors has not been fully tested or verified, and the use of them
may cause clinically significant degradation of performance and
results. IL does not assume any obligation or warranty
engagement concerning precision and/or accuracy of the
measurements or for any damage to the instrument directly or
indirectly resulting from the use of reagents, consumables, and
expendable supplies other than those sold by IL.
All responsibility for parameter development and validation
of new or copied tests belongs to the user alone.

The right side of the screen contains the following fields:


TEST CODE
TEST REVISION
TEST CODE FOR HOST
EXTENDED NAME
CALIBRATION MODE
The information shown in these fields can be viewed but not edited from this
screen. Several buttons are found around these fields:
Clicking the Details icon opens the Test Details screen, which allows editing of
the fields (refer to section 4.2.2 for details).
Clicking the Printer icon, followed by a confirmation window Do you really want
to print the Test report? Yes allows the operator to print the Test Setup of the
selected test; No cancels the operation.
Clicking the Enable/Disable button, followed by a confirmation window Yes/No,
erases all information related to the selected test from the Patient Database and
the QC Database. If the test is disabled, clicking the Enable/Disable button will
enable it.
Clicking the Show Enabled check box allows the operator to view only the
enabled tests from the test table. When this checkbox is marked the list
presented displays just the enabled tests. This setting is saved when exiting from
this screen and also at power off.
Clicking the Copy Test button opens the Copy Test screen (refer to section 4.2.1
below).

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Setup and Utility

Clicking the New Test button opens the New Test screen (refer to section 4.2.2
for details).
Clicking the Delete icon, followed by a confirmation window, erases all
information related to the currently selected test. IL locked tests cannot be
deleted.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

4.1.3 Setup - TESTS - Sort Tests


This area of the software is used to sort the tests available in the system.

Selecting Tests from the Setup submenu and choosing Sort Tests opens the
Sort Tests screen:

Sorting the tests defines the display order of the tests in the patient database, the
order of the tests list during programming and the order of the tests in the
printouts.
The window on the left side of the screen displays a table of all currently enabled
Tests; a check mark to the left side of a test indicates that it is a Sorted Test.
The window on the right side of the screen displays the order in which the tests
are sorted.
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ACL Elite/Elite Pro Operator’s Manual

The Arrow and the Scissors icons at the bottom of the windows are used to
create a sorted list.
The default condition is to have the tests in both columns listed in alphabetical
order.

The operator selects the tests from the sorted tests box and presses the scissors
icon; the tests are then removed from the right side window.
This operation is necessary because the tests cannot be moved up and down in
the Sorted Tests list.
The arrow is used to move a test from the left (enabled tests) list to the right
(sorted) list in the desired position.
Tests are added after the cursor. If a mistake is made, the Scissors icon is used
to remove the test from the sorted list. No test can be added above the first test
in the list.

Enabled tests that are not sorted will be printed and viewed after those tests that
are sorted.
Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Database
View/Main screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No cancel the operation.

Instrumentation Laboratory 4.5


Setup and Utility

4.1.4 Setup - TESTS - Interference Table


Even though the ACL has been designed to minimize reagent carryover between
tests, it was found experimentally that performing an operation called “reagent
priming” might improve the system performance. The Interference Table option is
used to activate this operation between test pairs.

Selecting Tests from the Setup submenu, and choosing Interference Table
opens the Interference Table screen shown below.

This screen contains three windows:


TESTS WITH REAGENT PRIMING on the left side, which lists the tests that
require a preventive needle priming as defined in the test setup.
INTERFERING TESTS in the middle, which displays all tests that interfere with
the current test highlighted in the left window (Test with Reagent Priming).
ENABLED TESTS on the right side displays all the enabled tests in the system.
If an interfering test is executed before a test requiring reagent priming, the
reagent priming is executed before the first reagent dispensation.
The interference tests table is preset for IL-Predefined tests.

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ACL Elite/Elite Pro Operator’s Manual

The Arrow and the Scissors icons at the bottom of the windows are used to add
or remove a test.

The steps to setup the interference tests table are as follows:


1. Select a test with Reagent Priming defined from the list in the left box.
2. Select the interfering tests that affect the highlighted test selected in step 1
from the Enabled test box.
3. Move the test selected in step 2 to the interfering test column using the
arrow. Use the scissors to delete a test from the center column.
At the bottom of this screen, clicking the Confirm button saves the changes;
clicking the Cancel button rejects the changes; in both cases the system goes
back to the Main screen.
Warning:

After performing any software library upgrades it is important to check the


interference table especially if you have custom tests defined. Custom tests that
interfere with an IL Locked tests (tests with reagent priming defined) will no
longer be linked in the interference table. You will need to re-enter the
interference.
Reagent Prime Defined Interfering Test Status after Upgrade
IL Locked Tests Custom Tests After upgrade – no link
Custom Tests IL Locked Tests After upgrade – still linked

Instrumentation Laboratory 4.7


Setup and Utility

4.1.5 Setup - TESTS - Default Tests


The default tests are programmed on sample IDs without a test request from the
internal database or the Host.
If default test is enabled, a sample ID with no tests requested (status of N) will
get the test default automatically programmed. If the tests are included in the
selected Multi-Tests or Single Tests session they will be processed.
The list on the left shows all enabled tests. The list on the right shows the tests
selected as default.
The Arrow and the Scissors icons at the bottom of the windows are used to add
or remove a test.

Select the tests to be added to the Default Tests list from the box on the left
(Enabled Tests) and press the Arrow key. The selected tests will move to the
Default tests box.
The default tests can be disabled/enabled using the Enable Default Tests
checkbox.

Note: Default tests are added to a sample after checking the database and
performing a host query. If neither of these checks result in tests being
programmed on a sample, then the default tests will be added. Default tests will
not be added to a previously run sample with completed results. The default tests
will not be run if they are not included in the current single test or multi-test
session selected.

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4.1.6 Setup - TESTS - Reflex Tests


The Reflex Tests allow the user to program and/or execute a test generated by a
condition of the master test. Reflex logics are applied one time on each sample.
Additional logic checking is not performed on results that originated on test
orders from reflex test rules
Up to 60 rules can be defined. A rule is composed of 1 to 3 conditions. A
condition may be either numeric result based (on a specific unit) or dependent
upon errors that occurred on the master test (i.e. error 6, error 7, error 12, etc.).
Each rule can program and/or execute automatically up to 10 tests.

Clicking the Details icon when the cursor is on a specific rule displays all the
conditions and tests. All of these can be modified.
Moving the cursor using the up and down arrows, then clicking the
Enable/Disable button will select or deselect each single rule. When a rule is
enabled a check mark appears close to the rule number. If a rule is checked it
will be applied (see System Configuration for general Reflex Rules activation in
section 4.1.20).

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Setup and Utility

Clicking the Delete icon deletes the rule.


Clicking the Print icon prints all the reflex rules.
To insert a rule, use the Insert Icon.
Clicking the Detail icon, the Reflex Rules Details window appears.

The Details icon allows viewing /editing of the conditions for the current reflex
rule.

The upper window allows the insertion of the rule condition by pressing the
Insert Icon.

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The Reflex Rule Conditions window appears.

The test generating the reflex test can be chosen from the Test ID List.
For the numeric results class use the appropriate Unit field to select which unit
should be checked by the rule.
Two classes of conditions are available: value, based on numeric results; error-
based on the error that occurred.

For the numeric results, the unit can be selected according to the test and the
units defined in the specific test setup.
Then select the Comparison in terms of >; =; < for the value entered above.

In the Value field, after checking the value check box, enter in the numerical
value for comparison. Press the green check to confirm and save the condition.
The second class includes the result error (data reduction errors), e.g. error 6, error
7, error 12, etc. Most errors are based upon the measured unit; therefore this unit
should be used when defining the logics. See the Troubleshooting section 6 for
additional information on each specific error.

For the error conditions, it is possible to group multiple errors (up to 5) in a single
rule by using the Select icon.
Move the cursor on the error to be selected, and then press the Select button; a
check mark appears close to the selected errors. Press the green check to
confirm and save the condition.

Instrumentation Laboratory 4.11


Setup and Utility

Multiple conditions are checked using the “AND / OR” qualifiers.


Up to 3 conditions can be linked to the same rule using the AND/OR option.
If the AND option is selected, both selected conditions must be fulfilled to
generate the reflex test(s).
If the OR condition is selected, only one of the conditions must be fulfilled to
generate the reflex test(s).
The lower part of the Reflex Rules Details screen allows the reflex tests to be
selected by using the Arrow and Scissors icons.
Rules and conditions can be reviewed or deleted by pressing the details or the
delete icons.

The Print icon prints all the relevant information for all rules and conditions stored.
Below are listed some possible examples of reflex rules. These rules do not
represent any particular clinical aspects but only possible selective examples.
Each customer should define his own reflex rules. For the reflex rules execution
please refer to the System Configuration section.
Reflex Rules examples

• PT > 50 seconds then PT-e


• PT (sec) = error 6 then PT-e
• PT (sec) = error 7 then PT-e

• APTT > 110 seconds then APTT-e


• APTT (sec) = error 6 then APTT-e
• APTT (sec) = error 7 then APTT-e

• Fib-C > 600 mg/dL (or g/L) Fib-C H


• Fib-C < 100 mg/dL (or g/L) Fib-C l
• D-Dimer > 1050 ng/mL D-D h

• VWF > 150 % VWF h

Note: Only one level of reflex logic checks is applied to each sample. No
additional reflex logic checks are applied to the results of tests that were added
to a sample from the first level of reflex logic checking.

The following table lists the reaction curve error codes along with the unit
that should be used when defining a reflex logic for that error.

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Error Definition Cause Reflex unit


Code
5 Optical ADC Saturation Measured
Failure
6 Not Coag First threshold not passed Measured
7 Coag Error Second threshold not passed Measured
8 Coag Error Delta time between thresholds is Measured
greater than the selected value
9 Coag Error Initial slope of the reaction curve is Measured
higher than the selected value
10 Coag Error Final Slope of the reaction curve is Measured
higher than the selected value
11 Final Delta Final delta of the reaction is higher Measured
Error than the selected value
12 Coag Error Maximum peak of the first derivative Measured
is below the selected limit value
13 Coag Error Maximum peak of the second Measured
derivative is below the selected limit
value
14,30 Offset Error Offset value is outside limits Measured
31 Curve Delta of reaction curve does not meet Measured
Delta Error limit specified for test
32 Noisy Erratic reaction readings Measured
Baseline
33 Noisy Erratic reaction readings Measured
Reaction
45 & Mean not One of the two test results is not valid Reported
46 Calculated (non numeric result)

4.1.7 Setup – Multi-Tests - Profiles


This area of the software allows users to define and view their own choice of
Multi-Tests (Profiles or Test Group Profiles). Multi-Tests Profiles are composed
of single tests and Test Group Profiles are composed of test groups. Refer to
section 4.1.10 for details on setting up Multi-Tests - Tests Group Profiles.

Up to 30 Multi-Tests profiles can be created (code numbers from 1 to 99). The


same number cannot be used for a multi-tests profile and a test group profile.
A multi-tests profile can contain a maximum of 20 tests. A test group profile can
contain a maximum of 20 test groups.

Selecting Multi-tests and Profiles from the Setup submenu and then choosing
View/Define opens the Profiles View screen shown below.
The order in which the tests are entered in the Profile is one of the major
determinants of the analysis sequence of the tests when the profile is selected.

Instrumentation Laboratory 4.13


Setup and Utility

The window on the left side of the screen displays a list of Profiles defined, while
the window in the middle displays the individual tests in the Profile highlighted on
the left.
Each Profile is assigned a numeric code (profile code: 1-99), and for each there
is an associated NOTE field. Notes can only be viewed on this screen.
The information shown for these fields can be viewed but not edited from this
screen. Several buttons are found near these fields:

Clicking the Details icon opens the Profiles Details screen, which allows editing
of the fields (refer to the specific section below).
Clicking the Delete icon, followed by a confirmation window Do you want to
delete the current profile? Yes allows the operator to delete the selected profile;
No will cancel the operation.
Clicking the Print icon, followed by a confirmation window Do you really want to
print the current profile? Yes prints the selected profile setup; No will cancel the
operation.
Clicking the New Profile button allows the operator to access the New Profile
screen (refer to the specific section below).
• ACTIVE BUTTONS at the bottom of this screen are:
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ACL Elite/Elite Pro Operator’s Manual

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.
The Profiles Details screen:

As mentioned above, any changes to be made to the fields shown in the Profiles
View screen are done through the Profiles Details screen, which opens by
clicking the Details icon.

NOTE: If the user wishes to define a NEW profile, clicking the New Profile
button will open the New Profile screen, which has blank fields to be filled in (see
below). Since the purpose of the New Profile and the Profiles Details screens is
very similar, they have an identical design. When the fields are completed in the
New Profile screen, it becomes a Profiles Details screen.

Two fields in the top part of the screen display the Profile ID and the assigned
Profile Code. Two windows are located below: the window on the left displays all
Enabled Tests and the one on the right contains the tests that make up the
selected profile. Tests that use an in cup dilution or in-session calibration cannot
be placed in a multi-tests profile

The user defines the tests in the profile with the help of the Arrow and the
Scissors icons to add and delete the tests from the enabled tests window to the
tests in profile window. The NOTE field at the far right is open for the user to add
desired comments (free text).
The materials map is automatically created as soon as the tests are inserted
according to the default position of the Setup liquids. If a reagent’s default

Instrumentation Laboratory 4.15


Setup and Utility

position for a profile’s material map is already occupied by another reagent, the
next available “like” position is then automatically assigned. If all the positions in
a homogeneous area R1 to R4, R9 to R12 (ACL Elite Pro only), R7 to R8, A1 to
A10 and R5 to R6, are filled, the liquid cannot be placed and a message warns
the user that the test cannot be added to the profile
The large window in the bottom of the screen reports the information currently
stored for this profile in the Materials Map:
- Liquid ID: the name of the materials used to analyze the selected profile
- Position: the selected position (A1…A10 or R1…R12) for the specific liquid
material
- Refrigerated: a check indicates that the selected liquid material must be
kept at 15°C, positions R1 to R4, R9 to R12 (ACL Elite Pro only)
- Stirred: a check indicates that the selected liquid material must be stirred by
the magnetic stir bar (positions R1 to R4)
- Needle: indicates which needle (sample or reagent) dispenses the selected
material.
Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Profiles View
screen.
The Globe icon allows modification of the profile names in the selected
language.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

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ACL Elite/Elite Pro Operator’s Manual

4.1.8 Setup – Multi-Tests – Test Groups


The Test Group is a combination of tests using the same wavelength, optical
reference and same acquisition cycle.
Test Groups are predefined by IL. A User can create a new test group when
they are logged in at the Lab Manager security level.

Selecting Multi-Tests from the Setup submenu, and then choosing Test Groups
opens the Test Groups screen, shown below.
The window on the left side of the screen displays a list of the current groups of
tests, “Test Groups ID”, while the window on the right side displays the individual
tests in the highlighted Group.
Each Test Group is assigned a numeric code, and on the right there is space to
enter a NOTE for each. Notes can be viewed but not defined on this screen.
Several buttons are located around these windows:
Clicking the Details icon allows the operator access to the Test Group Details
screen (refer to the specific section below).
Clicking the Print icon, followed by a confirmation window Do you really want to
print Test Group? Yes prints the test group setup; No will cancel the operation.

Instrumentation Laboratory 4.17


Setup and Utility

Clicking the Confirm button saves the changes and the system goes back to the
Main screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.
The Test Group Details screen:
Clicking the Details icon in the Group Tests screen opens the Test Group Details
screen shown below.

The test group ID and code are displayed in the upper part of this screen; on the
right there is space for the user to enter notes.
The larger window on the left of the screen is used to describe the sequence of
operations for each of the tests included in the specific test group, while the
smaller window on the right lists the tests enabled.

Clicking the Materials Map button opens the Tests Materials Map screen. This
screen is used to check the number and the characteristics of the positions
where the reagents for these tests are located (refrigerated or not; mixed or not;
use of sample or reagent needle). Note: the setup of the liquid materials is
described in Section 4.1.13.

Clicking the Material Check button, displays the actions to be taken by the
instrument when a low liquid level is detected. The actions can only be changed
after a test group is initially saved.
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ACL Elite/Elite Pro Operator’s Manual

Clicking the Confirm button saves the changes and the system goes back to the
Test Group Details screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Creating a New Test Group

The user can create test groups when they are logged in at the Lab Manager
level. When creating a new group there are several items that need to be
considered for tests to be compatible in the group.

- The test group must have a minimum of one test


- The tests must utilize the same wavelength
- The tests must have similar Acquisition Setup settings. The actual
acquisition time does not have to be the same, however the mixing, ramp
and inter-ramp settings must be the same.
- The time to pipette the second test in the group must be less than the
incubation time for the first test.
- The test group can have one RP (Reagent Prime) and this occurs as the
first aspiration in the group.
- The test group can have one CL (Clean) cycle at the end of the group
- The group can only have one Optical Reference and or Reference step.
- The material check screen can only be modified after a test group is saved.

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Setup and Utility

Clicking the New Test Group button will opens a blank Test Group detail screen.

- The Enable Max Samples Value box allows you to limit the number of
samples that can be processed when using this group. For the IL locked
tests this field can be edited at the Service security level.

- The list of available tests is displayed in the Enabled Tests box. Highlight
the desired test and move the test into the group using the arrow icon.
Repeat the step for all desired tests in the group. You will notice that the
second and all subsequent tests that are added into the group are placed
below the previous ones.

- Once all of the tests are placed into the group you then need to modify the
sequence of the pipetting steps. When you are doing this you need to
consider items such as grouping similar operations or moving pipetting
steps so they occur during incubations.

- The next thing you need to consider is the incubation time clocks. For
steps with a “set timer” time constraint you need to have a “wait until timer
expires” to follow it. If you have two simultaneous steps with “set timer” the
system will respect the time for the first step when it encounters the “ wait
until timer expires”. In this case the second timer is ignored if both tests are
run.

- Excessive optical reference steps must be deleted. The group only requires
one.

Test Group ID: Enter an ID name for the group (8 alphanumeric characters)

Test Group Code: Enter a unique numeric value between 501 – 999.

Double Samples: A check in this box will initiate all testing to be performed in
duplicate for this group.

Notes: This field can be used for free text comments about the test group.
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ACL Elite/Elite Pro Operator’s Manual

Materials Map: Displays the material map for the group

Assign Step No.: Pressing this button displays a window that allows you to
change the step number for the current step highlighted.

Add Step: This button opens the window that allows you to program a new step
for the group.

Refer to the Setup Tests Definition for details on filling in this screen

Clicking the Confirm button saves the changes.

Instrumentation Laboratory 4.21


Setup and Utility

The following table contains a list of IL locked Test Groups and the tests
contained within it.

Test Group Name Tests within Test Group


PT SP APTT SP, FIB(g/L), PT
PT_ SP APTT SP,FIB_(mg/dL), PT
HS LYOTT APTT LY, FIBHS(g/L), PTHS, TT-8
HS_LYOTT APTT Ly, FIB HS_(mg/dL), PT HS, TT-8
HS LYO APTT Ly, FIBHS(g/L), PTHS
HS_ LYO APTT Ly, FIB HS_(mg/dL), PTHS
HS+ LYO APTT Ly, FIB HS+(g/L), PT HS+
HS+_ LYO APTT Ly, FIB HS+_(mg/dL), PT HS+
HS+ SP APTT SP, FIB HS+(g/L), PT HS+
HS+_ SP APTT SP, FIB HS+_(mg/dL), PT HS+
RPT SYS APTTSYS, R-FIB(g/L), R-PT
RPT_ SYS APTTSYS, R-FIB _(mg/dL), R-PT
ATDD FIB AT* , DD, DDh, FIB-C(g/L)
ATDDFIB_ AT* ,DD, DDh, FIB-C_(mg/dL)
HS SP APTT SP, FIBHS(g/L), PTHS
HS_ SP APTT SP, FIB HS_(mg/dL), PT HS

4.1.9 Setup – Multi-Tests – Test Group Profiles

This area of the software allows users to define and view their own choice of Test
Groups to be run in Multi-Tests analytical sessions.

Up to 30 Multi-Tests profiles can be created (code numbers from 1 to 99).


Each profile can contain a maximum of 20 tests combinations each. The actual
maximum number of tests you will be able to add will depend on the available
reagent positions.

Selecting Multi-tests and Test Group Profiles from the Setup submenu and
then choosing New Test Group Profile opens the screen shown below.

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The window on the left side of the screen displays a list of Test Groups defined,
while the window in the middle displays the tests groups in the current Profile.
Each Profile is assigned a Profile ID (8 alphanumeric characters max.), numeric
code (profile code: 1-99), and for each there is an associated NOTE field.

The user defines the tests groups in the profile with the help of the Arrow and
the Scissors icons to add and delete the groups from the left window to the right
window. The NOTE field at the far right is open for the user to add desired
comments (free text).
The materials map is automatically created as soon as the test group is inserted
according to the default position of the Setup liquids. If the default position for a
reagent is already occupied by another reagent, the next available “like” position
is then automatically assigned. If all the positions in a homogeneous area R1 to
R4, R9 to R12 (ACL Elite Pro only), R7 to R8, A1 to A10 and R5 to R6, are filled,
the liquid cannot be placed and a message warns the user that the tests group
cannot be added to the profile

The large window in the bottom of the screen reports the information for this
profile’s Materials Map:
- Liquid ID: the name of the materials used to analyze the selected profile
- Position: the selected position (A1…A10 or R1…R12) for the specific liquid
material
Instrumentation Laboratory 4.23
Setup and Utility

- Refrigerated: a check indicates that the selected liquid material must be


kept at 15°C, positions R1 to R4, R9 to R12 (ACL Elite Pro only)
- Stirred: a check indicates that the selected liquid material must be stirred by
the magnetic stir bar (positions R1 to R4)
- Needle: indicates which needle (sample or reagent) dispenses the selected
material.
Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Profiles View
screen.
The Globe icon allows modification of the profile names in the selected
language.

The Test Group Profiles Details screen:


As mentioned above, any changes to be made to the fields shown in the Profiles
View screen are done through the Profiles Details screen, which opens by
clicking the Details button.

NOTE: Since the purpose of the New Profile and the Profiles Details screens is
very similar, they have an identical design. When the fields are completed in the
New Profile screen, it becomes a Profiles Details screen.

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Clicking the Delete icon, followed by a confirmation window Do you want to


delete the current profile? Yes allows the operator to delete the selected profile;
No will cancel the operation.
Clicking the Print icon, followed by a confirmation window Do you really want to
print the current profile? Yes prints the selected profile setup; No will cancel the
operation.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Instrumentation Laboratory 4.25


Setup and Utility

4.1.10 Setup – Multi-Tests - Sort Multi-Tests


This area of the software is used to sort the test profiles defined in the system.
Profiles, Test Groups and Test Group Profiles that are not on the sorted list will
not be visible as run modes under Analysis. The operator only needs to sort the
profiles, test groups and test group profiles they will run.

Selecting Multi-Tests – Sort Multi-Tests from the Setup submenu opens the
Sort Multi-Tests screen, shown below.

The 3-windows on the left side of the screen list Profiles, Test Groups and Test
Group Profiles. A check mark on the left side indicates that item is in the Sorted
Profile list.
The window on the right part of the screen displays all Sorted Profiles.

The Arrow and Scissors icons are used to sort profiles and groups. As the
operator selects the first entry and presses the Arrow icons, the profile/group is
copied from one position to another of the sorted profiles list in the right side
window. If a mistake is made, the Scissors icon is used to remove the profile
from the sorted list. The profile is inserted below the cursor. Profiles that are not
sorted will not be visible on the Analysis menu drop down selection.

Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Main screen.
• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.

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- Shutdown followed by a confirmation window Do you really want to


shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.
-

4.1.11 Setup – Default Multi-Tests


The Default Multi-Tests Profile selection determines the tests that may be run
and their associated material map setup when a user activates a run using the
“Runner” icon from the main database screen.

Selecting Multi-Tests from the Setup submenu, and then choosing Default
Multi-tests opens the Test Groups screen, shown below.

The box on the left lists all of the Multi-Tests Profiles and Test Group Profiles
created. Select the desired Default selection from the list and move it to the
column on the right using the Arrow. If you want to change the selected Default
Profile, use the scissor icon to remove.

To Enable the Default Multi-Tests place a check in the box. The desired tests to
run still need to be programmed on a sample even though the Default Multi-tests
are enabled.

4.1.12 Setup - LIQUIDS


This area of the software allows the user to define and view the setup for all the
liquid materials needed to run tests on the ACL Elite/Elite Pro. The system will
store 300 liquids of which 200 are reserved for IL use and 100 are available for
the operator to define.
Instrumentation Laboratory 4.27
Setup and Utility

Selecting Liquids from the Setup submenu opens the Liquid Setup screen:

A list of IL predefined liquids is already stored in the software.

This screen displays the characteristics of all the liquid materials currently
configured in the system.
- LIQUID ID: the short name of the liquid material. For Control liquids this ID
can be all numeric (1 to 10 characters). This is the control ID sent to the
Host if the analyzer is interfaced. All other liquids must be an alphanumeric
ID

- EXTENDED NAME: the complete name of the liquid material (Max. 15


alphanumeric characters)
- LOT No.: the lot number of the material

- EXPIRATION DATE: the expiration date as it is shown on the vial label. It is


possible to use the expiration date as a function of the Reagent Map
Warnings (see Reagent Map section 3.2.3).

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ACL Elite/Elite Pro Operator’s Manual

- ON BOARD STABILITY: the stability as claimed in the insert sheet. It is


possible to use the on-board stability value for the real time stability timer as
a function of the Reagent Map Warnings (see Reagent Map section 3.2.3).
Enter number followed by h for hours and d for days.
- CURRENT VOLUME: quantity of liquid (in mL) remaining in the container
depending on the specific reagent used (non-editable from this screen)
- ASSIGNED VOLUME: quantity of liquid (in mL) present in a new container
before starting the analytical session (default volume as defined on the
product label)

- WARNING VOLUME: quantity of liquid (in mL) below which the material
map position and reagent map icon colors will change from green to orange.
This field should be filled in for all reagents to be monitored.

- LIQUID TYPE: calibrator, control, reagent, solution


This screen also displays a “Used By” table showing the tests for which each
material is used. In this table, the user may also record the ISI values. For the
Calibrators, the user may enter the assigned value for the standard as reported
in the product insert sheet.
ISI and Calibration Plasma assigned values can be inserted by clicking the
Assign Value button and entering the value using either the keyboard or the
numerical keypad. The default setting for all assignments is blanked out. The
user must enter the calibrator values and ISI value prior to running the analyzer.
The calibrator value for the PT test run in the laboratory should be set to 100.
The ISI value is found on the PT reagent insert sheet and is lot specific

Note: Whenever the ISI value is modified, all the results will use the new ISI
value to calculate the INR. The ISI value entered must fall within the specified
ISI range as defined in the Liquid details for the PT reagent.

Note: The optional external barcode reader setup allows the operator to
configure the system to automatically reset the onboard stability and/or assigned
volume whenever a vial label is read. Refer to section 4.1.16 for further details.

Note: For the IL locked PT tests the ISI value entered for the primary PT test is
automatically imported into the secondary tests (i.e. extended (e) and double (d)
tests). This option is also available for custom (non-IL locked) PT tests. Refer to
section 4.2.6 for further details.

Instrumentation Laboratory 4.29


Setup and Utility

ACL Elite/Elite Pro TECHNICAL BULLETIN IMPORTANT INR NOTICE

INR FORMULA
ISI
INR = (PT Patient / PT Normal)

PT PATIENT = Patient’s PT in seconds

PT NORMAL = Mean* of the Normal Range (on the ACL Elite/Elite Pro this is called the Reference Value)

ISI value = International Sensitivity Index from the current lot # of thromboplastin reagent being used.

To assure appropriate reporting of INR results, you must follow these steps:

1. Make sure instrument is in the READY mode. From the SET UP MENU select the LIQUIDS SUBMENU,
then select the appropriate THROMBOPLASTIN REAGENT (LIQUID ID) from the list in the left upper part
of the screen.
2. Select the PT TEST that uses this Thromboplastin reagent and click on ASSIGN VALUE.
3. Enter the ISI VALUE of the Thromboplastin Lot in use and select Confirm twice to enter value. Make sure
that all PT tests using the same Thromboplastin import the proper ISI assignment. Several PT TESTS using
the same Thromboplastin may be present such as PT extended, PT duplicate standard and PT duplicate
extended acquisition time. These tests will import the value from the standard test.
NOTE: The ISI value is specific for the lot number of prothrombin time reagent being used.
4. From the SET UP MENU select TESTS VIEW/DEFINE. Select the appropriate PT test and click on details.
5. Select CALCULATION SETUP and the instrument will show in the right part of the screen the selection of
the REFERENCE VALUE. This represents the Mean of Normal Population value in SECONDS, which is
used as the DENOMINATOR in the RATIO and INR CALCULATION.
6. Make sure that the value entered in this field represents the MEAN NORMAL POPULATION RANGE of the
local PT population. This value is editable and can be modified to reflect the laboratory established mean
normal range.
7. Confirm all PT Tests using the very same thromboplastin lot for Ratio/INR will be calculated using the same
value in seconds as the denominator (Mean Normal Population Range).
8. The instrument uses the following formula for RATIO CALCULATION.

RATIO CALCULATION = PATIENT PLASMA (seconds)


REFERENCE VALUE (seconds)

Reference Value means MEAN OF NORMAL POPULATION (seconds).


MEAN OF THE NORMAL POPULATION RANGE = Mean Normal PT Time = Mean of Patient Normal
Range in seconds as recommended in the CLSI Document C28-A, Vol. 15, No.4.
9. The INR will then be calculated as follows:
ISI
INR = (PT Patient/PT of Reference Value)

Using the Reference Value feature the denominator used in the Ratio and INR calculation will
accurately reflect the Mean of Normal Population Range.
*or Geometric mean
IMPORTANT WARNINGS:
• If the INR calculation is not properly setup, then erroneous patient results may be reported.
• If the product lot number changes, then the new ISI value from the package insert must be entered.
• In the ACL Elite/Elite Pro both screen and printout show/report Ratio and INR units separately

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ACL Elite/Elite Pro Operator’s Manual

Note: Whenever the Calibration Plasma target values are modified, the stored
calibrations for the tests are automatically updated and all future results will be
calculated according to the new assigned value.
A “Notes” field is available for the user to enter comments (free text).

Clicking the Details icon opens the Liquid Details screen that provides further
details about the selected material (refer to specific details below).
Clicking the New Liquid button opens the New Liquid screen for the user to
enter the characteristics of a new material (refer to specific details below).
Clicking the Confirm button saves the changes made and clicking the Cancel
button rejects the changes.
Clicking the Print icon and confirming the selection the liquid report is printed.
Clicking the Show Enabled checkbox, the list of liquids on the left will be
reduced to only display the liquids used by the enabled tests.
If the Show Enabled box is checked, QC liquids will not be visible on the list. To
view the QC liquids remove the check in the box.
A warning window opens after a change is made in any field: Liquid parameters
have been changed. Do you want to save them before proceeding? The operator
must select Cancel, Yes or No.
o Cancel: The window is closed; the new value entered is
displayed, but not yet saved.
o Yes: The window is closed and the changes are saved
o No: The window is closed, the changes entered are deleted
and the previous saved value is displayed

• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Instrumentation Laboratory 4.31


Setup and Utility

Liquid Details screen:


Clicking the Details button in the Liquid Setup screen opens the Liquid Details
screen. This allows access to further information about a selected liquid material:

The information in this screen can be viewed but not edited. The only exception
is the Default Position for the IL liquids only. The information provided in this
screen is:
- Liquid ID (maximum 10 alphanumeric character ID)
- Liquid Code (valid numbers for user defined liquid is 501 – 999)
- LIQUID TYPE (calibrator, control, reagent, solution)
- EXTENDED NAME (maximum 15 alphanumeric character name)
- DEFAULT POSITION (Must coincide with following 3 selections)
- ACCESSING NEEDLE
- Sample: Valid for positions A1 – A10 and R 7, 8
- Reagent: Valid for positions R1 – R6 and R9 – R12
- REFRIGERATED (checkbox)- Liquid must use Reagent needle and be
placed in R1-R4 or R9-R12 (ACL Elite Pro only)
- STIRRED (checkbox) – Liquid must use Reagent needle and be placed in
Positions R1- R4
- ISI Minimum and Maximum acceptable values for a Reagent
- IL LIQUID (available for IL use only)
Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes.
• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.
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ACL Elite/Elite Pro Operator’s Manual

New Liquid screen


Clicking the New Liquid button in the Liquid Setup screen opens the New Liquid
screen. This is the screen where the operator enters all information pertaining to
a new liquid material to be used on the ACL system, which will be displayed in
other screens.

The following fields are “open” for the operator to enter the desired alphanumeric
digits (fields with the * are mandatory):

- LIQUID ID*: the abbreviated name of the material (10 characters). For
Control liquids only, this ID can be all numeric.
- EXTENDED NAME*: the complete name of the material (15 alphanumeric
characters)
- LIQUID CODE*: the numeric code of the material (IL codes are reserved
from 1 to 500; user codes are from 501 to 999)
- LOT No.: the lot number of the material (8 characters).
- EXPIRATION DATE: the expiration date as it is shown on the vial label. The
system will monitor this date and alert the operator in the session error
history screen when the liquid date has expired.
- ASSIGNED VOLUME*: quantity of liquid (in mL) present in a new container
before starting the analytical session (default volume as declared on the
product label)

Instrumentation Laboratory 4.33


Setup and Utility

- WARNING VOLUME: quantity of liquid (mL) below which the material map
position and the reagent map icon colors will be changed from green to
orange This field should be filled in for all reagents to be monitored.
- ON BOARD STABILITY: the stability as it is claimed in the insert sheet.
Time can be entered using the following abbreviations: h=hours and d=days
(i.e. 24h or 1d).
- ISI Value Minimum: If this liquid is defined as a Reagent the minimum
acceptable ISI value for the reagent can be entered.
- ISI Value Maximum: If this liquid is defined as a Reagent the maximum
acceptable ISI value for the reagent can be entered

In the following fields the operator must make a choice among the given options:
- ACCESSING NEEDLE*: Sample, (external needle) can only aspirate from
A1 to A10 and R7 and R8. The Reagent,(internal needle) can only aspirate
from R1 to R6 and from R9 to R12 (ACL Elite Pro only)
- DEFAULT POSITION*: A1 to A10 or R1 to R8 or (R9 to R12 on the ACL
Elite Pro only). Default position can be modified also for IL liquids,
maintaining liquid requirement characteristics (refrigeration, stirring, needle,
etc.)
- LIQUID TYPE*: Calibrator, Reagent, Control, or Solution
In the following two areas the operator must “check” the checkbox if the liquid
requires the feature onboard (check = YES):
- REFRIGERATED (must use Reagent needle and positions R1 - R4 and R9
– R12)
- MIXED (must use Reagent needle and positions R1 – R4)
- IL LIQUID (dimmed)
Since only the first four positions of the Reagent Area (R1…R4) can be
refrigerated and mixed (on the ACL Elite Pro additional refrigerated only positions
are located in the area from R9 to R12), a warning window appears if the
operator tries to define an improper setup (i.e. a liquid is placed in position R5
and the operator checks the “Refrigerated” check box).

The warning reads:


“Invalid Liquid Setup. The specific liquid setup is invalid and cannot be stored.
Please correct setup before saving “

If the liquid material is an “IL predefined liquid”, another checkbox is


automatically checked; this checkbox cannot be edited, meaning that a “User
Liquid” cannot be identified as an “IL Liquid”.

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Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Liquid Setup
screen.
Clicking the Globe icon allows the user to modify the liquid ID and name in the
selected language.

• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Instrumentation Laboratory 4.35


Setup and Utility

4.1.13 Setup - INTERFACES - Host


This area of the software allows the user to define some characteristics of the
communication between the ACL Elite/Elite Pro and the Host Computer to which
it is interfaced.
Selecting Interfaces from the Setup submenu and selecting Host opens the
Host Setup screen shown below.

Two fields in this screen allow the operator to define:


- BAUD RATE – Choices are: 2400, 4800, 9600, 19200 or 38400.
- AUTOMATIC DATA TRANSMISSION (TX) – Choices are: “Not Required”,
“Patient Samples” or “QC, AR and Patient Samples”.”
Selecting automatic data transmission, the transmission of results is done at the
end of each test run during the analytical session.
Other buttons in the screen are “checked” by the operator if the feature is desired
(check = YES):
- HOST QUERY
- DELETE AUTOMATICALLY AFTER TRANSMISSION (TX)
Selecting automatic deletion will not allow for re-transmission of results at a
later time.
- UNIQUE INSTRUMENT ID (a digit between 1 and 99 can be defined)

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Tests downloaded from the LIS that are disabled in the analyzer will not be
displayed on the database.
Clicking the Confirm button saves the changes and clicking the Cancel button
reject the changes; in both cases the system goes back to the Main screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close will open or close the rotor holder cover.
- Database View will display the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes will close the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

For additional information on the host communication refer to Appendix A (Host


Communication Protocol) located at the end of this manual. Refer to section 2.5
for details on the cable pin configuration.

Instrumentation Laboratory 4.37


Setup and Utility

4.1.14 Setup - INTERFACES - Printer


This area of the software allows the user to configure the ACL Elite/Elite Pro
optional external printer.
Selecting Interfaces from the Setup submenu and selecting Printer opens the
Printer Setup screen:

On the top part of the screen, the operator defines:

- PRINTED SAMPLES: Any tests just analyzed (regardless of sample status)


or just the Completed (sample status is complete)
- REPORT TYPE: Cumulative(multiple samples per page) or Sample Report
(Single Sample per page)
- PRINTER PROTOCOL: ESC/P2 (for Epson-like printers) or HP-PCL (for
HP-like printers)

- PAPER DIMENSION: A4 (210 x 297 mm.) or Letter (216 x 280 mm./ 8½ x


11 inches)
- PAPER FORMAT: Single sheet or Continuous sheet

A check in the Automatic Print-Out box indicates that this feature is desired.
Automatic Printout occurs at the end of each run within a rotor according to the
selected criteria (any analyzed, completed; cumulative or sample report).

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The user defines the SAMPLE REPORT DATA area by pressing the
Enable/Disable button. Choices are: the Instrument Name, the Normal Ranges
and the Date/Time.
Clicking the Customize Header button allows further customization of the report
by providing 5 lines of 30 characters each of free text to the user as entered in
the Custom Header screen.
On both screens - Printer Setup and Custom Header Setup, clicking the Confirm
button saves the changes and clicking the Cancel button rejects the changes; in
both cases the system goes back to the Printer Setup screen.
• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Note: The ACL Elite/Elite Pro support the use of a Parallel or USB connection
for the external printer. If the USB connection is used the printer must be
connected and turned on prior to the system being booted up. If the printer is
turned off while the instrument is on, the analyzer must be rebooted in order for
printing to occur.

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Setup and Utility

4.1.15 Setup - INTERFACES – Internal Barcode


This area of the software allows the user to configure the internal barcode reader
used for sample identification on the ACL Elite/Elite Pro system.
Selecting Interfaces from the Setup submenu and selecting Barcode opens the
Barcode Setup screen:
The first step is to activate the Internal Barcode Reader by checking the
checkbox Internal BCR enabled seen on top of the screen.
The four fields visible on the screen correspond to the four families of barcodes
that may be activated on the ACL along with their corresponding subtypes of
barcodes.
For each field, the user must choose one of the options according to the
laboratory’s needs, as shown below.

CODABAR: Disabled
No Checksum
AIM Mod 16
NW7 Mod 11
NW7 Mod 16

CODE 39: Disabled


No Checksum
Mod 43

INTERLEAVED 2 OF 5: Disabled
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ACL Elite/Elite Pro Operator’s Manual

No Checksum
USS Mod 10
OPCC Mod 10

CODE 128: Disabled


No Checksum

Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Main screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

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Setup and Utility

4.1.16 Setup - INTERFACES –External Barcode (optional)

The external barcode reader is an option that allows the reagent vial barcodes to
be read when the material map is displayed. Click on the External BCR
Enabled button to enable the feature.

The Code 128 dropdown box provides two selections: Disabled, No Checksum

Reset Reagent Volume when Scanned: Checking this box will


automatically reset the reagent volume on the map to the default
volume defined for the liquid.

Reset Timer when Scanned: Checking this box will automatically


Set the onboard stability timer to the default value defined for the liquid.
If the pause timer is checked for a reagent, when the vial label is read it will
uncheck the pause button. If the vial is read a second time, at this point the timer
and volume will be reset

Onboard stabilities and default liquid volumes must be defined for the two options
listed above to be functional.

When the material map is displayed the external barcode reader is active.
The external barcode reader can be used to read the label on the reagents.
The position to place the vial onboard the system will blink. If the lot number
Expiration date are invalid a warning message will be displayed.

Notes:
- The barcode device has been tested in accordance with EN60825-1 LED
safety, and has been certified to be under the limits of a Class 1 LED
device.
- The scanner’s housing is not water-tight, therefore do not submerge the
scanner in water. The scanner housing and window should be cleaned with
a soft cloth or facial tissue dampened with water or a mild water based
detergent. Do not clean the scanner or window with alcohol or solvents.

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4.1.17 Setup - INTERFACES - Keyboard


This area of the software allows the user to configure the ACL Elite/Elite Pro
standard keyboard for the language used in the laboratory and to decide on the
use of the on-screen pop-up numerical keypad.
Selecting Interfaces from the Setup submenu, and selecting Keyboard opens
the Keyboard Setup screen.
The window in this screen selects:
- KEYBOARD TYPE:
English (UK), French, German, Italian, Spanish or USA (English).
- NUMERICAL KEYPAD
Disabled, All numerical fields, or All numerical fields and Sample ID

Clicking the Confirm button saves the changes and clicking the Cancel button
reject the changes; in both cases the system goes back to the Keyboard Setup
screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

4.1.18 Setup - INTERFACES - Network


Not supported in this Software Revision.

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Setup and Utility

4.1.19 Setup - INTERFACES - Modem


Not supported in this Software Revision.

4.1.20 Setup - SYSTEM CONFIGURATION


This area of the software allows the user to configure some of the system
features of the ACL Elite/Elite Pro.

Selecting System Configuration from the Setup submenu opens the System
Configuration screen:

This screen allows the user to select the preferred options for the following:
PATIENT DATABASE LISTING: defines the order of the patient samples in the
database; 4 options are available.
1. Last sample entered is at the top
2. Last entered is at the end

3. Sample ID order Ascending


4. Sample ID order Descending
Options 1 and 2 are based upon date/time of sample entry and options 3 and 4
are based upon the Sample ID alphanumeric sort.
QC/AR DATABASE LISTING: defines the order of the QC materials in the
database: last material entered is at the top or last entered is at the end.

REFLEX STATUS: if rules are defined in the Setup/Tests/Reflex Tests, three


options are available: Program Reflex only, Execute reflex before closing
session, Disabled. For additional information please refer to section 4.1.7.

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s Program Reflex only: add the tests to the sample ID but do not execute the
analysis. Test will remain pending until executed in a subsequent session.
s Execute reflex before closing session: program tests and execute them
during the current session provided the tests are defined within the current
profile session in use.
s Disabled: turn off ALL reflex programming and testing.
CURRENT LANGUAGE: English, French, German, Italian, Spanish or Japanese
(Kanji). Reboot the analyzer after changing the language setup. Entries in the
logbook, File Error and Session Error history are not updated for entries prior to
the language change date and time.

DEFAULT SCREEN: When the system boots up you can select from the
following two screens as the initial screen: Database View or Multi-Tests Pre-
Analysis (pre-analysis of last multi-test session is displayed).

LIQUID SENSOR checkbox: enable/disable the use of the sample and reagent
probe liquid level sensor.
Wash-R emulsion sensor checkbox: enable/disable the use of this sensor.

Warning: If Liquid Sensors and Wash-R Sensor are disabled both a warning
message and a flag on all sample results will be presented. If the Liquid Sensor
is disabled the operator must carefully monitor the volume of liquids and samples
to ensure adequate amounts are present for testing. The automatic host
transmission of results is disabled when the sensors are disabled. At the end of
each session a pop up box will alert the operator to confirm sufficient
sample/reagent remains onboard the analyzer. After confirmation of the
volumes, the operator may initiate a manual upload of the results to the host.
When the sensor is re-enabled the host communication will automatically be re-
activated.
REM Enabled: enable/disable the use of the Rotor Exchange Module. Not
applicable for the ACL Elite. When the REM is disabled the
operator can use the system by manually loading the rotors.
Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Main screen.
• ACTIVE BUTTONS at the bottom of this screen are:

- Open/Close opens or closes the rotor holder cover.


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

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Setup and Utility

4.1.21 Setup – SECURITY

This area of the software allows the Laboratory Manager to configure the
privilege level for the users (Supervisor or Operator) and define IDs and
passwords for all personnel using the ACL Elite/Elite Pro system.
Up to 99 users can be defined in the Security area.

The first operation to be performed by the Laboratory Manager is the definition of


the level of entry for the other two user groups.

The Laboratory Manager, using their password, will have access to the Lab
Manager View button.
Note: It is advisable upon installation of the system to enter a new Lab Manager
ID and password.
Clicking on the Lab Manager View button a screen where both Supervisor and
Operator access definition will appear.

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In this screen, for each menu/submenu, the level of entry can be defined by the
Laboratory Manager according to the specific laboratory needs.
LEVEL: From the drop down menu select the level to define: Supervisor, or
Operator
Note: The Lab Manager must define the screen access levels at both the
Supervisor and Operator. Defining no access at the supervisor level for a
submenu does not automatically exclude access at the operator level.

For each menu/submenu the Laboratory Manager has three basic options:
s No Access
s Access, View* only

s Access, Edit*
*The V and E listed under the Environment column stand for View and Edit
No Access means that it will not be possible to enter in a menu or submenu; the
option will be dimmed.
Access-View Only means that access is possible. The screens can be viewed
but no modification can be performed.
Access-Edit means that the access is possible and Edit capability is available
(depending on the type of screen).

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Setup and Utility

Selecting the Details icon after choosing the menu/submenu the above screen
will appear.
In the Access Mode box the Laboratory Manager can define the Access/No
Access for the specific menu/submenu.
If the Access option is chosen the Laboratory Manager can then define either
View Only or Edit capability for the selected menu/submenu.

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When a new user has to be entered in the system the New User button has to be
chosen from the main Security entry screen.

The next screen will appear.

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Setup and Utility

In this screen the following information needs to be entered.


USER NAME: type the user name (it must be unique). It is advisable to keep the
name short (minimum 3 and maximum 15 characters) as it will be used to log in
to the system.

EXTENDED USER NAME: type the extended user name to differentiate between
users. (Maximum 20 characters)
LEVEL: the Laboratory Manager will define for each user the entry level:

s Lab Manager
s Supervisor
s Operator
PASSWORD: the new user will enter his password.
CONFIRM PASSWORD: re-enter the same password for confirmation.
Password has to be minimum 3 and maximum of 9 characters.

When logging onto the system User Name and Password will be required.

It is recommended that when the system is not in use to log-out (using the key
icon) requiring the next user to log-in.
When using the Security/Password system, all-important operations are logged
into the Logbook (see section 5 Diagnostic).

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4.1.22 Setup – Audible Alarms


The audible alarms setup screen allows for labs to enable/disable the alarm
sounding for various system conditions.

Selecting Audible Alarms from the Setup menu opens the following screen:

3 Alarm sounds are pre-set by the Analyzer, referred to as: A, B, C.


The audible alarms can be enabled/disabled for the following conditions:

- END OF ANALYTICAL SESSION (Alarm A)


- HOLD STATUS (Alarm B): This condition occurs during a stat interrupt
when the current test in process is complete
- FAILURE STATUS (Alarm C): System error condition encountered
- INSUFFICIENT REAGENT (Alarm B): Reagent Shortage during the
analytical session
- INSUFFICIENT WASH-REFERENCE EMULSION (Alarm B): Wash-
Reference bottle is empty
- QC OUTSIDE SD RANGE (Alarm B): Alert when a QC failure occurs on the
system
- MISSING MATERIAL/CALIBRATION BEFORE ANALYSIS STARTS (Alarm
B): Missing material observed during pre-analytical check
- MISSING MATERIAL/MISSING SAMPLES (Alarm B): Missing material or
samples observed during pre-analytical check
- ROTOR RE-USE (Alarm B): Physical cuvette map for the rotor does not
match the logical map, operator must enter/confirm cuvette positions

Move the cursor to the desired Audible Alarm Condition and press the DeSelect
button to enable/disable the alarm for this condition.

If the alarm is enabled it will sound at a 60 second interval for up to one hour.

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Setup and Utility

4.1.23 Setup - DATE/TIME


This area of the software allows the user to configure the format of the Date and
to set the current Date and Time for use on all appropriate screens and printouts
of the ACL Elite/Elite Pro system.
Selecting Date/Time from the Setup submenu opens the Date and Time screen:

DATE FORMAT: in this field the user chooses among the following options:

dd.mm.yyyy (European style)


yyyy.mm.dd (Japanese style)
mm.dd.yyyy (US style)

In order to set date and time, two numeric fields are available.
Clicking the Confirm button saves the changes and clicking the Cancel button
reject the changes.
ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close will open or close the rotor holder cover.
- Database View will display the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes will close the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

Warning: Changing date to a prior date may impact the result (Patient, QC,
Calibration & AR) database FIFO operation. Results processed on dates furthest
from the current system date will be the first ones to be automatically deleted.

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4.1.24 Setup - UNITS


This area of the software allows the user to configure the units used for
temperature on the ACL Elite/Elite Pro system.
Selecting Units from the Setup submenu opens the Units screen:

The TEMPERATURE UNIT field has the following options: °C or °F.


Clicking the Confirm button saves the changes and clicking the Cancel button
rejects the changes; in both cases the system goes back to the Main Screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close will open or close the rotor holder cover.
- Database View will display the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes will close the session, allowing the operator to log out
and/or turn the system off; No will cancel the operation.

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Setup and Utility

4.2 Setup - TESTS - Define


This area of the software is used to view and define tests.

Warning: After defining a new or copied test, the test settings should be printed
and verified to confirm correct entry. IL assumes no responsibility for the
performance of non-IL locked tests on the analyzer. Each laboratory must verify
and confirm the validity and results of the user defined tests definitions.
Selecting Tests from the Setup submenu and then choosing View/Define opens
the View Tests screen:

On top of the test list a rectangular box will show the number of tests present in
the Library Application. The box will show two numbers: the enabled tests and
the total number of tests.
The large window on the left of the screen displays a table of all configured tests.
Each test is identified by an abbreviated name, Test ID, shown on the right side
column. Both columns to the left of the test names contain checks to indicate
whether each test is:

- currently Enabled and ready to be run on the ACL


- an IL pre-defined Locked test.

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ACL Elite/Elite Pro Operator’s Manual

Warning: IL pre-defined tests were developed and tested specifically for


use with HemosIL reagents and IL supported supplies for use
on the ACL™ Elite/Elite Pro.
The proper performance of other reagents and supplies has not
been fully tested or verified, and the use of them may cause
clinically significant degradation of performance and results.
IL does not assume any obligation or warranty engagement
concerning precision and/or accuracy of the measurements or
for any damage to the instrument directly or indirectly resulting
from the use of reagents, consumables (new or washed), and
expendable supplies other than those sold by IL.
All responsibility for parameter development and validation
of new or copied tests belongs to the user alone.

The right side of the screen contains the following fields:


TEST CODE
TEST REVISION
TEST CODE FOR HOST
EXTENDED NAME
CALIBRATION MODE

The information shown in these fields can be viewed but not edited from this
screen. Several buttons are found around these fields:
Clicking the Details icon opens the Test Details screen which allows editing of
the fields (refer to the specific section below).
Clicking the Printer icon followed by a confirmation window “Do you really want
to print?” Yes allows the operator the choice to print the Test Setup of the
selected test; No will cancel the operation.
Clicking the Enable/Disable button followed by a confirmation window Yes/No,
erases all information related to the selected test from the Patient Database and
the QC Database. If the test is disabled, clicking the Enable/Disable button will
enable it.
The test database can contain up to 300 tests; 200 reserved for IL applications
and 100 reserved for customized applications; up to 100 tests can be enabled
(active) at the same time.

Instrumentation Laboratory 4.55


Setup and Utility

Clicking the Show Enabled check box allows the operator to view only the
enabled tests from the test table. When this checkbox is marked the list
presented is relative to the enabled tests. This information is saved exiting from
this screen and also at power off.
Clicking Delete erases only the open tests (customized); IL predefined tests
cannot be deleted.

4.2.1 COPY TEST


Clicking the Copy Test button opens the Copy Test screen.

The upper field indicates the “Test to be Copied” ; the list contains all the tests
present in the test database.
The NEW TEST ID field allows the operator to name the new test (8 characters
maximum). This is a mandatory field.

The EXTENDED NAME field allows the operator to name the new test with a
more detailed name (15 characters maximum).

The TEST CODE FOR HOST represents the numeric code for the Host
communication (four characters maximum).
The TEST CODE is a unique numeric field (four characters maximum). This is a
mandatory field. The acceptable test code range for Non-IL locked tests is
between 501 and 999..

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The TEST REVISION helps the operator to keep track of the changes in the
application. The number must be keyed in manually (4 characters maximum).
The Confirm/Cancel button saves or rejects the changes and the system returns
to the View Test screen.

4.2.2 Setup – TESTS DETAILS

The Test Details screen is shown below. For new tests the fields will be blank,
while those for copied tests will contain the settings from the original test that was
copied.

In the new test details the following information is accessible.


• TEST ID – 8 characters
This field is editable for all tests including the IL predefined
tests. The TEST ID must be unique for each test. The TEST
ID is used for ordering tests as well as reviewing results
(i.e. TEST ID column).
The TEST ID is printed in the cumulative report.
At least one alpha-numeric character is mandatory.
• TEST CODE - 3 characters
This field is editable in an open test but not in the IL locked tests.
Available numbers for the open assays are from 501 to 999

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Setup and Utility

• EXTENDED TEST NAME - 15 characters


This field is editable in the IL and open test.
This field is printed in the sample report.
At least one alpha-numeric character is mandatory.

• TEST CODE FOR HOST - 4 characters (editable)


This field is editable for all tests.
This field represents the Code for Host transmission.
• TEST REVISION - 4 characters
This field is editable in an open test.
Format is from 0.00 to 99.99.
• CALIBRATION MODE - One of the following options may be selected:
- None: No calibration is needed for this test.
- One Time per Session: This test does not have a dedicated
calibration cycle; the calibration is performed with the
analytical session and can be stored and used for further
analysis.
- Each Rotor: This test does not have a dedicated calibration
cycle; the calibration is performed for each analytical session
within the rotor. The previous calibration can be reviewed but
cannot be used for further analysis.
- Dedicated: This test has a dedicated calibration cycle and
that this calibration can be stored.
• IMPORT CALIBRATION – One of the following options may be selected:
- None: No calibration import is needed for this test
- Test List dropdown: If it is necessary to import a calibration,
choose the test from the displayed test list. Only the tests
enabled with a calibration defined will appear.
• IMPORT RAW DATA FROM - The following options may be selected:
- None: This test does not import raw data from any other
test.
- Test List dropdown: if it is necessary to import the raw data,
choose the test from the displayed test list. All tests are
displayed.

Select Ranges from the test setup screen to modify the unit reporting option, the
ranges for the selected unit and the scale of the Y-axis of the reaction curves.
Note: When defining a new test the Ranges should be entered after all of the
subsections (Analysis, Calibration, Acquisition and Calculation) of the test setup
are defined

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The Range and Units table contains the following information.

§ Show in sample list If the unit has been checked (Yes), the unit is displayed
in the patient database and printed.
Note: This setting has no impact on transmission of results to a Host system.
All units for a test are always transmitted regardless of the setting in this
checkbox.

§ Correction parameters If any correction factor is applied to a specific unit, an


asterisk will appear.

§ Result Unit Units that are available in the selected test (from 1 to 4).

§ Normal Range Defines the normal range for each unit. Minimum and
Maximum values can be typed in. The normal range is
used to flag patient results. On the screen, the results are
displayed in black when within the Normal Range; the
results are displayed in violet when outside the Normal
Range; on the printout an asterisk will be printed (close to
the results out of normal range).
§ Test Range Defines the test range for each unit (i.e. Linearity Range).
Minimum and Maximum values cannot be edited in IL test
applications but can be edited in the customized
applications. The test range is used to flag patient results.
Values outside the Test Range are displayed in red; on
the printout these results will be in bold print.
Instrumentation Laboratory 4.59
Setup and Utility

§ Scale Range Numerical reporting range for the test. Numerical values
outside the scale range high are presented as asterisks
(***), and values outside the range low are presented as
dashes (---). Minimum and Maximum values cannot be
edited in the IL test applications but can be edited in the
customized applications.
§ Reaction Curve Graph Defines the Y-axis of the reaction curve (minimum and
maximum values). If fields are left blank, the system will
auto-scale based on the raw data obtained.

The Reference Value is entered in the Calculation Setup section.


The value is used for R (Ratio) and INR calculation for the tests.
This value is the denominator of the R and INR calculation and it should
represent the mean normal population time for the selected test.

The reference value for the standard test can be automatically imported into the
secondary related tests. For example, the PT (standard test) reference value
will be automatically imported into the Pte, PTd and Pted (secondary) tests. The
automatic import is built into the IL locked tests. For non-IL locked tests this
feature can be used if the tests are setup to do so. Refer to the Calculation
Setup section for more details

Clicking on the Unit Correction button it is possible to correct result units based
on a mathematical equation.
The calculated units for the tests can be corrected on this screen (i.e. %, R, INR,
g/L, mg/dL, U/mL, etc.), while the primary units (i.e. seconds, delta, absorbance,
etc.) can be corrected in the Calculation Section 4.2.6. Test results for IL locked
tests that have correction parameters entered for the primary (measured) unit will
display “Lab correlation applied” in the warning list box when the clot curve is
displayed.
Up to 3 intervals of corrections based on the result range can be activated.
The correction is represented by the following formula:

Y = mX + q
where “m” represents the slope and “q” the intercept on the Y axis.
X is the original result and Y is the corrected results.

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Minimum and Maximum Interval values represent the range of unit where the
correction is expected to be active. The values for these fields should be positive
numbers within the test range for the selected test.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
Correction Parameters (when not defined by IL in the IL Locked Test
Applications) definition used are the responsibility of the laboratory personnel.

Warning: Modification of the correction parameters for calculated units on the IL


Locked Tests (i.e. D-Dimer High) is not recommended. A message box will
display to alert the user if they attempt to change the settings.

The recommended sequence of operations when a new test is created is the


following.
1. Analysis: Loading setup

2. Calibration: Loading setup


3. Acquisition setup
4. Calculation setup

5. Ranges setup

Warning: When a new application is defined please consider that major changes
to the Analysis step setup (i.e. adding or removing steps), the
Calibration step setup (i.e. adding or removing calibration points) and
the Acquisition setup (i.e. change in acquisition time) will erase all the
Calculation setup conditions. This is done to prevent conditions of
possible test inconsistencies. For this reason it is important to ensure

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Setup and Utility

the Analysis loading, Calibration Loading and Acquisition Setup is


correct before defining the Calculation Setup.
It is advisable before any change is done to an open test either new or copied, to
print the parameters in order to have a reference to use when re-entry of
calculation setup is needed.
When a new application is defined please consider that minor changes to the
Analysis step setup (i.e. change of a liquid name or volume in an existing step)
and the Calibration step setup (i.e. change of a liquid name or volume in an
existing step) will not erase the Calculation setup conditions.

4.2.3 Analysis – Loading Setup


Analysis: Loading Setup screen flow

TEST
DETAILS

CLEANING

ANALYSIS:
LOADING
SETUP
REAGENT
PRIMING

STEP SETUP
(single step)

MATERIAL
CHECK

PARAMETERS PARAMETERS
Sample line Reagent Line

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Clicking the Analysis: Loading Setup button allows the user to view/edit the
reagents and sample setup in the trays during analysis.

This screen is used to define all the steps needed to carry out the analysis.
Test ID: in this field the test ID previously defined is displayed. This field is
present in all screens of the test setup.
EMPTY CUPS ON OUTER RING STARTING FROM POSITION NUMBER: this
field is used only when it is necessary to place an empty (0.5mL) cup on the
sample tray for pre-dilution purposes.

CALIBRATION POINTS REPLICATES: view field only; defined in calibration


setup.
Double Samples checkbox: check this box to run tests in duplicate mode.
Checking of the mean value is enabled under Calculation Setup
Step: this is the order of the execution of the analysis step by step.
Add button: this button is used to define in detail all the steps of the analysis. A
single step is the action of aspirating/dispensing liquids. A step can be carried out
by the sample needle the reagent needle or by both needles. The final result of a
step is the completion of a scope.

Instrumentation Laboratory 4.63


Setup and Utility

Several scopes can be selected:


- Optical Reference (Wash-R Emulsion) to be used with both 660 nm and
405 nm channel definitions.
- Reference (in Absorbance tests) to be used with 405 nm channel definition
only.
- Sample
- Sample a (activated sample as in APCR-V test)
- Sample 1, 2, 3 (For use with factor parallelism)
- Analytical Reference
- Analytical Reference a (activated analytical reference as in APCR-V test)

The Arrow/Scissors icons add or delete a possible scope.

List of “possible scope” presented in this screen is only an example; real


selections of possible scopes are indicated in the text above.

Once the scope is defined, it is necessary to define which needle will be used to
aspirate/dispense the liquids.

The parameters button for entering the Sample or Reagent line opens the Step
Setup Parameters window.

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ACL Elite/Elite Pro Operator’s Manual

The Loading parameters for the Sample and Reagent needle can be defined as
No Loading, No Dilution, In Line Dilution or In Cup Dilution.
Notes: a head volume of 10 microliters is always automatically added to each
total step condition both on the sample line as well as on the reagent line for all
three conditions: No Dilution, In Line Dilution and In Cup Dilution. All liquid
volumes should be entered as microliter volumes. Wash cycle aspiration is 130
ul of Wash-R per cycle.

No Loading: This line does not aspirate/dispense any liquid in this step.
No Dilution: The liquid is aspirated and dispensed as it is without any dilution.
The following fields must be entered.

• Liquid ID: choose from the liquid list


• Volume: enter the volumes in microliters (minimum 10; maximum = 140)

In Line Dilution: A diluent and the sample are aspirated one after the other and
dispensed together. The following fields must be entered.
• Diluent Liquid ID: choose the diluent liquid from the list

• Diluted Liquid ID: choose the liquid to be diluted from the list
• Volume: enter the volumes for each liquid in microliters (minimum single
liquid=2; maximum total volume is 140).

In Cup Dilution (Sample needle only): Diluent and sample are dispensed in an
empty (0.5mL) cup when a very high dilution is needed.

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The In Cup Dilution option is not available for the reagent needle as this needle
cannot aspirate/dispense in the sample tray area.
• Pre-dispensed Liquid ID: choose the diluent from the liquid list*
• Diluent Liquid ID: choose the diluent from the liquid list*

• Diluted Liquid ID: choose the liquid to be diluted from the list (i.e. plasma)
• Volume: enter the volumes in microliters (minimum single liquid=2;
minimum total cup volume=150; maximum total cup volume is 250).

The Washing field must be entered if a wash cycle is needed after each cup
dilution is completed. The value refers to the number of cycles and the range is
1-5.

The position of the empty (0.5mL) cup in the sample tray is defined by checking
the Inner Ring (A1- A10) or Outer Ring checkbox.
*When a highly diluted sample is required, the diluent must be added in two
phases. The diluent used in the first phase is called "pre-dispensed liquid". The
diluent used in the second phase, together with the sample, is called "diluent
liquid".
Warning: when a low volume sample needs to be dispensed, it is advisable to
use the In Line Dilution option or the In Cup Dilution option. It is not
recommended to dispense a low sample (below 10 microliters) alone
without any diluent/buffer.
Intermediate Rinse checkbox: if checked, the needle is dipped in the
waste/rinse reservoir to wash the exterior of the probe. This action is
recommended when low volumes are used.
Wash R. checkbox: if checked, the needles are washed in the rinse before
starting the next step. Must be activated to run washing between loading.
Washing between loading: defines how many rinse cycles are performed
between any sample line loading or between any reagent line loading. The
minimum is 0 and the maximum is 5.
Washing at step completion: defines how many rinse cycles are performed at
the end of loading phase for both sample line or reagent line for this step. The
minimum is 0 and the maximum is 5.
Timing constraint: some steps can be more critical on timing than others. For
these it is necessary to define a time interval that must be honored in the defined
step(s).
None: The following step is executed immediately after the completion of
the present liquid dispensation.

Step length: It is possible to define the time interval within which a single
step must be completed. The loading time is included in the total step
length. The system will wait for the remainder of the step length time if
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loading is complete before the time limit elapses. Mixing will occur after
the step length time expires.
Delay at Completion: After loading of the liquids in the step, a fixed
delay is added; loading time is not included within the Delay at
Completion time. No mixing occurs before starting the delay timer.
Step length and Delay at Completion are always applied to a single
step definition only
Set timer: At the end of the loading phase of the defined step, a TIMER
is set for a certain amount of seconds; this timer will be used across the
next loading step(s) (i.e.: the Cephalin step incubation time in the APTT
test has to wait for the step of the Calcium Chloride). Subsequent steps,
up to a Wait timer step, are executed immediately, only the timer is set.
Wait until timer is expired: The loading step is executed after the time
of a previously SET TIMER step expires (i.e.: the CaCl2 step in the APTT
test has to close the timer previously opened).
Note: Set Timer and Wait until timer is expired are used when a timer
spans across several steps (minimum of two). In this case the time will go
across multiple steps. When Set Timer is defined in one step, a
subsequent step must have a Wait until timer is expired condition in
order to close the timer opened previously. Both conditions of Set Timer
and Wait until timer is expired have to be used in one application
definition.

Time in seconds for the timing constraint field can be defined from 1 to 999
seconds (0 means disabled).

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Setup and Utility

Mixing area: In the current step, if it is necessary to mix the contents of the rotor
cuvette, the ramp checkbox must be checked.
The following fields must be filled in.
Centrifugation Time: rotor may spin from 1 second to 999 seconds. If the value
0 is input, the rotor will not spin.
Inter-ramp Interval: if the rotor is stopped after the first acceleration, this interval
must be defined. The minimum is 1 second and the maximum is 10 seconds. If 0
is input, no inter-ramp will occur.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
As soon as one step is entered, the details button becomes active and it can be
pressed to review and edit the fields.

The Delete icon can be used to delete a step in the analysis sequence.

§ CLEANING

From the Analysis: Loading Setup Screen, press the Cleaning button to display
the cleaning setup screen.

This screen is used to define the liquid and its volume used for cleaning the
reagent line and the sample line.
When the cleaning procedure is defined, it is carried out after the last step of the
test cycle.

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Liquids can be defined as Diluent Liquid ID and/or Diluted Liquid ID which


means that it is possible to use a single solution or to dilute the solution with
another liquid.
The total volume has to be within 10-140 microliters, independent from Diluent
Liquid only, Diluted Liquid only, both Diluent and Diluted Liquids.
Cycles no.: this is the number of the cycles (minimum 1 – maximum 5). If 0 is
entered no cleaning is performed.
Perform Sequentially: if checked, one line (sample needle line) is cleaned
before the other line (reagent sample needle); if not checked, the cleaning is
performed at the same time.

Washing at completion defines the washing done by the Wash-R Emulsion in


number of cycles at the end of the cleaning cycle (minimum 1 - maximum 5).
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
§ REAGENT PRIMING
From the Analysis: Loading Setup Screen, press the Reagent Priming button to
display the reagent priming setup screen.

This screen is used to define the liquid and its volume to be used for reagent
priming for the reagent line and/or the sample line.

When the reagent priming procedure is defined, it is carried out at the beginning
of the test cycle (before the first step).
When Reagent Priming is defined, the interfering tests that will trigger it needs to
be activated using the Interference Table setup in section 4.1.5.
Instrumentation Laboratory 4.69
Setup and Utility

Washing at startup defines the washing done by the Wash-R Emulsion in


number of cycles at the beginning of the reagent priming cycle.
Liquids can be defined as Diluent Liquid ID and Diluted Liquid ID which means
that it is possible to use a single solution or to dilute the solution with another
liquid.
The total volume has to be within 10-140 microliters, independent from Diluent
Liquid only, Diluted Liquid only, both Diluent and Diluted Liquids.
Cycles no.: This is the number of the cycles (minimum 1 – maximum 5). If 0 is
entered, no reagent priming is performed.
Before and after the reagent priming, a wash (using the Wash-R emulsion)
procedure can take place, a number can be defined (minimum 1-
maximum 5).
Perform Sequentially: If checked, one line (sample needle line) is primed before
the other line (reagent needle line); if not checked, the reagent priming is
performed at the same time.
Washing at completion defines the washing done by the Wash-R Emulsion and
number of cycles at the end of the reagent priming cycle (minimum 1 - maximum
5).
The Confirm/Cancel button leaves the screen saving or rejecting the changes
done and the system goes back to the Main screen.
§ MATERIALS CHECK
Once all the liquids are configured, it is possible to define whether the instrument
checks for the presence of the liquid container during the pre-analytical check.

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If a liquid is selected to be checked, you can define what actions to take if the
liquid becomes low during the analysis.
The Check in Pre-Analysis option defines if the analysis may start even if the
liquid is not present (optional presence). This applies to materials in positions A1
– A10 on the sample tray.
If the liquid is marked as mandatory, the analysis cannot start without it and the
options of Check and Continue or Abort is presented after the pre-analysis
checks.
If the liquid is not marked as mandatory, the analysis can start without it and the
Continue option is also presented after the pre-analysis checks allowing the
analysis to continue without a specific liquid.
The Check Selected Row box is used to define the liquid as mandatory.
The Check Selected Row option can only be used for the liquids positioned in A1
to A10 (auxiliary sample tray positions).
The available Actions of the system when a liquid is low are as follows:
§ Abort test: In some cases the presence of the liquid is required to
complete the session (i.e. calibration): if the liquid is low, the session will
be aborted. Samples and reagents pipetted into the rotor prior to the
shortage will not be analyzed.

§ Complete possible and signal: In this case if the liquid becomes low
during the session, the samples that had sufficient liquid aspirated and
dispensed will be completed; while those, after the low reagent condition
was detected, will be kept on hold and the system will warn the user.
Tests after the low condition remain pending. The run can be restarted
by refilling the reagents after session completion

§ Just signal: The instrument will only advise the operator that a liquid is
low but it will continue to perform all pipetting operations.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Instrumentation Laboratory 4.71


Setup and Utility

4.2.4 Calibration – Loading Setup


Analysis: Loading Setup screen flow

TEST
DETAILS

CLEANING

CALIBRATION
LOADING
SETUP
REAGENT
PRIMING

STEP SETUP
(single step)

MATERIAL
CHECK

PARAMETERS PARAMETERS
Sample line Reagent Line

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Click the Calibration: Loading Setup button to view/edit the liquids (reagents,
calibrators) setup in the trays during the test calibration.

This screen is used to define all the steps needed to carry out a calibration.
Test ID: in this field the test ID previously defined is displayed. This field is
present in all the screens of the test setup.
EMPTY CUPS ON OUTER RING STARTING FROM POSITION NUMBER: this
field is used only when it is necessary to place an empty cup (0.5 mL) on the
sample tray for pre-dilution purposes.
Calibration Points Replicates: The maximum number of replicates is 6. Since
the calibration must be performed on a single rotor, the total number of usable
rotor cuvettes is 18; the possible combinations (standard levels/replicates) are as
follows: 2 levels and 3, 4, 5, 6 replicates; 3 levels and 3, 4, 5, 6 replicates; 4
levels and 3, 4 replicates; 5 levels and 3 replicates; 6 levels and 3 replicates.

The Delete icon can be used to delete a step in the calibration sequence.

Add button: This button is used to define in detail a step of the calibration. A
single step is the action of aspirating/dispensing liquids. A step can be carried out
by the sample needle the reagent needle or by both needles. The final result of a
step is the completion of a scope.

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Setup and Utility

Step: this is the order of the execution of the calibration run.


Several scopes can be selected:
- Optical Reference (Wash-R Emulsion) to be used with both 660 nm and
405 nm channels definition.

- Reference (in Absorbance tests) to be used with 405 nm channel definition


only.
- Sample

- Standard (1-2-3-4-5-6)
- All (only if all steps have the same conditions)
The Arrow/Scissors icons add or delete a step.

Once the scope is defined, it is necessary to define which needles will be used to
aspirate/dispense the liquids in the step.
The Loading type for the needle of the sample line may be defined; here is the
definition of the Sample and/or Reagent line.
No Loading: This line does not aspirate/dispense any liquid in this step.
No Dilution: The liquid is aspirated and dispensed as it is.

In Line Dilution: A diluent and the sample are aspirated one after the other and
dispensed together.
In Cup Dilution: Diluent and sample are dispensed in an empty cup when a very
high dilution is needed.

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The parameters button for either the Sample or Reagent line opens the Step
Setup Parameters window.

No Dilution: The liquid is aspirated and dispensed as it is. The following fields
must be entered:
§ Liquid ID: choose from the liquid list

§ Volume: enter the volumes in microliters (minimum=10; maximum=140)


In Line Dilution: A diluent and the liquid are aspirated one after the other and
dispensed together. The following fields must be entered:

§ Diluent Liquid ID: choose the diluent from the liquid list
§ Diluted Liquid ID: choose the liquid to be diluted from the list (i.e. cal
plasma)

§ Volume: Enter the volumes in microliters (minimum single liquid=2;


maximum total volume is 140).
"In Cup dilution" option (Sample Probe option only) dilutes the material in an
empty 0.5mL cup prior to loading into a cuvette on the rotor. Used when a high
dilution ratio of material is required. The following fields must be entered:
§ Pre-dispensed Liquid ID: choose the diluent from the liquid list*
§ Diluent Liquid ID: choose the diluent from the liquid list*
§ Diluted Liquid ID: choose the liquid to be diluted from the list (i.e. cal
plasma)
§ Volume: enter the volumes in microliters (minimum single liquid=2;
minimum total volume=150; maximum total volume is 250).

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Setup and Utility

*In case a highly diluted sample is required, the diluent must be added in two
phases. The diluent used in the first phase is called "pre-dispensed liquid". The
diluent used in the second phase, together with the sample, is called "diluent
liquid".
The In Cup Dilution option is not available for the reagent needle as this needle
cannot aspirate/dispense in the sample tray area.

Note: a head volume of 10 microliters is always automatically added to each total


step condition both on the sample line as well as on the reagent line for all three
conditions: No Dilution, In Line Dilution and In Cup Dilution.
The washing field must be entered if a wash cycle is needed after each cup
dilution is completed. The value refers to the number of cycles and the range is
1-5. Each wash cycle rinses with 130ul of Wash-R.
The position of the empty cup (0.5mL) in the sample tray is defined by checking
the Inner Ring or Outer Ring checkbox. Standard dilutions must use the Outer
Ring.
The Confirm/Cancel button leaves the screen saving or rejecting the changes.

Warning: when a low volume sample needs to be dispensed, it is advisable to


use the In Line Dilution option or the In Cup Dilution option. It is not
recommended to dispense a low sample (below 10 microliters) alone, without
any diluent/buffer.

Intermediate Rinse checkbox: if it is checked, the needle is dipped in the


waste/rinse reservoir to rinse the exterior of the probe. This action is
recommended in case of low volume use.

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Wash R. checkbox: if it is checked, the needles are washed in the rinse before
starting the next step.
Washing between loading: It is possible to define how many rinse cycles are to
be performed between any sample line loading or between any reagent line
loading. The minimum is 0 and the maximum is 5. Each wash cycle rinses with
130ul of Wash-R.
Washing at step completion: it is possible to define how many rinse cycles are
to be performed at the end of loading phase for both sample line or reagent line.
The minimum is 0 and the maximum is 5. Each wash cycle rinses with 130ul of
Wash-R.

Timing constraint: since some steps can be more critical than others, it is
necessary to define some time interval that must be honored in the defined
step/s.
None: The following step is executed immediately after the completion of
the present liquid dispensation.
Step length and Delay at Completion are always applied to a single
step definition only.
Step length: It is possible to define the time interval within which a single
step must be completed. The loading time is included in the total step
length. For example, the loading of the substrate in the AT test: activation
time must be respected because it is a critical step in the reaction.
Delay at Completion: After loading of the liquids in the step, a fixed
delay is added; loading time is not included within the Delay at
Completion time. No mixing occurs before starting the delay timer.
Note: Set Timer and Wait until timer is expired are used when a time
has to include several steps (minimum of two). In this case the time will
go across multiple steps. When Set Timer is defined in one step, a
subsequent step must have a Wait until timer is expired condition in
order to close the timer opened previously. Both conditions of Set Timer
and Wait until timer is expired have to be used in one application
definition.

Set timer: At the end of the loading phase of the defined step, a TIMER
is set for a certain amount of seconds; this timer will be used across the
next loading steps (i.e.: the Cephalin step incubation time in the APTT
test has to wait for the step of the Calcium Chloride). Subsequent steps,
up to a Wait Timer step, are executed immediately, only the timer is set.
Wait until timer is expired: The loading step is executed when the time
of a previously SET TIMER step expires (i.e.: the CaCl2 step in the APTT
test has to close the timer previously opened).

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Setup and Utility

Time in seconds for the timing constraint field can be defined from 1 to 999
seconds (0 means disabled).
Mixing area: If in the current step is necessary to mix the contents of the rotor
cuvette, the ramp checkbox must be checked.
The following fields must be filled in.

Centrifugation Time: rotor may spin from 1 second to 999 seconds. If the value
0 is input, the rotor will not spin.
Inter-ramp Interval: If the rotor is stopped after the first acceleration, this interval
must be defined. The minimum is 1 second and the maximum is 10 seconds. If 0
is input, no inter-ramp will occur.
The Confirm/Cancel button leaves the screen saving or rejecting the changes.

As soon as one step is entered, the details button becomes active and it can be
pressed to review and edit the fields.
§ CLEANING

From the Calibration Loading setup screen, Press the Cleaning button to display
the cleaning setup.

This screen is used to define the liquid and its volume to be used to clean the
reagent and sample lines.
When the cleaning procedure is defined, it is carried out after the last step of the
test cycle.

Liquids can be defined as Diluent Liquid ID and/or Diluted Liquid ID which


means that it is possible to use a single solution or to dilute the solution with
another liquid.
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The total volume has to be within 10-140 microliters, independent from Diluent
Liquid only, Diluted Liquid only, both Diluent and Diluted Liquids.
Cycles no.: this is the number of cycles (minimum 1 – maximum 5). If 0 is
entered, no cleaning is performed.
After the cleaning, a wash (using the Wash-R emulsion) procedure can take
place: a cycle number can be defined (minimum 1 - maximum 5).
Perform Sequentially: if checked, the sample needle line is cleaned before the
reagent line; if not checked, the cleaning is performed at the same time.
Washing at completion defines the washing done by the Wash-R Emulsion in
number of cycles at the end of the cleaning cycle (minimum 1- maximum 5).
Each wash cycle rinses with 130ul of Wash-R.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
§ REAGENT PRIMING
From the Calibration: Loading Setup Screen, press the Reagent Priming button
to display the reagent priming setup screen.

This screen is used to define the liquid and its volume to be used for reagent
priming for the reagent and/or sample lines.
When the reagent priming procedure is defined, it is carried out at the beginning
of the test cycle (before the first step).

When Reagent Priming is defined, the interfering tests that will trigger it needs to
be activated using the Interference Table setup in section 4.1.5.

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Setup and Utility

Washing at startup defines the washing done by the Wash-R Emulsion in


number of cycles at the beginning of the reagent priming cycle.
Liquids can be defined as Diluent Liquid ID and Diluted Liquid ID which means
that it is possible to use a single solution or to dilute the solution with another
liquid.
The total volume has to be within 10-140 microliters, independent of Diluent
Liquid only, Diluted Liquid only, both Diluent and Diluted Liquids.
Cycles no.: this is the number of the cycles (minimum 1 - maximum 5). If 0 is
entered, no reagent priming is performed.
Perform Sequentially: if checked, the sample line is primed before the reagent
line; if not checked, the reagent priming is performed at the same time.
Washing at completion defines the washing done by the Wash-R Emulsion and
number of cycles at the end of the reagent priming cycle (minimum 1 – maximum
5). Each wash cycle rinses with 130ul of Wash-R.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

§ MATERIALS CHECK
Once all the liquids have been configured, it is possible to define whether the
instrument checks for the presence of the liquid, and also what action to take if
the liquid volume is low.

If a liquid is selected to be checked, you can define what actions to take if the
liquid becomes low during the analysis.

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The Check in Pre-Analysis option defines if the analysis may start if the liquid is
not present (optional presence).
If the liquid is marked as mandatory, the analysis cannot start without it and the
message Check and Continue or Abort is presented after the pre-analysis
checks.
If the liquid is not marked as mandatory, the analysis can start without it and the
Continue option is presented after the pre-analysis checks allowing the analysis
to continue without a specific liquid.
The Check Selected Row box is used to define the liquid as mandatory.
The Check Selected Row option can only be used for the liquids positioned in A1
to A10 (auxiliary sample tray positions).
The available Actions of the system when a liquid is low are as follows:
§ Abort test: In some cases the presence of the liquid is required to
complete the session (i.e. calibration); if the liquid is short, the session
will be aborted.
§ Complete possible and signal: In this case if the liquid becomes low
during the session, the samples that had sufficient liquid aspirated and
dispensed will be completed; while those, after the low reagent condition
was detected, will be kept on hold and the system will warn the user
(tests after the low condition will remain pending).
§ Just signal: The instrument will only advise the operator that a liquid is
low but it will continue to perform all pipetting operations.

The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Instrumentation Laboratory 4.81


Setup and Utility

4.2.5 Acquisition Setup


Click the Acquisition: Setup button to open the screen to view/edit the data
acquisition settings for the test.
This screen is used to define all the acquisition parameters.
The acquisition profile is represented in the following drawing.

INTER-RAMP DATA

INTERVAL DELAY ACQUISITION

TIME TIME

RAMP RAMP RAMP

0.4 s 0.4 s # 0.4 s

Each mixing Ramp is fixed at 0.4 seconds.


Inter-Ramp Interval, Delay Time and Acquisition Time are defined according to
the application.
In general terms clotting reactions always have an Inter-Ramp Interval while
chromogenic and latex reactions do not use Inter-Ramp Interval.

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If the Ramp checkbox is checked, the other parameters can be entered.

First mixing ramps (ramp up and down) are set at 0.8 seconds total.
INTER-RAMP INTERVAL : time in seconds between the two ramps (0 means no
inter-ramp; or 1 to 10 seconds defines the time between the two ramps).

Second ramp up after the inter-ramp interval and before the acquisition delay is
set at 0.4 seconds.
ACQUISITION DELAY: time where no data points are recorded during the
acquisition (1-60). If 0 is entered, no delay is considered.
SAMPLING RATE: interval between the data points in milliseconds (50 to 1000
milliseconds in 50 millisecond interval)
ACQUISITION TIME: time used to read the reaction (1-1200 seconds)
SPEED: 600 or 1200 rpm
ACQUISITION CHANNEL: 405 (Absorbance) or 660 (nephelometric) nm.

The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Instrumentation Laboratory 4.83


Setup and Utility

4.2.6 Calculation Setup


Calculation: Setup screen flow

TEST
DETAILS

CHECKS

CALCULATION
SETUP

DEFINE
PARAMETERS

CALIBRATION
SETUP

CALCULATION
ALGORITHMS

CALIBRATION DEFINE
CURVE SETUP PARAMETERS

CALCULATION
ALGORITHMS

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Click the Calculation: Setup button to view/edit the data calculation settings for
the test.
This screen is used to define all the steps needed to manage the raw data
(calibration and analysis).

Test ID: In this field the test ID that has been previously defined is displayed.
This field is present in all screens of the calculation setup.
Normalization: two criteria may be selected: S/R * 100 or log (R/S). The first
algorithm is commonly used for the clotting assays, while the second is mostly
used for chromogenic assays. S means the value (in mV) of the sample and R
means the value (in mV) of the Wash-R emulsion (for S/R*100) and also the
Optical Reference (for log (R/S)).
Scope: Defines the calculation for all the steps defined in the loading step setup:
- Optical Reference (Wash-R Emulsion)

- Reference (in Absorbance tests)


- Sample, Sample a (activated sample as in APCR-V test)
- Analytical Reference, Analytical Reference a (activated analytical
reference as in APCR-V test)
- ALL
Ratio: Select the formula used to calculate the Ratio. Available options are:

- None (No ratio calculation performed)


- R = S / Ref. Value

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Setup and Utility

- R = S / Std 1

- R = S / Std 2
- R = S / Std 3
Import Ref Value from: Select either None or a test from the drop down list.
The reference value entered for the primary test is automatically imported into
the secondary tests (i.e. extended (e) and double (d) tests). This value is the
denominator of the R and INR calculation and should represent the geometric
mean of the normal population time for the selected test.
Normalized Ratio: Select the formula from the drop down list.
- None (no calculation performed)

- INR = R^ISI
- NR = R(S) / Ref
Import ISI Value from: Select either None or a test from the drop down list.
The ISI value entered for the primary test is automatically imported into the
secondary tests (i.e. extended (e) and double (d) tests).
Algorithm Type – Seven selections are available:
None, Trend Algorithm, Threshold, Threshold/Second Derivative, First
Derivative, Second Derivative and Delta.

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NONE

TREND
ALGORITHM
Page 4.88

THRESHOLD
Page 4.89

ALGORITHM
TYPE
THRESHOLD
2nd DERIVATIVE
Page 4.92

FIRST
DERIVATIVE
Page 4.96

2nd
DERIVATIVE
Page 4.98

DELTA
Page 4.110

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Setup and Utility

Once the Algorithm type has been selected the Define Parameters screen can
be accessed to define the calculation of the selected Algorithm Type.
§ None
No algorithm is applied. Only the raw data will be available.

§ Trend Algorithm
Selecting Trend the following selections are possible:

Two Smoothings can be selected in terms of number of points.


The reaction curve can be analyzed in two areas: the First Part (Offset or Min)
and the Final Part (Final or Max). Number of points to be used to calculate the
average or determine the Min/Max for the trend algorithm can be defined.
Presented Units
The only available units for the Trend algorithm are the first part of reaction curve
Offset/Minimum and the Final/Maximum for the final part of the curve.

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Curve Checks
The Check Saturation checkbox activates a monitor on the reaction curve
readings to ensure they are within the hardware limit of the lamp used.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

§ Threshold Algorithm
Selecting Threshold the following selections are possible:

Two smoothings can be selected in terms of number of points: 1st Smooth and
2nd Smooth.
Smoothings are calculated using the moving average mean criteria; the criteria to
calculate the moving average mean is defined by the number of points (degree)
used to calculate the new smoothed values.

Delta Check defines the minimum acceptable delta for the normalized data
reaction curve.
The reaction curve can be analyzed in two areas: the First Part (Offset or Min)
and the Final Part (Final or Max). Number of points to be used to calculate the
average or determine the Min/Max for the first and final parts can be defined.
Pressing the Threshold Parameters button will display the following window

Instrumentation Laboratory 4.89


Setup and Utility

o
The 1 Threshold Parameters window allows you to set the following
parameters.
The Threshold Search Direction provides the option to search for the threshold
value in the Forward (starting from the beginning of the reaction) or Backward
(starting from the end of the reaction and moving toward the beginning) direction.
Threshold Mode allows selection of Absolute (total) or % of Curve to calculate
the threshold.
st
1 Threshold defines where the clot time should be taken; a numerical value
should be entered. The threshold represents a fix change in turbidity from the
initial offset of the reaction curve.

Backwards Threshold Settings settings not applicable for this algorithm.


Presented Units

Time in seconds (calculated against the first threshold) is in general the


presented unit, other units such as the Initial Reaction Offset/Minimum and the
Final/Maximum part of the reaction can be chosen.

Curve Checks
The Check Saturation checkbox activates a monitor on the reaction curve
readings to ensure they are within the hardware limit of the lamp used.

2 nd Threshold defines where one of the checks on the clot curve should be
taken; a numerical value should be entered. This value is used as a verification
that a real clotting curve is present.
In general the second threshold is used to discriminate between real clotting
curves and noisy or unstable clot curves or low Fibrinogen.

Delta Time is used to check bi-phasic curves; it represents the difference in


seconds between two thresholds.

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Initial Slope is used to check non-phasic curves; it represents the initial slope of
the reaction curve at the beginning of the acquisition time. In case the slope
check is not met an error will be generated.

Primary Unit Correction


Accessing the Correction Parameters window it is possible to set value
corrections based on the reaction offset.

Correction Parameters are applied here on the primary unit, in this case seconds.

The Offset Interval can be defined and a correction curve in terms of slope (m)
and intercept (q) can be set.
Up to 3 intervals of corrections based on the result range can be activated.
The correction is represented by the following formula:
Y = mX + q
where “m” represents the slope and “q” the intercept on the Y axis.
Minimum and Maximum Interval values represent the range of unit where the
correction is expected to be active.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
For example, this correction is used for the Fibrinogen-PT-Based method in very
lipemic samples.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Instrumentation Laboratory 4.91


Setup and Utility

§ Threshold/Second Derivative Algorithm


Selecting Threshold/Second Derivative the following selections are possible:

1st and 2nd Derivative calculation in terms of number of points to be used.


Five smoothings can be selected in terms of number of points: 1st Smooth, 2nd
Smooth and 3rd Smooth are used for the raw data; the 4th and 5th Smoothings
are used for the First Derivative.
Smoothings are calculated using the moving average mean criteria; the criteria to
calculate the moving average mean is defined by the number of points (degree)
used to calculate the new smoothed values.

The reaction curve can be analyzed in two areas: the First Part (Offset/Min) and
the Final Part (Final/Max). Number of points to be used to calculate the average
or determine the Min/Max for the two parts can be defined.

Delta Check defines the minimum acceptable delta for the normalized data
reaction curve.
Presented Units

Time in seconds (calculated either against the first threshold or on the maximum
peak of the second derivative; see Initial Slope and Delta Time) is in general the
presented unit, other units such as the Initial Reaction Offset/Minimum and the
Final/Maximum Reaction Part can be chosen.
Pressing the Threshold Parameters button displays the following window:

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o
The 1 Threshold Parameters window allows you to set the following
parameters.
The Threshold Search Direction provides the option to search for the threshold
value in the Forward (starting from the beginning of the reaction) or Backward
(starting from the end of the reaction and moving toward the beginning) direction.
Threshold Mode allows selection of Absolute (total) or % of Curve to calculate
the threshold.
st
1 Threshold defines where the clot time should be taken; a numerical value
should be entered. The threshold represents a fixed change in turbidity from the
initial offset of the reaction curve.

Click on the Backwards Threshold Settings box to enable calculation from the
end of acquisition time moving backwards to the beginning.
Threshold Mode allows selection of Absolute (total) or % of Curve to calculate
the threshold.

Value field defines where the clot time should be taken; a numerical value
should be entered. The threshold represent a fix change in turbidity from the
initial offset of the reaction curve.

Curve Check
Accessing the Curve Check Parameters window it is possible to make the
following selections.

Instrumentation Laboratory 4.93


Setup and Utility

The Check Saturation checkbox activates a monitor on the reaction curve


readings to ensure they are within the hardware limit of the lamp used.

2 nd Threshold defines where one of the checks on the clot curve should be
taken; a numerical value should be entered. This value is used as a verification
that a real clot curve is present.
In general the second threshold is used to discriminate between real clot curves
and noisy, unstable clot curves or low Fibrinogen.

Delta Time is used to check bi-phasic curves; it represents the difference in


seconds between two thresholds. In case the delta time is not met the raw data
will be analyzed using the Second Derivative criteria

Initial Slope is used to check non-phasic curves; it represents the initial slope of
the reaction curve at the beginning of the acquisition time. Number of points and
slope value can be entered (numerical values). In case the slope check is not
met the raw data will be analyzed using the Second Derivative criteria.

Second Derivative calculation in terms of number of points to be used.


Second Derivative represents the acceleration of the reaction and can be used as
criteria to find the clotting point searching for the maximum peak of the second
derivative.

Click on the Noise Check 1 button to activate. If enabled, the system will
determine the clot time searching backwards through the data curve for a value
that is a percentage of the curve delta. The desired percentage is entered in the
Percent field. The delta between the original time (time or threshold) and the
backward calculation time is determined. The Max Time Delta value is the
maximum allowable time delta between the two values.

Click on the Noise Check 2 button to activate. If enabled the system seeks the
next maxima value or time starting from the original value or time. If there is no
further drop in the normalized data curve then the local maxima value and time
will equal the original.
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In the Points field enter the minimum number of points the curve must fall in
order for the local maxima to be considered a true peak. The Min Peak Delta is
the percentage of the overall delta of the curve the local max value must exceed
in order for it to be considered a true peak. The Min Decrease is the minimum
difference in signal (absolute) for the local maxima to be considered a true peak.

Click on Coagulation Location Check button to activate. If enabled the system


will check the coagulation point to ensure it falls within the Percent of the total
curve delta.

Primary Unit Correction


Accessing the Correction Parameters window it is possible to set value
corrections based on the reaction offset.
Correction Parameters are applied here on the primary unit, in this case seconds.

The Offset Interval can be defined and a correction curve in terms of slope (m)
and intercept (q) can be set.
Up to 3 intervals of corrections based on the result range can be activated.

The correction is represented by the following formula:


Y = mX + q
where “m” represents the slope and “q” the intercept on the Y axis.

Minimum and Maximum Interval values represents the range of unit where the
correction is expected to be active.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
For example, this correction is used for the Fibrinogen-PT-Based method in very
lipemic samples.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Instrumentation Laboratory 4.95


Setup and Utility

§ First Derivative Algorithm


Selecting First Derivative the following selections are possible:

1st Derivative calculation in terms of number of points to be used.


It represents the speed of the reaction and can be used as criteria to find the
clotting point searching for the maximum peak of the first derivative.

Five smoothings can be selected in terms of number of points: 1st Smooth, 2nd
Smooth and 3rd Smooth are used for the raw data; the 4th and the 5th
Smoothings are used for the First Derivative.
Smoothings are calculated using the moving average mean criteria; the criteria to
calculate the moving average mean is defined by the number of points (degree)
used to calculate the new smoothed values.
The reaction curve can be analyzed in two areas: the First Part (Offset/Min) and
the Final Part (Final/Max). Number of points to be used to calculate the average
or determine the Min/Max for the first and final parts can be defined.
Delta Check defines the minimum acceptable delta for the normalized data
reaction curve.
Presented Units
Time in seconds (calculated on the maximum peak of the first derivative) is in
general the presented unit, other units such as the Initial Reaction
Offset/Minimum and the Final/Maximum Reaction Part can be chosen.

Primary Unit Correction


Accessing the Correction Parameters window it is possible to set value
corrections based on the reaction offset.
Correction Parameters are applied here on the primary unit, in this case seconds.

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The Offset Interval can be defined and a correction curve in terms of slope (m)
and intercept (q) can be set.
Up to 3 intervals of corrections based on the result range can be activated.
The correction is represented by the following formula:

Y = mX + q
where “m” represents the slope and “q” the intercept on the Y axis.
Minimum and Maximum Interval values represent the range of unit where the
correction is expected to be active.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
For example, this correction is used for the Fibrinogen-PT-Based method in very
lipemic samples.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Curve Check
Accessing the Curve Check Parameters window it is possible to make the
following selections.

Instrumentation Laboratory 4.97


Setup and Utility

The Check Saturation checkbox activates a monitor on the reaction curve


readings to ensure they are within the hardware limit of the lamp used.

First Derivative limit check in terms of absolute value to be used to verify that a
proper clot is occurring.

First Part is the initial turbidity check value of the reaction.


Second Derivative calculation in terms of number of points to be used and check
limit value to be used to verify that a proper clot is occurring.

§ Second Derivative Algorithm


Selecting Second Derivative the following selections are possible:

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1st Derivative calculation in terms of number of points to be used.


2nd Derivative calculation in terms of number of points to be used.
It represents the acceleration of the reaction and can be used as criteria to find
the clotting point searching for the maximum peak of the second derivative.

Five smoothings can be selected in terms of number of points: 1st Smooth, 2nd
Smooth and 3rd Smooth are used for the raw data; the 4th and the 5th
Smoothings are used for the First Derivative.
Smoothings are calculated using the moving average mean criteria; the criteria to
calculate the moving average mean is defined by the number of points (degree)
used to calculate the new smoothed values.

The reaction curve can be analyzed in two areas: the First Part (Offset/Min) and
the Final Part (Final/Max). Number of points to be used to calculate the average
or determine the Min/Max for the first and final parts can be defined.

Delta Check defines the minimum acceptable delta for the normalized data
reaction curve.
Presented Units

Time in seconds (calculated on the maximum peak of the second derivative) is in


general the presented unit, other units such as the Initial Reaction
Offset/Minimum and the Final/Maximum Reaction Part can be chosen.

Curve Checks
The Check Saturation checkbox activates a monitor on the reaction curve
readings to ensure they are within the hardware limit of the lamp used.
Second Derivative value defines when the maximum peak of the second
derivative should give a result as time in seconds; a numerical value should be
entered.

Primary Unit Correction


Accessing the Correction Parameters window it is possible to set value
corrections based on the reaction offset.
Correction Parameters are applied here on the primary unit, in this case seconds.

Instrumentation Laboratory 4.99


Setup and Utility

The Offset Interval can be defined and a correction curve in terms of slope (m)
and intercept (q) can be set.

Up to 3 intervals of corrections based on the result range can be activated.


The correction is represented by the following formula:
Y = mX + q

where “m” represents the slope and “q” the intercept on the Y axis.
Minimum and Maximum Interval values represents the range of unit where the
correction is expected to be active.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
For example, this correction is used for the Fibrinogen-PT-Based method in very
lipemic samples.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

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§ Delta Algorithm
Selecting Delta the following selections are possible:

Two Smoothings (1st and 2nd) can be selected in terms of number of points.
Smoothings are calculated using the moving average mean criteria; the criteria to
calculate the moving average mean is defined by the number of points (degree)
used to calculate the new smoothed values.
The reaction curve can be analyzed in two areas: the First Part (Offset/Min) and
the Final Part (Final/Max). Number of points to be used to calculate the average
or determine the Min/Max for the first and final parts can be defined.
Delta Check defines the minimum acceptable delta for the normalized data
reaction curve.

Presented Units
Delta is in general the presented unit, other units such as the Offset/Minimum
and the Final/Maximum of the reaction can be chosen.

The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

Curve Checks
Accessing the Curve Check Parameters window it is possible to make the
following selections.

Instrumentation Laboratory 4.101


Setup and Utility

st
1 Threshold defines where one of the checks on the clot curve should be taken;
a numerical value should be entered. This value is used as a verification that a
real clot curve is present.
The threshold represent a fix change in turbidity from the initial offset of the
reaction curve.

Offset Min checks the reaction to see if the offset value is less than this value. If
the offset is less than the value the response is failed.

The Check Saturation checkbox activates a control on the reaction curve


readings to ensure they are within the hardware limit of the lamp used.
nd
2 Threshold defines where one of the checks on the clot curve should be
taken; a numerical value should be entered. This value is used as a verification
that a real clot curve is present. In general the second threshold is used to
discriminate between real clot curves and noisy or unstable clot curves or low
Fibrinogen.

Delta Time is used to check bi-phasic curves; it represents the difference in


seconds between two thresholds.

Initial Slope is used to check non-phasic curves; it represents the initial slope of
the reaction curve at the beginning of the acquisition time. Number of points and
slope value can be entered (numerical values).

Final Slope is used to check non-phasic curves; it represents the final slope of
the reaction curve at the end of the acquisition time. Number of points and slope
value can be entered (numerical values).

First Part checks the initial reaction mixture to be sure it has not exceeded the
value entered (turbid reaction)

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Max / Final checks if the final reaction mixture is turbid or not. Maximum
absorbance reading minus the final absorbance reading cannot exceed this limit.
Pressing the Threshold Parameters button will display the following window

The 1o Threshold Parameters window allows you to set the following


parameters.
The Threshold Search Direction provides the option to search for the threshold
value in the Forward (starting from the beginning of the reaction) or Backward
(starting from the end of the reaction and moving toward the beginning) direction.
Threshold Mode allows selection of Absolute (total) or % of Curve to calculate
the threshold.
st
1 Threshold defines where the clot time should be taken; a numerical value
should be entered. The threshold represents a fixed change in turbidity from the
initial offset of the reaction curve.

Backwards Threshold Settings - settings not applicable for this algorithm.

Correction Parameters
Accessing the Correction Parameters window it is possible to set value
corrections based on the reaction offset. Correction Parameters are applied here
on the primary unit, in this case seconds.

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Setup and Utility

The Offset Interval can be defined and a correction curve in terms of slope (m)
and intercept (q) can be set.

Up to 3 intervals of corrections based on the result range can be activated.


The correction is represented by the following formula:
Y = mX + q
where “m” represents the slope and “q” the intercept on the Y axis.
Minimum and Maximum Interval values represent the range of unit where the
correction is expected to be active.
For “m” and “q” coefficients both positive and negative value coefficients can be
entered.
For example, this correction is used for the Fibrinogen-PT-Based method in very
lipemic samples.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.

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Once the Algorithm type is selected and defined some additional settings on the
main calculation setup may be defined.

Delete Parameters: is used to delete the defined parameters with a single


button.
Calculate mean field: if the option to run the test in duplicate (double test field)
was chosen, calculate mean can be used to obtain the mean of the selected
units with each single result of the duplicate.
Check mean field: this field activates the flag of the duplicate values when they
are far from the mean; this unit is represented in % variation of the selected unit.
For example if the inserted value is 10% the check is done as Mean + 10%. A
flag is presented when the Duplicate is out of Range.
Ratio selection: selects the mode for the Ratio Calculation. Either against the
AR (Analytical Reference) on each single sample tray or against the Reference
Value. The Reference Value represents the Mean Normal Range of the Local
Normal Patient Population and each laboratory should establish its own
Reference Value.
The keyboard or the numerical keypad can be used to type the proper value.

If the calculation versus the Reference Value is activated, all Results in Ratio and
INR will be calculated using the Reference Value as denominator.
RATIO = Sample Result / Reference Value

For the Ratio Selection (R) , 3 selections are possible:


- None: no calculation is done.
- R= S/Reference Value: Ratio equals the sample result is divided by the
Reference Value.
Instrumentation Laboratory 4.105
Setup and Utility

- R= S/Standard X: Ratio equals the sample result divided by the selected


standard value of the calibration.
X = selected from the standards defined in the calibration.
Normalized Ratio Field: 3 selections are possible.

- None: no calculation is done.


ISI
- INR= R
- NR=R(S)/Reference Value
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
Pressing the Check button displays the Checks screen.

This screen is used when an Analytical Reference has been set and the user
needs to activate a flag criteria based on the Analytical Reference and the
Analytical Reference Activated value (i.e. APCR-V assay).
The check is done in % versus the measured value of the Analytical Reference.
A % absolute value and the type of Value should be defined.
Several possibility for the AR value can be chosen between the following ones:

s Reference Value (value manually entered by the operator)


s Std 1 (against the first calibration standard point)
s Std 2 (against the second calibration standard point)

s Std 3 (against the third calibration standard point)

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Selecting the Calibration curve setup button displays the Calibration Setup
screen.

Algorithm Type: 7 options are available: None, Trend Algorithm, Threshold,


Threshold/Second Derivative, First Derivative, Second Derivative, Delta.
Define Parameters: This option in Calibration Setup has the same selections as
for the test calculation setup; please refer to the previous section in this chapter
(4.2.7).
Delete Parameters: It is used to delete the defined parameters with a single
button.

Response type: the measured unit is displayed in this field


Check CV checkbox: if the user wants to flag the CV of the calibration replicates,
this checkbox should be selected.

Outlier checkbox: If checked, the outlier result is automatically discarded in the


calibration calculation.
The instrument calculates the mean, then discards the furthest value from the
mean, then the new mean is recalculated using the remaining points.
Dilution Ratio %: to be defined according to the calibration loading setup (up to
two decimals may be entered).
CV: when a minimum of three replicates has been configured, the field can be
filled in with the acceptable CV% value. When the obtained CV% value is higher
than the defined limit, the specific calibration standard point is flagged.

Instrumentation Laboratory 4.107


Setup and Utility

Final Unit: It represents the calculated unit of the calibration. The unit can be
selected from a list including: mg/dL, g/L, %, ng/mL, U/mL, ug/L, umol/L, IU/mL,
%, mg/mL, ug/mL.
New Unit: If a unit different from those included in the list is configured, the user
can configure a custom unit by typing it in this field (up to 8 characters).
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
Calibration Curve Setup: pressing this button displays the Calibration Curve
setup screen.

This screen aims to define the mathematical relation between X (measured unit)
and Y (calculated unit).

Normalization of X and Y: X and Y can be recalculated according to the


selected options.
- X (as it is)
- R= X/Std Z (Z = selected from the standards defined in the calibration.)

And for the Y:


- Y (as it is)

- R= Y/Std Z (Z = selected from the standards defined in the calibration.)


Correct with AR in analysis checkbox: the AR result in the run is used to
modify the calibration curve (it represents a single point calibration); all patient
results will be calculated on the basis of the modified calibration, if the checkbox

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is checked. This option is valid only for the dedicated calibration sessions and
only for the calibration unit.
Correct Ratio with 100% Std: if the checkbox is activated, the Ratio (and
consequently the INR) is calculated using as denominator the new 100% as it is
obtained from the modification of the curve.
Extrapolated Result
The Extrapolated Result function is automatically executed and it is embedded
into the software. It is not visible on any screen and cannot be modified by the
operator. When a result is above 150% of the highest calibration point or below
60% of the lowest calibration point, it will be flagged.
Define as Mandatory: it defines which calibration point is mandatory.
The calibration curve can use multiple functions to better interpolate the
calibration standards.
The curve can be divided into three different segments and different functions
may be applied to each of them.

In order to define the segments, it is necessary to define start and end points that
correspond to the standards previously defined. For example Factor Assays use
3 segments to cover the entire range.
The end point of the first segment corresponds to the start point of the second;
the end point of the second segment corresponds to the start point of the third.
F(X) and G(y): lists the selectable functions.
1 X Y
2 1/X 1/Y
2
3 X Y2
4 ln (X) ln /Y)
5 ln [ln (X)] ln [ln (Y)]
6 log (X) log (Y)
7 log [log (X)] log [log (Y)]
X Y
8 e e
X Y
9 10 10
q' checkbox: When checked, it is possible to force the curve to pass through the
desired calibration point standard. If multiple segments have been defined, the q'
must correspond to the interconnection point between two segments (end of one
segment - start of the other segment).
Calibration Curve Checks:
A different slope range flag can be attributed to the different calibration curve
segments. Limit is from –99999 to +99999.
If the curve is not divided into segments, only the first line must be filled in.

Instrumentation Laboratory 4.109


Setup and Utility

If the slope is outside of the given range, an error is presented.


2
A different r flag can be attributed to different calibration curve segments. If the
2
r value is lower than the given limit presented (format is x.xxxx), a flag is
displayed.

If the curve has not been divided into segments, only the first line must be filled
in.
The Confirm/Cancel button leaves the screen saving or rejecting the changes
and the system goes back to the Main screen.
Clicking the Confirm button saves the changes; clicking the Cancel button
rejects the changes; in both cases the system goes back to the View Tests
screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log out
and/or to turn the system off; No will cancel the operation.

Parallelism Setup

Selecting the Parallelism setup button allows definition of the checks used for
factor assays with parallelism.

Three dilutions can be performed on each sample. The Dilution Ratio %


displays the dilution percentage used on the system.

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The results for the Parallelism can be selected for display and printouts in various
units using the following checkboxes.

o CR %: the system will take the results in seconds for each dilution,
convert these results to % activity by reading it off the calibration curve,
then multiply the results by the dilution factor.
o Ave CR%: the average of the 3 CR% results.
o CV-CR% : the CV of the CR% results.

Slope*: If enabled, a minimum and maximum acceptable value for the slope of
the line based on the 3 dilution values can be entered. Results outside these
limits will be flagged “out of range” and printed in bold.

Intercept*: If enabled, a minimum and maximum acceptable value for the


intercept of the line based on the 3 dilution values can be entered. Results
outside these limits will be flagged “out of range” and “results printed in bold.

* To enable and enter values you must be at the Lab Manager level

R2 : If enabled, a minimum and maximum acceptable value for the R2 for the
linear regression line (seconds vs. uncorrected % recovery) based on the 3
dilution values can be entered. Results outside these limits will be flagged “out of
range” and results printed in bold.

Maximum % Variance: Maximum allowable difference between the recalculated


results. This check is determined by comparing dilution result 1 to dilution result
2 and also comparing dilution result 2 and dilution result 3.

Maximum % CV: Maximum allowable CV% for the recalculated results.

Pressing the Units button will display the available units for parallelism. You can
select four of the units to display and print.

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Setup and Utility

Highlight the desired unit and press the Show in Sample List. A check will be
placed in the left hand column. These units will display on the screen and be
printed. Up to 4 units can be selected.

Available units include:


o AVECR% Average of the recalculated results in %
o CV-CR% CV of the recalculated results in %
o Slope Slope of the parallelism line
o INT Intercept of the parallelism line
2
o r Correlation of the parallelism line based upon
the results versus the dilution %. This is determined
using linear regression analysis.

For Slope and INT you must enter a range to report and flag these units.

Results for factor parallelism can be printed in 3 ways:

1. Sample Report - This report will include 4 of the following selected by the
user:
a. Ave CR%
b. CV CR%
c. Slope
d. Int. (Intercept)
2
e. r

2. Cumulative Report – This report will include:


a. 1 st dilution , 2 nd dilution and 3 rd dilution results expressed in seconds
(s), percent (%) and the corrected result in % (CR%)
st
Note: For the IL locked tests the 1 dilution is 100%, 2nd dilution is
rd
50% and the 3 dilution is the 25%.
b. Ave CR%
c. CV CR%
d. Slope
e. Int. (Intercept)
2
f. r

3. Parallelism Detail Report


This report will include everything that is included on the cumulative report for
a sample along with a list of the errors associated with the sample.

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4.3 UTILITY
The Utility portion of the ACL Elite/Elite Pro software groups all functions related to
saving data and handling the ACL software. For ease of use, Section 4.3.1 shows the
Utility submenu, and Sections 4.3.2 and above are labeled as the items in this submenu.

4.3.1 UTILITY Submenu


This group of functions can be accessed from the Main screen by pressing the
UTILITY button on the menu bar:

UPGRADE IL LIBRARY

BACKUP/RESTORE

ARCHIVE

SOFTWARE
- Software Identification
- Software Upgrade
- SW Master Upload-Upgrade
- SW Slave Upload-Upgrade
- SW REM Upload-Upgrade

SAVE LAST ROTOR MAP

SAVE TRACE

4.3.2 UTILITY- Upgrade IL Library


This utility is used to upgrade the IL tests library.
Follow the instructions indicated on the screen.
The screen will indicate to insert the IL Library diskette into the floppy (upper right
side of the instrument) and press continue.

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Setup and Utility

At the end of the IL Library Upgrade all modifications are listed on the screen.

The modifications that occurred can also be printed on a report.

4.3.3 UTILITY- Backup/Restore


This utility is used to backup or restore the system configuration.
Backup will save the following information to one or more floppy disks:
instrument configuration in terms of Host, Printer, Barcode and Keyboard; all
tests setup, profiles setup, test group setup, liquids setup, interference table,
default tests, reflex tests; QC setup, AR setup, etc.
Restore will copy the saved setup information from the floppy disks back into the
analyzer.

Note: Patient results, Calibration curves, QC results and AR results cannot be


backed up and restored.
View Backup Date will display the date the backup was created.

The disk used to create the backup should be a preformatted unprotected Double
Sided High Density 3-1/2” floppy disk.

Warning: You can back up an ACL Elite and restore it to an ACL Elite Pro;
however you cannot backup an ACL Elite Pro and restore it to an ACL ELite.

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4.3.4 UTILITY- Archive


This utility is used to copy/transfer analytical data to a floppy disk.

Four checkboxes allow selection of the set of data to be copied/transferred.

- PATIENT DATA (Sample Entry date range is selectable)*


- QC DATA (date range, QC liquid, and tests are selectable)
- AR DATA (date range and tests are selectable)
- CAL DATA (tests are selectable)
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Setup and Utility

*Patient data is archived based upon the sample entry date and not the date the
sample was analyzed.
Enabling the checkbox Remove Data After Archive will delete the selected data
for completed samples from the ACL database.

To start the archiving procedure, press the START button.


The file name created by the instrument, is composed of two letters and six
numerical characters: the two letters identify the kind of selection made by the
operator (CD = Calibration Data, QC = Quality Control, PD = Patient Data, AR =
Analytical Reference), the numbers correspond to the date when this operation is
carried out (ddmmyy). The file extension is .000. These files are viewable using
common programs capable of reading text data.
The Data archived includes the following: test name, patient name with related
demographics, results, flags and calibration curve parameters, depending on the
selection made.
Warning: Archived data cannot be restored back to the ACL Elite/Elite Pro. The
data can be viewed using a standard PC capable of viewing text data.

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4.3.5 UTILITY- SOFTWARE - Software Identification


Selecting the Utility button on the menu bar and selecting Software
Identification opens the SW Identification screen.
The following information can be viewed but not edited on this screen:

MASTER SW IDENTIFICATION

SLAVE SW IDENTIFICATION

REM SW IDENTIFICATION (Not available on the ACL Elite)

IL TEST LIBRARY

The Confirm button leaves the screen and the system goes back to the Main
screen.

4.3.6 UTILITY- SOFTWARE - Software Upload-Upgrade


This option allows upgrade and upload of the major software areas when a
software release becomes available.
To start the upgrading and uploading procedures, select the software to be
upgraded and uploaded (Slave, Master or REM), insert the disk and follow the
instructions on the screen.

The procedure to load a new software revision is done in two steps for each of
the 3 areas of the software (Slave, Master and REM).

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Setup and Utility

The software Upload operation copies the entire information to the hard disk.

The software Upgrade operation installs the software from the hard disk through
the system.

Slave Upload and Upgrade*


Second operation is the Slave Upload (copying information to the hard disk).
Insert the disk, select Slave Upload and continue.
When the Upload procedure is completed, please select Slave Upgrade
(software installation from the hard disk) and continue.
Master Upload and Upgrade*
First operation is the Master Upload (copying information to the hard disk).
Insert the disk, select Master Upload and continue.
When the Upload procedure is completed, please select Master Upgrade
(software installation from the hard disk) and continue.
REM Upload and Upgrade*
Third operation is the REM Upload (copying information to the hard disk).

Insert the disk, select REM Upload and continue.


When the Upload procedure is completed, please select REM Upgrade (software
installation from the hard disk) and continue.

At the end of each operation please verify that the Software Identification reports
the correct revision number.
*Warning: each Upgrade kit will include detailed instructions that supersede the
above instructions if they are different.

Please follow the Upgrade package instructions to perform Upload and Upgrade
operations.

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4.3.7 UTILITY- Save Rotor Map


Selecting the Utility button on the menu bar and selecting Save Rotor Map,
opens the Save Rotor screen shown below.

This utility is used to save the analysis raw data to a floppy disk.
The system retains the raw data for all testing performed for the last 31 days.
The user can type the file name and select the file format by checking the
appropriate checkbox.
The DAT files are compatible with the Windows Research Program.
Note: the DAT file is only available if one test (up to 19 samples maximum) is
executed on the rotor. If more tests are executed on the same rotor the DAT file
option will not be available.
The TXT files are ASCII files and are compatible with the most common text
editors and spreadsheet (i.e. Word or Excel).
A maximum of 8 characters can be used for file name. Do not enter the filename
extension when entering a file name. The extension will automatically be added
depending upon the checkbox selected (TXT or DAT).
The file name format is: RMdxxhyy
o xx = day of the month the run was performed

o yy = hour of the day the run was performed*


Insert the disk and press Continue.
The Cancel button will exit to the main screen.

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*Note: If multiple runs are performed within the hour selected, all runs will be
saved on the disk. A run time stamp separates the various run data on the disk.
The end of run time is used for the time stamp.

4.3.8 UTILITY- Save Trace


This utility is used to save all the operations performed by the instrument.
This utility is used for troubleshooting purposes in case a software defect may
appear (i.e. database error, system lockups, etc.).
The system saves a up to 31 trace files, one for each day for the past 31 days

Type the file name using the following format: Trace_XX.txt


Using a file name already on the disk will overwrite the previous file.
XX is the day of the month you want to save the trace on.
th
For example, to save the trace for the 10 day type: Trace_10.txt
In case the system may need to be rebooted, the trace file can still be performed
after restarting the analyzer.
The dimension of the trace file is maximum 1.44 Mb.
Note: The trace file will only monitor internal software or database errors. A
trace file does not include information about abnormal results.

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4.3.9 UTILITY- Test/Material – Backup and Upload

This feature allows single material and test definitions to be copied onto disks
and uploaded from disk.

Selecting the Backup option from the menu displays the following screen

The Test/Material drop down box allows you to select a material ID, Test ID or
Test Group to backup.

The Test/Material list below the selection will then display either the material
IDs, Tests or Test Group based upon the above selection.

Check the Comments box to include the internal comments in the backup

In the Filename box enter the filename (8 characters maximum with no


extension needed)

Press the confirm button to start the backup or the cancel button to exit the
screen.

Selecting the Upload option from the menu displays the following screen

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Select Test/Material from the drop down box.

A check in the Overwrite box will cause the new information uploaded to replace
the information currently defined in the system.

Enter the Filename of the Material or test to be uploaded (8 characters maximum


with no extension needed).

Press the confirm button to start the backup or the cancel button to exit the
screen.

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Diagnostics and Maintenance
5.0 Introduction
The purpose of this Section is to familiarize the ACL Elite/Elite Pro user with the
software-driven diagnostics procedures that are performed automatically by the
system at the operator’s request. Through the ACL diagnostics programs, the user
can access the error history and logbooks of the system as well as perform checks on
key hardware items.
In addition, this Section contains all necessary information to perform Preventive
Maintenance procedures, and thus keep the ACL Elite/Elite Pro in top functional
condition.

5.1 The DIAGNOSTIC Submenu


The Diagnostic submenu can be accessed from the Main screen by pressing the
DIAGNOSTIC button on the menu bar:

PRIMING
CLEANING
MAINTENANCE
TEMPERATURE CONTROL
NEEDLES POSITION
SESSION ERROR HISTORY
FILE ERROR HISTORY
LOGBOOK
SERVICE (dimmed). Only accessible to Service
The following sections contain details about each of the items in the
Diagnostic submenu.

5.1.1 Priming

INSTRUCTIONS to perform a PRIMING CYCLE


(from the READY status)
• Click the Diagnostic button on the Main menu bar

• Select Priming from the Diagnostic menu


The ACL starts a priming cycle, washing needles and pistons.
Duration: approximately 50 seconds

The Priming feature of the Diagnostics menu allows the operator to perform
an automatic priming cycle on the ACL in order to wash the loading module’s

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Diagnostics and Maintenance

pistons and needles. This priming cycle can only be activated if the system is
in the Ready mode.
The priming cycle must be performed at the following times:
- beginning of a working day or a shift
- end of a working day or a shift

- when the ACL has been OFF for a prolonged period of time
- after replacement of the Wash-Reference Emulsion bottle
In order to perform a priming cycle, click the Diagnostic button on the Main
menu bar and select the Priming option from the Diagnostic submenu to
open the Priming screen:

The window in this screen displays a bar that moves during the cycle
activation to show the elapsed time, for a total of approximately 50 seconds.
The two piston dilutors will move up and down priming the tubing line with an
approximate consumption of 6 mL of Wash-R Emulsion (20 strokes per single
piston dilutor – total of 40 strokes; each single stroke of 0.15 mL).

• ACTIVE BUTTONS at the bottom of this screen are:


- Stop followed by a confirmation window Do you really want to stop the
current operation? OK confirms the choice of Stop and Cancel cancels
the operation:

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- Database View displays the Database View or Main Screen.


- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No cancels the operation.

NOTE: when the instrument is in standby, an automatic priming cycle is


performed every 30 minutes. The consumption of Wash-R Emulsion is
approximately 0.9 mL (3 strokes per single piston dilutor – total of 6 strokes;
each single stroke of 0.15 mL).

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Diagnostics and Maintenance

5.1.2 Cleaning

INSTRUCTIONS to perform a CLEANING CYCLE


(from the READY status)
Before starting the cleaning cycle, place the desired cleaning solutions in
reagent position R6 (for the reagent line) and reagent position R7 (for the
sample line).
• Click the Diagnostic button on the Main menu bar
• Select Cleaning from the Diagnostic menu
The ACL starts a cleaning cycle for the reagent and sample needles.
Duration: dependent upon the cycle configuration (see details below)

The Cleaning feature of the Diagnostic menu allows the operator to perform
an automatic deep cleaning of the ACL needles using selected cleaning
solutions, followed by rinse cycles using the Wash-Reference Emulsion.
Before starting the cycle, the selected cleaning solutions must be placed in
reagent position R6 for the reagent line and reagent position R7 for the
sample line.

For recommendations on cleaning solutions, refer to Section 5.2.3 and 5.2.7.

In order to perform a cleaning cycle, click the Diagnostic button on the Main
menu bar and select the Cleaning option from the Diagnostic submenu to
open the Cleaning screen shown below. Note: This procedure may only be
started when the ACL is in the READY status.
In this screen the operator may define the configuration of the cleaning
operation:

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- VOLUME - volume in microliters of cleaning solutions (positions R6 and


R7) to be used in each single cycle to clean the reagent and the sample
lines: default is 130 microliters. Minimum volume is 0 and maximum
volume is 130 microliters.

- CYCLES No.- the number of cleaning cycles using the cleaning


solutions (same for both lines); default is 3 cycle. Minimum is 1 and
maximum is 5 cycles. Selecting 0 no cycles will be executed.

- WASHING AT COMPLETION - number of rinse cycles (defined for each


line) using Wash-Reference Emulsion; default is 5 cycles. Minimum is 1
and maximum is 5 cycles. Selecting 0 no cycles will be executed.

At a minimum either the sample, reagent or both lines need to be defined


prior to pressing “Start” for the cleaning cycle to be performed.
CLEANING PROCEDURE
Materials needed:
§ 4 glass vials (10 mL volume; diameter 23 mm)
§ 16 mL of Cleaning solution

§ 16 mL of Factor Diluent
Place the Cleaning solution in position R6 and R7 using the two glass vials
indicated above (maximum volume 10 mL; 23 mm diameter) filled with 8 mL
each of one of the following solutions:

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Diagnostics and Maintenance

§ IL Cleaning Solution (P/N 98317-00) for a normal cleaning procedure or


§ IL Cleaning Agent (P/N 98327-00) diluted 1:8 for a Decontamination
procedure.
Clicking the Start button starts the cleaning cycle and opens a window
displaying a bar that moves to show the elapsed time of the procedure.

If no liquid is detected in the vials the cleaning will be aborted.


After the first step using the appropriate cleaning solution substitute the two
vials filled with Factor Diluent in R6 and R7. Re-start the cleaning.

If the liquids are not in the appropriate positions, the cycle will automatically
abort and an error window will appear.
Clicking the Cancel button leaves the screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Stop stops the cleaning procedure.
- Database View displays the Database View or Main Screen.

- Shutdown followed by a confirmation window Do you really want to


shutdown ACL ? Yes closes the session, allowing the operator to log off
and/or turn the system off; No cancels the operation.

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5.1.3 Maintenance
The Maintenance subsection of the Diagnostic menu allows the user to
access and record dates related to the performance of specific maintenance
operations. This is meant to keep track of the frequency with which the
instrument is maintained and for troubleshooting purposes.

For information about Maintenance Procedures and recommended


frequency guidelines, refer to Section 5.2.

To open the Maintenance screen, click the Diagnostic button on the Main
menu bar and select the Maintenance option from the Diagnostic submenu:

The large window that occupies most of the screen displays a list of the
suggested maintenance operations along with their recommended frequency
in days.
Operation Days (Frequency)
§ CLEANING CYCLE 7
§ RINSE WASTE RESERVOIR 7

§ CLEAN OPTICAL SENSORS AND WINDOWS 14

§ CLEAN AIR FILTER 28

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Diagnostics and Maintenance

Next to the Maintenance/Operation column there are three other columns


containing the following information relative to each procedure:
LAST DATE: The date does not need to be typed in after performance of a
specific operation. Clicking the Date button causes today’s date to appear
automatically. Items displayed in red indicate that the maintenance is past the
listed frequency and is overdue. If a run is processed with maintenance
overdue, the Session Error History button will illuminate to alert the operator,
and the results will be flagged. The alert icon will also be illuminated when
maintenance is due. The Clear button will delete the date displayed.
DAYS: This number cannot be edited; it is the IL-recommended frequency in
days with which this procedure should be performed.
NOTE icon opens the Insert Notes screen for entry of free text (26 characters
maximum can be printed).
Clicking the Confirm button saves changes in the Notes screen.
Clicking the Cancel button rejects the changes; in both cases the
system goes back to the Main screen.
Clicking the Printer button, followed by a confirmation window Do you really
want to print? Yes/No, prints the maintenance list.
Clicking the Confirm button saves the changes and clicking the Cancel
button rejects the changes; in both cases the system goes back to the Main
screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No cancels the operation.

5.1.4 Temperature Control


Through the Temperature Control option of the Diagnostic submenu the
operator is able to check if the temperatures of the system are within their
acceptable ranges. This is a real-time update screen and the display will
flicker as the temperatures are constantly updating.
Clicking the Diagnostic button on the Main menu bar and selecting
Temperature Control open the Temperature Control screen:

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The window in this screen contains 3 columns:

- DEVICE - indicates the areas that are checked


- NORMAL RANGE (°C) - indicates the acceptable range for each device:
- Rotor holder: 38 to 39 °C 100.4 to 102.2 °F
- Peltier: 10 to 16 °C 50 to 60.8 °F
- Rotor transport* 34 to 40 °C 93.2 to 104.0 °F
- Rotor stack: 34 to 40 °C 93.2 to 104.0 °F
- TEMPERATURE (°C or °F according to the selected Units in Setup) -
indicates the actual temperature in the area
*Used to monitor Base of Rotor Stack in ACL Elite
Clicking the Printer button, followed by a confirmation window Do you really
want to print? Yes/No, prints the temperature list report.
Clicking the Confirm button exits the screen and the system goes back to the
Main screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.

- Shutdown followed by a confirmation window Do you really want to


shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

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Diagnostics and Maintenance

5.1.5 Needles Position


The Needles Position option of the Diagnostic submenu is used to center the
needles after changing or removing the needle block.
The needle position has to be verified with the rotor cover open, therefore
press the Open/Close Cover button to open the Rotor cover. Install
alignment tool.
Clicking the Diagnostic button on the Main menu bar and selecting Needles
Position causes a very quick self-initialization. After a reminder to open the
cover, the arm moves over the rotor holder area.

The Raise/Lower Arm button will raise/lower the arm over the rotor holder
area.
The Rotate button will move the rotor holder 90° (1/4 turn).
If the needles position procedure has to be carried out, the needle adjustment
tool must be placed on the rotor holder. For details on this operation, refer to
Section 5.2.6.

Remember to remove the tool at the end of the procedure.


Clicking the Stop button, followed by a confirmation window Do you really
want to stop the current operation? OK the system goes back to the main
screen; Cancel will cancel the operation.
In order to verify the needle centering with the rotor cover closed, repeat the
operation described in 5.2.6.

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• ACTIVE BUTTONS at the bottom of this screen are:


- Database View displays the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

5.1.6 Session Error History


Any error or alarm occurring during an analytical session is recorded in the
system.
Up to 200 errors can be stored in the error file. The file is handled
automatically using the first in first out approach.
If the user wants to view the errors and alarms while the session is active,
clicking the Diagnostic button on the Main menu bar and then selecting the
Session Error History option will open the Session Error History screen:

The window in this screen contains descriptions of all the errors and warnings
that occurred during the current session along with the date and time. The
latest error or warning appears at the top of the list.
Clicking the Printer button, followed by a confirmation window Do you really
want to print? Yes/No, prints the error list.

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Diagnostics and Maintenance

Clicking the Confirm button exits the screen and the system goes back to the
Main screen.
As soon as a new session starts, the previous session errors are
automatically erased and the permanent errors are transferred to the File
Error History database.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

5.1.7 File Error History


The ACL Elite/Elite Pro software records, stores and displays all the errors
and warnings that occurred since the system was first turned on.
Up to 100 errors can be stored in the error file. The file is handled
automatically using the first in first out approach.
The error history may be viewed in the Error File History screen (shown
below), which opens by first clicking the Diagnostic button on the Main menu
bar and then selecting File Error History from the Diagnostic submenu.

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This screen displays descriptions of all the errors and warnings along with the
date and time when they occurred. The latest error or warning appears at the
top of the list.
Clicking the Printer button, followed by a confirmation window Do you really
want to print? Yes/No, prints the error list.
Clicking the Clear button followed by a confirmation window deletes all the
messages in the file. Available at the IL-Service Level only.
Clicking the Confirm button exits the screen and the system goes back to the
Main screen.
• ACTIVE BUTTONS at the bottom of this screen are:
- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

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Diagnostics and Maintenance

5.1.8 Logbook
The ACL Elite/Elite Pro software records, stores and displays information on
all the actions performed on the system since it was first turned on.
Actions traced in the Logbook are all the conditions in which an operator
decision is taken. For example, a Liquid entry, a change in assigned value, a
modification in the setup and/or in the configuration, etc. are recorded.
Up to 200 messages can be stored in the logbook file. The file is handled
automatically using the first in first out approach.
The logbook may be viewed in the Logbook screen, which opens by first
clicking the Diagnostic button on the Main menu bar and then selecting
Logbook from the Diagnostic submenu.

This screen displays descriptions of all the actions and the login level along
with the date and time when they occurred. The latest action appears at the
top of the list.

§ DATE/TIME: date and time when the action occurred


§ LEVEL: password level
§ USER NAME: user

§ ACTION: description of the action performed


§ NOTE: user editable field for comments
Clicking the Notes button the operator is allowed to enter comments for each
logbook message. (26 characters maximum)

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Clicking the Printer button, followed by a confirmation window Do you really


want to print? Yes/No, prints the logbook records.
Clicking the Confirm button exits the screen and the system goes back to the
Main screen.

• ACTIVE BUTTONS at the bottom of this screen are:


- Open/Close opens or closes the rotor holder cover.
- Database View returns to the Database View or Main Screen.
- Shutdown followed by a confirmation window Do you really want to
shutdown ACL? Yes closes the session, allowing the operator to log off
and/or turn the system off; No will cancel the operation.

5.1.9 Service (dimmed)


This section is not accessible at the user level.
The procedures listed in the Service section of the software are to be
performed only by trained IL Service Engineers and therefore are not
included in this Operator’s Manual.

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Diagnostics and Maintenance

5.2 MAINTENANCE PROCEDURES

5.2.1 Introduction
The ACL is a precision instrument. In order to keep it in functional condition
IL recommends that a trained operator, at the minimum frequency specified,
carry out the following operations.

Warning:
The instrument should be decontaminated before performing any
maintenance procedure and/or service. For instructions related to
Decontamination Procedures, refer to Section 5.2.7 below.
While performing maintenance procedures, the operator should wear
protective clothing and gloves to prevent direct contact with items
potentially contaminated with blood. Hands should also be washed
immediately after gloves are removed and before leaving the laboratory.
Also refer to NCCLS GP25-A Vol. 13 No. 22: Clinical Laboratory Waste
Management, Dec. 1993.

5.2.2 Daily Preventive Maintenance


The following checks and procedures should be performed on the ACL
before starting the daily testing or once per shift.

IMPORTANT NOTE: The ACL will perform optimally if it is left ON at all


times. The complex electronic circuit is most reliable if the number of ON/OFF
cycles is kept to a minimum. Leaving the instrument in the Standby mode
guarantees minimum power consumption and maximum readiness for
operation at any time. For additional information refer to Section 1.

• Check Wash-Reference Emulsion


The Wash Reference Emulsion bottle is fitted with a liquid level sensor that,
reports in real time the amount of solution left in the bottle (mL). This sensor
also produces a warning to alert the operator when the solution in the bottle
is insufficient for additional testing.
If the sensor is switched off in the Setup Configuration option, the operator
must check that the level of liquid in the bottle is at least 1.5 to 2 cm from the
bottom.

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If the level is lower, replace the Wash-Reference Emulsion bottle with a full
one and perform the priming procedure before using the system for testing
(refer to Section 5.1.1 or to Priming Procedure below).

NOTE: at a level of 2 cm, there is enough solution to perform testing in one


or two more rotors (taking into account the bottle dead volume).

• Check Waste Liquid Container


Check the level of the waste container and empty if necessary. Also verify
visually that the waste flows freely into the container. For correct installation,
please refer to Section 2.

Warning: The liquid waste of the instrument should be considered a


source of contamination and should therefore be discarded following
the laboratory’s waste procedures, in compliance with the local
regulations. Also refer to: NCCLS GP25-A , Vol. 13, No. 22: Clinical
Laboratory Waste Management, Dec. 1993.

• Perform Priming Procedure


The priming procedure is used to flush the liquid flow path of the system, thus
ensuring removal of sample or reagent residues that may accumulate during
sample analysis. The priming procedure is an effective way to maintain the
ACL’s needle assembly and the rinse reservoir in good working condition.
The ACL automatic priming procedure should be performed at the beginning
and at the end of each working day.
In order to perform the priming cycle, click the Diagnostic button on the Main
Menu bar and select the Priming option from the Diagnostic submenu. The
Priming screen opens with a message “Priming in progress” and priming
begins immediately. When the dispenser system finishes flushing the sample
and reagent needles, the instrument returns automatically to the Main menu.
For additional details, refer to Section 5.1.1.
Important: While the priming cycle is in progress, the operator should
visually inspect three items:

- The number of bubbles in the dilutor chamber is reduced to a minimum.


If bubbles are still present, pinch the chamber outlet tubes while the
piston is descending and release them before the piston reaches the
bottom dead center. Repeat the priming cycle as needed until all
bubbles are gone.

- There are no blockages or leaks in the liquid flow path and the liquid is
flowing smoothly from reservoir to dilutors and from dilutors to needles.
- There is free flow of the liquid waste from the washing chamber to the
instrument outlet tube and then to the waste container.

Instrumentation Laboratory 5.17


Diagnostics and Maintenance

• Empty Rotor Waste


To access the container with the used rotors, open the small door on the front
of the analyzer body, to the right of the reagent area. Grab the handle of the
container and pull outwards to remove it.
Properly discard the used rotors found in the rotor waste container.

Location of Rotor Waste and Rotor Waste Container

Warning: Rotors contain potentially contaminated materials; discard


and incinerate used rotors according to the proper local regulations.

Note: A partially used rotor may be left in the rotor housing. A 24-hour
timer is set when a new rotor is introduced. After 24hours the user will
be prompted to enter the open cuvette positions for subsequent runs in
the rotor. In order to remove a rotor from the rotor holder, press the
Open/Close icon to open the rotor-holder cover and manually retrieve the
rotor, making sure not to spill its contents while transporting it to the waste
container. Close the rotor holder cover by pressing the Open/Close icon on
the screen. A partially used rotor may be placed back on the rotor housing to
use the remaining cuvettes. Prior to placing a rotor back on the analyzer, the
last used cuvette in the rotor should be filled with 200ul of Wash –R.

Warning: Do not return a partially used rotor to the rotor preheater.

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5.2.3 Weekly Preventive Maintenance


Weekly preventive maintenance for the ACL consists of cleaning all the key
instrument areas that normally come in contact with sample and reagents
and therefore accumulate residues that will, if allowed to build up, impair the
instrument functionality and affect test results.

The parts/areas to be cleaned are:


- The instrument body, including autosampler and rotor holder area
- The needle assembly

- The rinse reservoir

• General Instrument Cleaning Procedure


Wipe down all exposed surfaces of the analyzer body, the inside of the auto-
sampler compartment and the rotor compartment (excluding the rotor holder)
using a cloth soaked in a 0.1 N Hydrochloric Acid (HCl) solution (IL Cleaning
Solution P/N 98317-00). Rinse using a cloth soaked in deionized water. Wipe
dry.

• Cleaning of Sample Spillage


In case of sample spillage in the auto-sampler or in the rotor compartment, it
may be required to clean the cup/tube sensor and the two optical paths in the
analysis area.

Cup/Tube sensor inside the sample tray area: wipe the two vertical faces of
the sensor using a clean cloth or cotton tip applicator soaked in a 0.1 N HCl
solution. Spills in the rotor compartment should be clean using dilute (1:8)
cleaning agent P/N 98327-00. Follow with deionized water and dry with a
clean cloth or cotton tip applicator.
Optical paths in the analysis area: refer to Section 5.2.4 below.
• Needle Cleaning Procedure
Although the daily priming procedure helps in maintaining the
sampling/dispensing needles in good working order, after a while protein and
other deposits will accumulate in the inside and the outside of the
sampling/dispensing needles. The following cleaning procedure should be
performed on a weekly basis in order to remove those deposits.

The procedure requires interaction between the operator and the ACL
software. For additional details, refer to Section 5.1.2 - Cleaning.

Instrumentation Laboratory 5.19


Diagnostics and Maintenance

ACL setup:
Place 8 mL of a 0.1 N HCl solution in 2 vials.
Place the filled vials in reagent positions R6 and R7
For more detailed information please refer to 5.1.2 Cleaning.
Cleaning cycle
Click the Diagnostic button on the Main menu bar and select the Cleaning
option of the Diagnostic submenu to display the Cleaning screen.
In this screen the operator defines the configuration of the cleaning operation,
according to the needs of the instrument (refer to Section 5.1.2).
Clicking the Start button starts the cleaning cycle and opens a window
displaying a bar that moves to show the elapsed time of the procedure.

WARNING: If suspect infectious samples have been tested on the


system, refer to Section 5.2.7 to proceed with the appropriate
Decontamination Procedure.

• Rinse Reservoir Cleaning Procedure


Follow the steps below to clean the rinse reservoir:
Click the Diagnostic button on the Main menu bar and select Needles
Position.
This will cause the needle arm to move to the top of the rotor holder.
Remove the rinse reservoir, wash it thoroughly with a 0.1N HCl solution and
rinse it with deionized water.

Return the rinse reservoir to its position. Press the STOP icon and confirm
with OK. The needle arm goes back to the home position into the waste rinse
reservoir. The instrument returns to the Ready State.

5.2.4 Biweekly Preventive Maintenance


The rotor holder and the optical path components found in the analysis area
must be cleaned every two weeks under normal instrument use.
Rotor Holder and Optical Path Cleaning Procedure
Press the Open/Close Rotor icon to open the rotor holder cover.

Proceed as follows using the figure below as a reference:

5.20 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Cleaning the Optical Path

- Using a cotton tip applicator moistened with deionized water, clean all 20
holes in the rotor holder and the surface of the channel sensor. Use a clean,
dry cotton tip applicator to remove all moisture from these areas. The cotton
swab should not be pushed down below the rotor holder assembly
- Clean the LED sensor surface (under the rotor holder) and the LED fiber
optic surface using a cotton tip applicator moistened with deionized water.
Use a clean, dry cotton tip applicator to dry these areas well.
- Using a cotton tip applicator moistened with deionized water, clean the
halogen lamp fiber outlet below the rotor holder and the chromogenic channel
sensor filter surface mounted in the rotor holder cover, as seen in the figure
above.

Use a clean, dry cotton tip applicator to dry the areas after cleaning.
Press the Open/Close Rotor icon to close the rotor holder cover.

5.2.5 Monthly Preventive Maintenance


• Checking and Cleaning the Air Filter
In order to clean the analyzer air filter, it must first be removed from its
location on the right side of the instrument. Insert a finger in the holder slot;
pull up and slide the filter out (see figure below).

Instrumentation Laboratory 5.21


Diagnostics and Maintenance

Removing the Fan Filter

Check the filter. If it is dirty or blocked, clean it with compressed air or by


washing it in water and blowing it dry.

If the filter appears damaged, it should be replaced.


Do not place a wet filter back into the analyzer position.
Insert the clean or new filter back in its holder.

5.2.6 As-needed Maintenance


• Waste Line Cleaning Procedure
This procedure is performed to prevent formation of clots or to clean any
possible blockages (due to clotting) in the waste line. The frequency with
which this procedure should be done depends on the daily workload; once a
day may be necessary for heavy sample loads and less frequently for lighter
loads.

NOTE: This procedure may have to be performed more often


than as needed, depending on instrument use.

5.22 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Materials required:
-
- a 20 mL plastic syringe
- a 20 cm PVC tube, 4 mm ID, 6 mm OD (this tube dimensions must be
such that it will fit onto the syringe on one end and into the waste line at
the other end)
- 20 mL deionized water
- a container for the deionized water

Preparation
Remove the needle from the plastic syringe (if necessary) and fit the PVC
tube on the end on the syringe. Fill the syringe with deionized water.
Procedure
Click the Diagnostic button on the Main menu bar and select Needles
Position for the Diagnostic submenu. This will cause the arm to move to the
top of the rotor holder.
Remove the rinse reservoir and clean it if necessary (refer to Section 5.2.3).

Insert the free end of the PVC tube into the waste line (hole in the rinse
reservoir area). Carefully inject the deionized water into the waste line and
check that the liquid flows from the external waste line of the instrument to
the waste container.
Repeat the procedure several times to ensure removal of any potential
blockage.

Replace the rinse reservoir. Click the Stop icon and confirm it with OK ; the
arm goes back to waste position and ACL returns to the Ready Status.

• Replacing the Needle

- Press the Open/Close Rotor Cover icon to open the rotor cover.
- Click the Diagnostic button on the Main menu bar and select Needles
Position from the Diagnostic submenu. The needle arm moves over the
rotor holder.
- Label the two tubings that connect to the needle assembly (i.e. top and
bottom).

- Loosen the white knob on the back of the needle, disconnect the tubing,
disconnect the sensor cable and remove the needle block.
- Insert the new needle block, connect the sensor cable, connect the two
tubings and position the block higher than the arm top surface.
Follow the needle positioning procedure as described in the next section.

Instrumentation Laboratory 5.23


Diagnostics and Maintenance

• Needle Positioning Procedure


The procedure to reposition or adjust the ACL sampling/dispensing needles
is necessary in the following situations:
- after having dismantled the needles block for cleaning or
decontamination of the needles
- after having changed the needles block
Procedure
- In order to verify needle centering with the cover open, press the
Open/Close Rotor Cover icon to open the rotor cover.
- Insert the “needle alignment tool” (a special tool in the shipping kit) into
the rotor holder with side A facing up (refer to figures on next pages).
- Click the Diagnostic button on the Main menu bar and select Needles
Position from the Diagnostic submenu. An Open Cover? Yes/No screen
will display if you did not open the cover beforehand. Click Yes to open
the cover. The needle arm moves over the rotor holder.

- Loosen the white knob on the back of the needle arm and move the
needle block (or insert a new one) so that its top surface is higher than
the arm top surface.

- Click the Raise/Lower Arm button to lower the arm to the rotor holder
over the tool.

5.24 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

- Adjust the height of the needle block so that the needles touch the upper
surface of the tool and confirm that the two needles match the two white
reference dots on the tool surface.
- Tighten the needles using the white arm knob, making sure that the
position has not changed after the tightening.

- Click the Raise/Lower Arm button to raise the arm.


- Remove the tool and insert an ACL rotor; manually push the center of
the rotor snap to fit the rotor properly.

- Click the Raise/Lower Arm button to lower the arm and verify that the
needles enter the rotor holes (cuvette position 1) without touching the
edges of the holes.

- Click the Raise/Lower Arm button to raise the arm.


- Click the Rotate button to move the rotor to the next position (cuvette 6
of the rotor) and repeat the same procedure (as for cuvette position 1).

- Repeat as above for cuvettes position number 11, 16 and 1.

- If the centering of the needles is correct, as shown in examples A and B


of the Needle Alignment figure, proceed to the next step. If the needles
are not centered, correct the position.

- Remove the rotor manually.

- Click the Stop icon and confirm it with OK.

- The arm returns to the waste rinse reservoir position.

- In order to verify the needle centering with the cover closed, click the
Diagnostic button and select again Needles Position.

- The needles arm moves over the rotor holder.

- Verify that needles are contained in the rotor cover holes.


- Press STOP and confirm with 4 and the arm returns to the waste
reservoir position.
- Perform a Priming cycle (see Section 5.1.1).

NOTE: The alignment of the needles may not be identical for the four tested
rotor cuvettes. If a needle/needles do not enter the rotor port/ports or if the
sample needle is positioned to the right of the center in any one cuvette (as in
example C of the figure below), the needles must be re-adjusted in the
cuvette where it is furthest to the right, and the entire procedure must be
repeated.

Instrumentation Laboratory 5.25


Diagnostics and Maintenance

Needle Positioning Tool: Top view

Needle Positioning Tool: Side view

5.26 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Needles Alignment

• Replacing the Halogen Lamp


This operation should be done by an IL Representative Service Engineer.

Instrumentation Laboratory 5.27


Diagnostics and Maintenance

5.2.7 Decontamination Procedure


Introduction
This section describes the procedure to be used to decontaminate the ACL
Elite/Elite Pro, either as a general precaution to prevent and eliminate
potential bacterial contamination, or after using the system to test a highly
infectious sample (i.e. from known or suspected Australia Antigen positive
and/or HIV positive subjects, etc.).

Warning: if spillage of a non-infected sample should occur during the course


of normal system use, clean the affected areas following the procedure
indicated in Section 5.2.3.

The use of the ACL system for the analysis of known or suspected highly
infectious samples should be followed by careful disinfecting of the
instrument surfaces and parts which have been in contact with the samples.
The disinfecting agent used to perform the procedure indicated below is a 1:8
dilution of IL Cleaning Agent P/N 98327-00, which is a solution of sodium
hypochlorite with a concentration of less than 0.625% of available chlorine.
The 1:8 diluted solution is prepared by mixing 1 part Cleaning Agent with 7
parts of distilled water.

WARNING: Use only IL Cleaning Agent (P/N 98327-00) diluted 1:8 with
distilled water.

CAUTION: The use of undiluted IL Cleaning Agent may cause corrosion


of metal parts.

Decontamination procedure

Materials required
- 2 glass vials (23 mm diameter, 10 mL maximum volume)
- Prepare approximately 16 mL of diluted Cleaning Agent solution (mix 1
part of IL Cleaning Agent and 7 parts distilled water; e.g. 2 mL of
Cleaning agent and 14 mL of distilled water)
Load the ACL reagent position R6 and R7:
- Reagent position R6 – Place the glass vial filled with 8 mL of diluted
Cleaning Agent solution
- Reagent position R7 – Place the glass vial filled with 8 mL of diluted
Cleaning Agent solution
- Select Diagnostic, then select Cleaning
- Press Start

5.28 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

At the end of the cleaning cycle the ACL returns to the cleaning screen.
Replace the Clean solution with Factor Diluent and repeat the procedure.
Press the cancel button to return to the main screen.
Refer to section 5.1.2 for further details on the cleaning cycle
Remove the vials in position R6 and R7.
Perform a Priming cycle.
Replace the external waste tube and the waste container.

NOTES:
The discarded items must be placed in an appropriate container for further
incineration, according to proper local regulations.

In case of suspected severe contamination, replace the tubing and discard


the old one in an appropriate container for further incineration, according to
proper local regulations

Instrumentation Laboratory 5.29


Diagnostics and Maintenance

5.3 Maintenance Table

Maintenance Procedure
Daily - Empty, if necessary, the liquid waste container
- At the beginning and at the end of each working day or
once per shift, carry out a priming cycle
- Remove and discard used rotors from the rotor holder at
the end of the operation
Weekly - Perform an instrument cleaning procedure by cleaning
all exposed surfaces and the inside of the autosampler
and rotor compartments, with the exception of the rotor
holder, with a cloth soaked in a diluted solution of IL
Cleaning Solution (P/N 98317-00) and rinse with
deionized water (clean the rotor holder with diluted
IL Cleaning Agent (P/N 98327-00)
- Perform a cleaning procedure for needles carrying
out a dedicated cleaning cycle
- Perform a rinse waste reservoir cleaning procedure
Bi Weekly - Clean with a cotton tip applicator:
- the halogen lamp optic fiber surface
- the LED sensor
- the LED fiber optic surface
- the 20 holes of the rotor holder

4 Weeks - Check the air filter

Annual - Replace the air filter


- Replace the sample and reagent tubes
- Replace the waste tube
- Replace the needle block
- Replace the waste reservoir
As needed - Perform a waste line cleaning procedure at the end of
each working day, or more frequently if the number of
samples makes it necessary
- Perform a needle position procedure

5.30 Instrumentation Laboratory


ACL ELITE
ACL ELITE PRO Serial Number: Month:

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Daily

Perform System Prime

Empty Liquid and

Rotor Waste

Weekly

Perform Clean Cycle

Clean Rinse Reservoir

Bi-Weekly

Clean Optical Sensors

Monthly

Clean Air Filter

Instrumentation Laboratory
Instrumentation Laboratory
Troubleshooting
6.0 Introduction
Following the Maintenance guidelines described in Section 5 of this Manual is of
paramount importance to keep the ACL Elite/Elite Pro system in good working order
and to minimize instrument failures.
In the event of a malfunction, the ACL automatically notifies the user of the situation
through a system of warnings and alarms. With the help of built-in system checks and
the guidelines offered in this Section, the user would be able to resolve most of the
problems that may arise.

6.1 Failures, Alarms and Warnings


The following general definitions apply to the types of messages that the ACL
Elite/Elite Pro displays in case of system problems:

• A WARNING, displayed in the form of a yellow ICON on the bottom part of the
screen, announces a problem to the user. Clicking on the icon allows viewing of
text that describes the problem. As a general rule, the instrument may continue to
be used with some limitations, depending on the problem.

• An ALARM warns the user of a problem that needs immediate attention. Some
system sub-functions and operations will still be available. If the failure persists
after the operator switches the instrument off and on again (in case this is
suggested), the problem should be referred to a Service Engineer.

• A FAILURE message indicates a problem serious enough to prevent further use


of the instrument and requires the intervention of a Service Engineer.
All Warnings, Alarms and Failures are grouped in the following 10 categories
depending on the their origin. Each group is addressed in the Sections indicated
below:
- System anomalies Section 6.1.1

- REM (Rotor Exchanger Module) anomalies Section 6.1.2

- Temperature anomalies Section 6.1.3


- Mechanical anomalies Section 6.1.4

- Acquisition station anomalies Section 6.1.5

- Liquids anomalies Section 6.1.6


- Optics anomalies Section 6.1.7

- Operative anomalies Section 6.1.8

- Parsing and loading anomalies Section 6.1.9


- Database anomalies Section 6.1.10
Instrumentation Laboratory 6.1
Troubleshooting

6.1.1 System Anomalies


FAILURES
Error Message Possible Explanation Remedial Action
ACL thermal shut Temperature inside the Contact Service.
down analyzer is higher than
75 oC. The instrument
shuts down automatically.
ACL shut down The output current of the Contact Service.
+5 V supply is higher
than 11 A. The instrument
shuts down automatically.
Hard disk failure Problem with the Contact Service.
controller or damaged
hard disk.
Floppy disk failure Problem with the Contact Service.
controller or damaged
floppy disk.
RAM memory failure Bios finds RAM problem. Contact Service.
Full Hard disk The hard disk is full. Contact Service.
Opening File Missed critical opening Reload the main
file. software. If the failure
persists, contact
Service.
File length alarm Wrong length of a critical Reload the main
file. software. If the failure
persists, contact
Service.
File read alarm Missed reading of a Reload the main
critical file. software. If the failure
persists, contact
Service.
File write alarm Missed writing of a critical Reload the main
file. software. If the failure
persists, contact
Service.
File close alarm Missed closing of a Reload the main
critical file. software. If the failure
persists, contact
Service.
Exhausted memory Exhausted master Reload the main
memory. software. If the failure
persists, contact
Service.

6.2 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Error opening window Error while opening a Reload the main


window on the master. software. If the failure
persists, contact
Service.
Master manager error Error on the master error Reload the main
manager. software. If the failure
persists, contact
Service.
Unexpected internal Unexpected internal Reload the main
message message on the master. software. If the failure
persists, contact
Service.
Internal sending failed Internal sending failed on Reload the main
the master. software. If the failure
persists, contact
Service.
Queue/semaphore Error while creating a Reload the main
creating error queue or semaphore on software. If the failure
the master. persists, contact
Service.
Driver installation Error while installing. Reload the main
error software. If the failure
persists, contact
Service.
Timer allocation error Error while allocating Reload the main
timer on master. software. If the failure
persists, contact
Service.
Internal library error Internal error in the library Reload the main
on master. software. If the failure
persists, contact
Service.
Len parse error Error in the message Reload the main
length from master to software. If the failure
slave. persists, contact
Service.
Subtype parse error Error in the message Reload the main
code (subtype) from software. If the failure
master to slave. persists, contact
Service.
Type parse error Error in the message Reload the main
code (type) from master software. If the failure
to slave. persists, contact
Service.
Invalid parameter Error in the parameter Reload the main
message from master to software. If the failure
slave. persists, contact
Service.

Instrumentation Laboratory 6.3


Troubleshooting

Database failure Major error in the Reload the main


database handling. software. If the failure
persists, contact
Service.
Coded SW failure Major error in code Reload the main
handling. software. If the failure
persists, contact
Service.

ALARMS
Error Message Possible Explanation Remedial Action
Master and slave do not
Slave communication Reload the main
communicate.
failure software. If the failure
persists, contact
Service.
A/D converter failure Periodic error while Reload the main
handling the ADC. software. If the failure
persists, contact
Service.
Slave code absent Missing slave code. Reload the main
software. If the failure
persists, contact
Service.
Slave download error Failed loading the slave Reload the main
code. software. If the failure
persists, contact
Service.
Check DB error Consistency error in the Reload the main
data base. software. If the failure
persists, contact
Service.
Check parameters Error in consistency of Reload the main
error the parameters. software. If the failure
persists, contact
Service.

6.4 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

WARNINGS
ACL thermal warning* The temperature inside Switch the system off,
the analyzer is higher wait a few seconds
than 60oC. and switch it back on.
If the error persists,
contact Service.
REM communication Missing communication Switch the system off,
error with REM. Either the wait a few seconds
(N/A on the ACL Elite) software is missing or and switch it back on.
REM is not working. If the error persists,
contact Service.
REM command error Command not executed Switch the system off,
correctly. wait a few seconds
(N/A on the ACL Elite)
and switch it back on.
If the error persists,
contact Service.
REM download error Download not executed Switch the system off,
correctly. wait a few seconds
(N/A on the ACL Elite)
and switch it back on.
If the error persists,
contact Service.
DB restoring Error Failure to restore Switch the system off,
database. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
DB backup Error Failure to backup Switch the system off,
database. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
File open warning Missed opening a non- Switch the system off,
critical file. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
File length warning Incorrect length of a non- Switch the system off,
critical file. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
File read warning Missed reading a non- Switch the system off,
critical file. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
File write warning Missed writing a non- Switch the system off,
critical file. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
Instrumentation Laboratory 6.5
Troubleshooting

File close warning Missed closing a non- Switch the system off,
critical file. wait a few seconds
and switch it back on.
If the error persists,
contact Service.
Floppy disk full The current floppy disk is Replace with a new
full. floppy disk or Disk
drive.
Floppy disk missing# The current floppy disk is Check the floppy disk
missing. on disk drive.
Floppy disk write The current floppy disk is Replace with a new
protected# write protected. floppy disk.
Printer fail **# Printer is not connected Check printer and
or not working. connection.
Paper end No more paper in printer. Reload printer paper.
Internal BCR failure The internal barcode Switch the system off,
reader is not working. wait a few seconds
and switch it back on.
Reload the main
software. If the error
persists, contact
Service.

* Thermal Fail
This warning indicates the instrument is overheating internally which may
have an effect on the temperature of the measuring chamber. The reason
may be a clogged air filter obstructing the airflow in and out of the analyzer.
Check the air filter on the right side of the analyzer; clean or replace it as
necessary following the instructions in Section 5 (Maintenance). Make sure
that there is free airflow and that the ambient air temperature is below 35oC.

NOTE: The ACL Elite/Elite Pro works optimally when the ambient
o
temperature is in the range of 15 to 32 C, and does not fail in the range
o
of 10 to 40 C.

If cleaning the air filter does not resolve the warning and the ambient
temperature is within limits, contact Service.
** Printer Fail
If the printer does not produce a printout due to a printer failure, the results
may be obtained from the video. Results transmitted via the RS232 C data
link (if connected and enabled) are also correct.
In order to troubleshoot the printer, verify that the paper is correctly loaded.
Also verify that the proper transmission protocol has been selected in the
ACL Elite/Elite Pro Setup (ESCP2 or PCL), and that the printer supports the
selected emulation protocol.
#
The actual error displayed will vary depending upon the submenu where the
request was made. If the failure persists, contact Service.

6.6 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

6.1.2 REM (Rotor Exchange Module) Anomalies*


*(N/A on the ACL Elite)
FAILURES
Error Message Possible Explanation Remedial Action
REM elect fail REM electrical failure. Please logout.
Switch the system off,
wait a few seconds
and switch it back on.
If the error persists,
contact Service.
REM voltage out of REM voltage out of Please logout. Switch
range range. the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Verify that there is no
REM vertical alarm Robotic vertical arm
obstruction interfering
motor failure.
with movement. If
there is no
obstruction, but the
error persists, the
system may be used
in the manual mode
by disabling the REM.
If the error persists,
contact Service.
Verify that there is no
REM horizontal alarm Robotic horizontal arm
obstruction interfering
motor failure.
with movement. If
there is no
obstruction, but the
error persists, the
system may be used
in the manual mode
by disabling the REM.
If the error persists,
contact Service.
Verify that there is no
REM transport alarm Transport motor failure.
obstruction interfering
with movement. If
there is no
obstruction, but the
error persists, the
system may be used
in the manual mode
by disabling the REM.
If the error persists,
contact Service.

Instrumentation Laboratory 6.7


Troubleshooting

Verify that there is no


REM CPU failure REM CPU failure.
obstruction interfering
with movement. If
there is no
obstruction, but the
error persists, the
system may be used
in the manual mode
by disabling the REM.
If the error persists,
contact Service.
The system may be
REM arm EM fault Arm EM failure.
used in the manual
mode by disabling the
REM. If the error
persists, contact
Service.
The system may be
REM arm EM driver Arm circuit failure.
used in the manual
fault
mode by disabling the
REM. If the error
persists, contact
Service.
The system may be
REM transport EM Transport EM failure.
used in the manual
fault
mode by disabling the
REM. If the error
persists, contact
Service.
The system may be
REM transport EM Transport circuit failure.
used in the manual
driver fault
mode by disabling the
REM. If the error
persists, contact
Service.
The system may be
REM stack EM fault Stack EM failure.
used in the manual
mode by disabling the
REM. If the error
persists, contact
Service.
The system may be
REM stack EM driver Stack circuit failure.
used in the manual
fault
mode by disabling the
REM. If the error
persists, contact
Service.

REM errors can be generated if the Rotor Waste door is


opened while the analyzer is executing a rotor exchange.

6.8 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

6.1.3 Temperature Anomalies


ALARMS (also see notes at the end of this table)
Error Message Possible Explanation Remedial Action
Thermal power off Power circuit is off. Please logout. Switch
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Incubation Incubation temperature Allow 30 minutes after
temperature out of out of range after power powering on to allow
range at startup on. temperature
stabilization. If the
error persists, contact
Service.
Incubation Incubation temperature Message may appear
temperature out of out of range during for a few seconds if
range normal operation the rotor cover has
been left open. If the
warning persists after
the rotor cover has
been closed for
several minutes,
contact Service.
Peltier out of range at Peltier temperature out of Wait 30 minutes after
startup range after power on. turning power on. If
the warning persists,
See Note 1.
contact Service.
Although the reagent
refrigeration is not
working correctly, the
system may continue
to be used as long as
the reagents are left
on the analyzer only
for the time required
for the testing.
Peltier out of range Peltier temperature out of If the warning
range during normal persists, contact
operation. Service.
Although the reagent
See Note 1.
refrigeration is not
working correctly, the
system may continue
to be used as long as
the reagents are left
on the analyzer only
for the time required
for the testing.

Instrumentation Laboratory 6.9


Troubleshooting

Transport out of Transport temperature Wait 30 minutes after


range at startup out of range at startup. turning power on. If
the warning persists,
(N/A on the ACL Elite) See Note 2.
contact Service.
In the meantime,
although the thermal
regulation of the rotor
transport is not
operating correctly,
the system may be
used.
Transport out of Transport temperature If the warning
range out of range. persists, contact
Service.
(N/A on the ACL Elite) See Note 2.
In the meantime,
although the thermal
regulation of the rotor
transport is not
operating correctly,
the system may be
used.
Stack out of range at Rotor stack temperature Wait 30 minutes after
startup out of range at startup. turning power on. If
the warning persists,
See Note 2.
contact Service.
In the meantime,
although the thermal
regulation of the rotor
stack is not operating
correctly, the system
may be used.
If the temperature is
Stack out of range Rotor stack temperature
out of range the
out of range.
system may be used
See Note 2. provided Q.C. is
processed during the
session and the
results are within
established limits. If
the error persists,
contact Service.

NOTES:
1. Error Message: Peltier Temperature out of Range

Explanation: Temperature is outside the 10-16oC range.


Remedial Action: Select DIAGNOSTIC from the Main Menu, and then
select TEMPERATURE CONTROL.

- If the video displays ------ or **** for the Peltier, the temperature may be
very high or very low. The instrument may continue to be used provided

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ACL Elite/Elite Pro Operator’s Manual

that the reagents are left on board only for the duration of the testing, and
are refrigerated afterwards. Contact Service.
- If the video displays a temperature value from 4 to 12 oC for the Peltier,
the system is fully operational and precautions need to be taken.
However, the Service Engineer should be called to rectify the situation.
- If the video displays a low temperature value (from 20 to 36 oC), check
that the ambient temperature is not higher than 32 oC. If the problem is
not corrected, contact Service.

NOTE: As noted above, a high temperature may be caused by dirty


filters or ambient temperatures outside the optimal operational range.

2. Error Message: Transport or Stack Temperature out of Range


Explanation: Temperature is outside the 36-39oC range.
Remedial Action: Select DIAGNOSTIC from the Main Menu, and then
select TEMPERATURE CONTROL.

- If the video displays ------ or **** for the transport or stack temperatures
and the instrument has been properly warmed up, contact Service.

- If the video displays a high temperature value (from 36 to 50 oC), check


the air filter and ambient conditions as indicated in 6.1.1 (page 6.7). If the
problem is not corrected, contact Service.

- If the video displays a low temperature value (from 20 to 36 oC), check


that the instrument has been properly warmed up and that the ambient
temperature is higher than 15 oC. If the problem is not corrected, contact
Service.

NOTE: The system is fully operational even when the pre-heater


temperature is out of range, unless the message “INCUBATION TEMP
OUT OF RANGE” appears at the start of analysis.

Instrumentation Laboratory 6.11


Troubleshooting

6.1.4 Mechanical Anomalies


ALARMS
Error Message Possible Explanation Remedial Action
Please logout. Switch
Autosampler alarm Autosampler problem.
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Rotor alarm Rotor holder problem.
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Horizontal motor Horizontal motor arm
the system off, wait a
alarm problem.
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Vertical motor alarm Vertical motor arm
the system off, wait a
problem.
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Reagent dilutor alarm Reagent dilutor problem.
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Sample dilutor alarm Sample dilutor problem.
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Please logout. Switch
Cover alarm Rotor cover problem.
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.

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ACL Elite/Elite Pro Operator’s Manual

WARNINGS
Error Message Possible Explanation Remedial Action
Please logout. Switch
Autosampler warning Autosampler intermittent
the system off, wait a
problem.
few seconds and
switch it back on. If
the error persists,
contact Service.
Verify that there is no
Rotor warning Intermittent problem with
obstruction interfering
rotor holder.
with movement. If the
error persists, contact
Service.
Verify that there is no
Horizontal motor Intermittent problem with
obstruction interfering
warning horizontal motor arm.
with movement. If the
error persists, contact
Service.
Verify that there is no
Vertical motor Intermittent problem with
obstruction interfering
warning vertical motor arm.
with movement. If the
error persists, contact
Service.
Verify that there is no
Reagent dilutor Intermittent problem with
obstruction interfering
warning reagent dilutor.
with movement. If the
error persists, contact
Service.
Verify that there is no
Sample dilutor Intermittent problem with
obstruction interfering
warning sample dilutor.
with movement. If the
error persists, contact
Service.
Verify that there is no
Cover warning Intermittent problem with
obstruction interfering
rotor cover.
with movement. If the
error persists, contact
Service.
The system may be
Stirrer fail Magnetic stirrer not
used without reagent
working.
stirring. In this case
the reagent should be
well mixed before
each run. If the error
persists, contact
Service.

Instrumentation Laboratory 6.13


Troubleshooting

6.1.5 Acquisition Station Anomalies


FAILURES
Error Message Possible Explanation Remedial Action
Acquisition timeout Acquisition running for Switch the system off,
alarm more than 30 minutes. wait a few seconds
and switch it back on.
If the error persists,
contact Service.

WARNINGS
Error Message Possible Explanation Remedial Action
Verify that there is no
Acquisition start error Home position not found
obstruction interfering
at start.
with movement. If the
error persists, switch
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
Verify that there is no
Acquisition sync error Home position not found
obstruction interfering
during acquisition.
with movement. If the
error persists, switch
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.
adc int error Unexpected ADC Log out, switch the
interruption system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Cuv int error Unexpected cuvette Log out, switch the
interruption system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Acq centrifuge error Rotor holder blocked Verify no obstruction
exist. Log out, switch
the system off, wait a
few seconds and
switch it back on.
If the error persists,
contact Service.

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ACL Elite/Elite Pro Operator’s Manual

Acq tx error Unable to Transmit data Log out, switch the


system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Acq rot fail error Rotor fail Log out, switch the
system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Acq opt ref error Optical reference fail Log out, switch the
system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Acq ref error Reference emulsion fail Log out, switch the
system off, wait a few
seconds and switch it
back on.
If the error persists,
contact Service.
Verify that the rotor
Acq cover open error Cover open during
cover is closed. If the
acquisition
cover is closed, but
the error persists,
please logout. Switch
the system off, wait a
few seconds and
switch it back on. If
the error persists,
contact Service.

6.1.6 Liquids Anomalies


ALARMS
Error Message Possible Explanation Remedial Action
Verify the Wash-R
Flush short Reference Emulsion not
bottle liquid level. If
present.
the liquid level is low,
replace with a new
bottle. If sufficient
liquid is present, the
user may temporarily
disable the Wash-R
sensor. It is then the
operators'
responsibility to verify
the Wash-R level. If
the error persists with
the sensor enabled,
contact Service.

Instrumentation Laboratory 6.15


Troubleshooting

WARNINGS
Error Message Possible Explanation Remedial Action
Verify the Wash-R
Flush warning Reference Emulsion
bottle liquid level. If
below 100 mL level.
the liquid level is low,
replace with a new
bottle. If sufficient
liquid is present, the
user may temporarily
disable the Wash-R
sensor. It is then the
operators'
responsibility to verify
the Wash-R level. If
the error persists with
the sensor enabled,
contact Service.
Sample liquid sensor External needle (sample) If the sensor is
off sensor disabled. disabled, it is the
operator's
responsibility to verify
appropriate liquid
levels. If the error
persists with the
sensor enabled,
contact Service.
Reagent liquid sensor Internal needle (reagent) If the sensor is
off sensor disabled. disabled, it is the
operator's
responsibility to verify
appropriate liquid
levels. If the error
persists with the
sensor enabled,
contact Service.
Sample liquid sensor External needle (sample) If the sensor is
fail circuit sensor error. disabled, it is the
operator's
responsibility to verify
appropriate liquid
levels. If the error
persists with the
sensor enabled,
contact Service.
Reagent liquid sensor Internal needle (reagent) If the sensor is
fail circuit sensor error. disabled, it is the
operator's
responsibility to verify
appropriate liquid
levels. If the error
persists with the
sensor enabled,
contact Service.

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ACL Elite/Elite Pro Operator’s Manual

Sample short in Insufficient sample in An insufficient sample


position xxx position xxx. level was detected. If
using a tube transfer
the remaining sample
to a sample cup and
repeat the test. If
sufficient sample is
present, but the error
persists, contact
Service.
If the error appeared
Cleaning not Cleaning not performed
during an analysis,
performed due to insufficient or no
check the cleaning
cleaning solution present.
material level and
perform a cleaning
cycle. If sufficient
material is present,
but the error persists,
contact Service.
Material onboard Timer for a material
Replace the material
stability expired in onboard has expired.
and reset the onboard
position “XX” This material will be
timer.
displayed in orange on
the material map.
Liquid “ID” short A specific non-mandatory An insufficient
liquid “ID” is absent or in material level was
insufficient amount. detected. Make sure
that the material level
is sufficient. If
sufficient material is
present, but the error
persists, contact
Service.
Mandatory Liquid “ID” A specific mandatory An insufficient
short liquid “ID” is absent or in material level was
insufficient amount. detected. Make sure
that the material level
is sufficient. If
sufficient material is
present, but the error
persists, contact
Service.

Error Message: Flush/Optic Channel Error


Explanation: Problem with Reference Emulsion dispensing
Remedial Actions:

- Check the level of the Reference Emulsion in the bottle. If the level is
lower than 1 cm, replace the bottle with a new one. Mix by gentle
inversion before placing in the instrument.

- Check that the Reference Emulsion was correctly dispensed into the
rotor cuvettes for the rotor in the analysis cycle. The positions of the
Reference Emulsion depend on the test (further details in Section 7).
Instrumentation Laboratory 6.17
Troubleshooting

- If the Reference Emulsion bottle is in place and it has sufficient liquid,


check that the fluidic path is free of obstructions.
NOTE: a quick way to check the fluidic path is to remove the needle
assembly from the sample arm. Using a beaker to collect the liquid,
perform an automatic PRIMING cycle and check that the liquid is
coming out of both needles. Remember to perform a NEEDLES
POSITION ADJUSTMENT after this check (refer to Section 5).
- Check that the LED is ON.
- If the LED is ON, perform the optic path cleaning as described in the
Maintenance Section 5.

- If none of the above resolves the problem, contact Service.

6.1.7 Optics Anomalies


WARNING
Error Message Possible Explanation Remedial Action
Please logout. Switch
Halogen lamp fail Halogen lamp is not
the system off, wait a
working.
few seconds and switch
it back on. The system
may be used without the
halogen lamp for
clotting-based tests
only. If the error
persists, contact
Service.

6.1.8 Operative Anomalies


WARNINGS
Error Message Possible Explanation Remedial Action
Waste full Rotor waste is full. Empty the rotor waste container. If
the error persists after emptying the
container, contact Service.
Waste open Rotor waste cover is Close the rotor waste container door.
open. If the error persists after this action,
contact Service.
No rotors (REM No more rotors in the Refill the rotor stack. If the error
active) rotor stack. persists after this action, contact
Service.
No rotors No more rotors in the Refill the rotor stack. If the error
(REM not rotor stack. persists after this action, contact
active) Service.
Rotor station No more rotors in the Refill the rotor stack. If the error
empty rotor stack. persists after this action, contact
Service.

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ACL Elite/Elite Pro Operator’s Manual

Rotor refill Only one or two rotors Refill the rotor stack. If the error
left in the rotor stack. persists after this action, contact
Service.
Cover open Rotor cover was Close rotor cover. If the error persists
during loading / opened during the after this action, contact Service.
incubation loading or incubation
operation.
Time out Time out not met Log out, switch the instrument off,
expired during during loading. wait a few seconds and switch it back
loading on again. If the error persists, contact
Service.
No test to No test to perform Check the programmed tests in the
perform programmed in the database match the tests in the multi-
database and after tests session. Verify that the
host query. connection to the host is working
properly. If they are both OK, contact
Service.
? No tests performed Verify the presence of necessary
due to missing liquids. liquids. If they are all on-board,
contact Service.

6.1.9 Parsing and Loading Anomalies


WARNINGS
Error Message Possible Explanation Remedial Action
Parsing error xxx Error found in the Verify the test definition
parameters during setup is accurate and
loading. complete. Switch the
instrument off, wait a
few seconds and
switch it back on. If the
error persists, contact
Service.
Run error xxx Error found during the Log out, switch the
run. instrument off, wait a
few seconds and
switch it back on. If the
error persists, contact
Service.
Session error xxx Error found during the Log out, switch the
session. instrument off, wait a
few seconds and
switch it back on. If the
error persists, contact
Service.

Instrumentation Laboratory 6.19


Troubleshooting

6.1.10 Database Anomalies


WARNINGS
Error Message Possible Explanation Remedial Action
Database warning Patient database at 95% Remove data from the
or higher. database
Database full Patient database at 100%. Remove data from the
database

6.2 Data Transmission Failure


The error Data Transmission is displayed when there has been an error in the
transmission of the data over the RS232 C interface.
Attempt to re-transmit the data as follows:

- Select SETUP from the Main Menu, select INTERFACE STATUS to view the
Data Transmission characteristics to the Host Computer

- Select Data Transmission connection (ACL-computer)

- Repeat the transmission from the Database.

If the fault persists, contact Service. For additional information please refer to
Appendix (Host Communication Protocol).

6.3 Data Reduction Error Codes


Any error that occurs during the data reduction process will be reported as a code
number. The following subsections describe all the error code numbers and their
meanings. Possible sources for the errors, identified by letter codes, are shown as
flags according to the following list:

Error Code Abbreviation Priority


Data reduction errors R 1 (Highest)
Temperature Errors T 2
Instrument errors (i.e. Sensor error) E 3
Calibration errors C 4
Analytical Reference Errors A 5
QC errors Q 6
Parallelism Errors P 7
Errors on Algorithms, ratio, Ranges… W 8
Material Errors ((i.e. expiration) M 9 (Lowest)

Error Codes, that will not generate a valid result, are represented by an Error Number.
The Error Number is presented instead of a valid result.

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ACL Elite/Elite Pro Operator’s Manual

Error codes that will generate a result plus an additional flag are indicated with a
message that explains the error.
Results with more than one error display the highest priority error.

6.3.1 Session Error Codes


Error 1 - No flush/optical error
Meaning No flush/optical error
Cause Nephelometric optical reference channel out of range
(above 4.0 V or below 1.5 V).
Flags Cycle aborted
Results No results in database.
Remedial Replace Reference Emulsion bottle and clean optics.
Action

Error 2 - Optical error


Meaning Optical error
Cause Absorbance optical reference channel out of range
(above 9.5 V or below 5.0 V).
Flags Cycle aborted
Results No results in database.
Remedial Clean optics.
Action

Error 3 - No flush
Meaning No flush
Cause Absorbance channel Reference Emulsion out of range
(above 3.5 V or below 0.0 V).
Flags Cycle aborted
Results No results in database.
Remedial Replace Reference Emulsion bottle and clean optics.
Action

Error 4 - Optical failure


Meaning Optical failure
Cause Acquisition data check (signal above 10 V).
Flags Cycle aborted
Results No results in database.
Remedial Replace Reference Emulsion bottle and clean optics.
Action

Instrumentation Laboratory 6.21


Troubleshooting

6.3.2 Reaction Curve Error Codes


Warning: For any sample, if you are unsure about the result after reviewing
the error code and clot curve, it is recommended the sample be rerun using
an alternate method.
Error code - 5
Meaning Optical failure
Cause ADC saturation (signal above 9.5 V at the end of the clotting
curve).
Flags R
Results Error 5 instead of the result.
Remedial Possible high Fibrinogen concentration. Dilute the sample
Action 1:1 with factor Diluent and repeat the test.

Error code – 6 *
Meaning Not coag
Cause First threshold not passed.
Flags R
Results Error 6 instead of the result.
Remedial Sample does not clot within the acquisition time.
Action Repeat the test in extended acquisition time.

Error code – 7 *
Meaning Coag error
Cause Second threshold not passed.
Flags R
Results Error 7 instead of the result.
Remedial Sample clot curve is noisy and does not give a normal clot
Action signal within the acquisition time. Repeat the test in extended
acquisition time.

Error code - 8
Meaning Coag error
Cause Delta time between the two thresholds is higher than the
selected value.
Flags R
Results Error 8 instead of the result.
Remedial Possible non-phasic clotting curve. Review the clot curve.
Action Possible sample interference with the clotting reaction.

* = See more details in section 6.4

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ACL Elite/Elite Pro Operator’s Manual

Error code - 9
Meaning Coag error
Cause Initial slope of the reaction curve is higher than the
selected value.
Flags R
Results Error 9 instead of the result.
Remedial Possible bi-phasic clotting curve. Review the clot
Action curve. Possible sample interference with the clotting
reaction.

Error code - 10
Meaning Coag error
Cause Final slope of the reaction curve is higher than the
selected value.
Flags R
Results Error 10 instead of the result.
Remedial Unstable endpoint of the clotting curve. Review the clot
Action curve. Possible sample interference with the clotting
reaction. Repeat the test in extended acquisition time.

Error code - 11
Meaning Final delta error is a check that the curve is not
dropping too much after reaching its maximum reading
Cause Final delta of the reaction curve (maximum abs reading
– final abs. reading) is higher than the selected value.
Flags R
Results Error 11 instead of the result.
Remedial If this is a nephelometric reaction, it may be an
Action indication of an unstable endpoint in the clotting curve.
Review the clot curve. Possible sample interference
with the clotting reaction. Repeat the test in extended
acquisition time.
If this is an absorbance test, it may be an indication of
an absorbance value outside the specified limit.

Error code - 12
Meaning Coag error
Cause Maximum peak of the first derivative is below the
selected limit value.
Flags R
Results Error 12 instead of the result.
Remedial First derivative peak is not significant enough to
Action indicate a real clotting reaction point. Review the clot
curve. Repeat the test in extended acquisition time.

Instrumentation Laboratory 6.23


Troubleshooting

Error code – 13
Meaning Coag error
Cause Maximum peak of the second derivative is below the
selected limit value.
Flags R
Results Error 13 instead of the result.
Remedial Second derivative peak is not significant enough to
Action indicate a real clotting reaction point. Review the clot
curve. Repeat the test in extended acquisition time.

Error code - 14
Meaning Offset error (delta algorithm)
Cause Offset value is greater than “First part” value defined in
calculation setup section of test definition or below
scale range low limit.
Flags R
Results Error 14 instead of the result.
Remedial Review the clot reaction curve “Y” axis scale to
Action determine if value is low or high (turbid). Rerun
Sample.

Error code - 30
Meaning Offset error (delta algorithm)
Cause Offset of the initial part of the curve is below the
selected limit value.
Flags R
Results Error 30 instead of the result.
Remedial Initial reaction turbidity is relatively low. Review the clot
Action reaction curve. Check integrity of reagents, and make
sure no bubbles are present

Error code - 31
Meaning Minimum Curve Delta not met
Cause The total delta of the reaction curve is less than the
limit specified in the test setup. (Reaction curve is flat,
and clot formation may not have occurred)
Flags R
Results Error 31 instead of the result.
Remedial Review the curve and rerun the sample. Sample may
Action have an extended clotting time.

6.24 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Noisy Baseline/Reaction Curve (Error 32/33)


Meaning Reaction curve baseline readings are erratic
Cause Interference in reaction readings
Flags Q - “Noisy Baseline/Reaction Curve” displayed in
Warning List box when clot curve is displayed
Results Numeric Result displayed
Remedial Review Curve and repeat sample
Action

6.3.3 Calibration Error Codes


Error code - 15
Meaning No cal - Insufficient data (curve with a single segment)
Cause Less than 2 calibration standards gave valid results in
the specific curve segment.
Flags on C – No cal - insufficient data
samples
Cal Results Error 15 instead of the result.
Remedial Invalid result. Review the reaction curve. Repeat the
Action calibration with freshly prepared materials.

Error code - 16
Meaning Invalid curve - Insufficient data (curve with more than
one segment)
Cause Less than 2 calibration standards gave valid results.
Flags on C – Invalid curve - insufficient data
samples
Cal Results Error 16 instead of the result.
Remedial Invalid result. Review the reaction curve. Repeat the
Action calibration with freshly prepared materials.

Error code - 17
Meaning Lower No. of standards
Cause A number of standards points are less than the ones
defined in the setup.
Flags on - C – n-1 Standard points
samples
Cal Results Error 17 instead of the result.
Remedial Invalid results. Review the reaction curve. Repeat the
Action calibration with freshly prepared materials.

Instrumentation Laboratory 6.25


Troubleshooting

Error code - 18
Meaning No cal - No mandatory standard/s
Cause A mandatory calibration standard does not give a valid
result (single curve segment).
Flags C – no cal no Standard
Results Error 18 instead of the result.
Remedial Invalid curve. Review the reaction curve. Repeat the
Action calibration with freshly prepared materials.

Error code - 19
Meaning Invalid curve segment - No mandatory standards
Cause A mandatory calibration standard does not give a valid
result (curve with more than one segment).
Flags on C – invalid curve no Standard
samples
Cal Results Error 19 instead of the result.
Remedial Invalid curve. Review the reaction curve. Repeat the
Action calibration with freshly prepared materials.

Error code - 20
Meaning Invalid standards replicates
Cause One or more of the replicates for a defined calibration
standard does not give a valid result.
Flags on C– Invalid Standard n
samples
Cal Results Error 20. Mean is flagged. CV is shown flagged (in
red).
Remedial Invalid standard. Review the reaction curve. Repeat
Action the calibration with freshly prepared materials.

Error code - 21
Meaning CV not shown – Insufficient replicates
Cause One or more of the replicates for a defined calibration
standard does not give a valid result. CV cannot be
calculated (replicates below or = 2).
Flags on C – Insufficient replicates
samples
Cal Results Error 21. CV is not shown.
Remedial Invalid standard. Review the reaction curve. Repeat
Action the calibration with freshly prepared materials.

6.26 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Error code - 22
Meaning Invalid replicate
Cause One replicate for a defined calibration standard does
not give a valid result.
Flags C – Invalid replicates
Results Error 22. Mean value is flagged.
0Remedial Invalid replicate. Review the reaction curve. Repeat
Action the calibration with freshly prepared materials.

Error code - 23
Meaning CV out of range
Cause CV of the replicates higher than the selected limit.
Flags on C – CV out of range
samples
Cal Results Error 23. CV is flagged.
Remedial Result out of range. Review the reaction curve. Repeat
Action the calibration with freshly prepared materials.

Error code - 24
Meaning No cal - slope out of range
Cause The slope of the curve (curve composed by a single
equation) is out of the defined range (single segment).
Flags on C – No Calibration: slope out of range
samples
Cal Results Error 24. Calibration curve not displayed.
Remedial Review the reaction curve. Repeat the calibration with
Action freshly prepared materials.

Error code - 25
Meaning Invalid curve - slope out of range
Cause One of the slopes of the curve (curve composed by
several segments) is out of the defined range.
Flags on C – Invalid segment - slope out of range
samples
Cal Results Error 25. Calibration curve is displayed.
Remedial Review the reaction curve. Repeat the calibration with
Action freshly prepared materials.

Instrumentation Laboratory 6.27


Troubleshooting

Error code - 26
Meaning R2 R2 out of range
Cause R2 The R 2 of the calibration is outside the selected limit.
Flag on C - R2 out of range
samples
Cal Results Error 26. Calibration curve is displayed. R2 value is
flagged.
Remedial Review the reaction curve. Repeat the calibration with
Action freshly prepared materials.

Error code - 27
Meaning No Calibration - No valid curve
Cause The calibration curve does not have any valid
segment.
Flags on No Calibration – no valid curve
samples
Cal Results Error 27. Calibration curve is not presented.
Remedial Review the reaction curve. Repeat the calibration with
Action freshly prepared materials.

Error code - 28
Meaning Curve non monotonic
Cause Invalid calibration due to a result not in sequence
compared to the other calibration points.
Flags on C – invalid segment
samples
Cal Results Error 28. Non monotonic curve.
Remedial Repeat calibration.
Action

Error - Extrapolated data


Meaning Extrapolated data.
Cause Test result is above 150% as compared to the highest
calibration standard or below 60% as compared to the
lowest calibration standard.
Flags on C - Extrapolated result.
samples
Cal Results None
Remedial None
Action

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ACL Elite/Elite Pro Operator’s Manual

Error – Invalid Adjacent Segment (Factor Assays)

Meaning One Segment of Calibration Curve contains an error.


Flags on C – Invalid Adjacent Segment
samples
Remedial Review results before reporting. Repeat any samples
Action if the results are suspicious.

6.3.4 Analytical Reference Error Codes


Error - AR invalid
Meaning AR invalid (using Reference Value for Ratio/INR
calculation)
Cause AR does not give a valid result.
Flags on A – AR invalid
samples
AR Results AR is flagged with an R that indicates the specific Error
code number.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR out of range


Meaning AR out of range (using Reference Value for Ratio/INR
calculation)
Cause AR gives a result out of range.
Flags on A – AR out of range
samples
AR Results AR is flagged in blue.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR invalid
Meaning AR invalid (AR used as reference for Ratio/INR
calculation)
Cause AR does not give a valid calculated result.
Flags on A – AR invalid. Ratio/INR on samples is not presented
samples
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Instrumentation Laboratory 6.29


Troubleshooting

Error - AR out of range


Meaning AR out of range (AR used as reference for Ratio/INR
calculation)
Cause AR gives a result out of range.
Flags on A – AR out of range. Ratio/INR on samples is not
samples presented
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR out of range


Meaning AR out of range (compared to a Calibration standard)
Cause AR does not have a valid Ratio result.
Flags on A – AR out of range, Ratio/INR on samples is not
samples presented
AR Results AR has no ratio calculated.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR not checked


Meaning AR not checked (compared to a Calibration standard
not defined)
Cause AR not checked.
Flags on A – AR not checked. Ratio/INR is given on samples
samples
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR out of range


Meaning AR out of range (no check on AR selected)
Cause AR gives an invalid result.
Flags on none
samples
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

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ACL Elite/Elite Pro Operator’s Manual

Error - ARa invalid


Meaning ARa invalid (check on ARa selected)
Cause ARa is invalid.
Flags on A - ARa invalid
samples
ARa Results ARa flagged.
Remedial Repeat the test with freshly prepared materials.
Action

Error - ARa out of range


Meaning ARa out of range (check on ARa selected)
Cause ARa is out of range.
Flags on A - ARa is cut of range
samples
ARa Results ARa is presented in blue.
Remedial Repeat the test with freshly prepared materials.
Action

Error - ARa invalid


Meaning ARa invalid (check on ARa not selected)
Cause ARa invalid.
Flags on none
samples
ARa Results ARa flagged.
Remedial Repeat the test with freshly prepared materials.
Action

Error - AR invalid
Meaning AR invalid (Ratio defined versus one Calibration
Standard)
Cause AR gives an invalid calculated unit.
Flags on A – AR invalid. Ratio/INR is presented on samples
samples
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Instrumentation Laboratory 6.31


Troubleshooting

Error - AR out of range


Meaning AR out of range (Ratio defined versus one Calibration
Standard)
Cause AR gives a calculated out of range result.
Flags on A – AR out of range. Ratio/INR is presented on
samples samples.
AR Results AR is calculated and presented in blue.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR invalid
Meaning AR invalid (No check on AR is selected)
Cause AR gives an invalid result.
Flags on none
samples
AR Results AR is flagged.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR out of range


Meaning AR out of range (Check on AR is selected)
Cause AR gives an out of range result.
Flags on A – AR out of range. Ratio/INR are not given if AR is
samples defined for Ratio/INR calculation
AR Results AR is flagged in blue.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - AR out of range


Meaning AR out of range (Check on AR is selected on
Calibration standard)
Cause AR gives an out of range result.
Flags on A - AR out of range. Ratio/INR are given but flagged
samples
AR Results AR is flagged in blue.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

6.32 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

6.3.5 QC Error Codes


Error - QC Invalid
Meaning QC not valid (Check QC – Not selected)
Cause QC gives a non-valid result.
Flags on No flag on samples
samples
QC Results QC result is not displayed and the specific code
number is presented.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - QC Invalid
Meaning QC not valid (Check QC -selected, flag samples - not
selected)
Cause QC gives a non-valid result.
Flags on No flag on samples
samples
QC Results QC result is not displayed and the specific code
number is presented.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - QC out of range


Meaning QC out of range (Check QC - selected, flag samples -
not selected)
Cause QC gives a result out of range.
Flags on No flag on samples
samples
QC Results Flagged with QC Invalid and appear in violet or red.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - QC invalid
Meaning QC invalid (Check QC - selected, flag samples -
selected)
Cause QC gives a non-valid result.
Flags on Q – QC Invalid, Flag on samples is present
samples
QC Results QC result is not displayed and the specific code
number is presented.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Instrumentation Laboratory 6.33


Troubleshooting

Error - QC out of range


Meaning QC out of range (Check QC - selected, flag samples -
selected)
Cause QC gives a result out of range.
Flags Q – QC out of range flag on samples is present
Results QC result is flagged in violet or red
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

6.3.6 Double Test Error Codes


Error code - 45
Meaning Mean not calculated (No check selected on mean)
Cause One of the two tests is not valid (non numeric result).
Flags on No flag on samples
samples
Results Error 45. Mean is not displayed.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error code - 46
Meaning Mean not calculated (Check selected on mean)
Cause One of the two results is not valid.
Flags on W – Mean not calculated. Flag on samples
samples
Results Error 46. Mean is not displayed.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error - Mean out of range


Meaning Mean out of range (Check selected on mean)
Cause One of the two results is out of normal range or
linearity range.
Flags on W -- Mean is flagged on samples
samples
Results Mean is presented in relation to the violated result
range.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

6.34 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Error - Mean out of range


Meaning Duplicate out of range (Check selected on mean)
Cause Difference between Replicates exceeds limit
Flags on W - Mean is flagged on samples
samples
Results Mean is flagged in violet.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

6.3.7 Ratio and INR Error Codes


Error code – 52/53/54/55/56/59/60/62/63/65
Meaning Ratio calculation error (i.e. Ratio for PT, APTT, TT,
etc.)
Cause One of the results needed for the calculation is not
valid.
Flags on W - Ratio calculation error. Flag on samples
samples
Results Error 52 = sample
Error 53 = Standard
Error 54 = AR
Error 55 = Sa
Error 56 = ARa
Error 59 = AR invalid
Error 60 = Standard invalid
Error 62 = sample invalid
Error 63 = Reference invalid*
Error 65 = ARa invalid
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.
*Reference Value is set to 0
Error code - 50
Meaning Ratio : S or Sa out of range (i.e. Ratio for APCR-V)
Cause S or Sa out of normal range.
Flags on W – Ratio: S, Sa out of range.
samples
Results Error 50. Ratio is not calculated.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Instrumentation Laboratory 6.35


Troubleshooting

Error code - 58
Meaning NR: AR or ARa out of range (i.e. NR for APCR-V)
Cause AR or ARa out of range.
Flags on W – R: AR, ARa out of range.
samples
Results Error 58. Ratio is not calculated.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.

Error code – 57/64/66


Meaning NR error
Cause Ratio not available to calculate the NR
Flags on W – NR error.
samples
Results Error 57 = Ratio not found*
Error 64 = AR Ratio invalid.
Error 66 = AR Delta invalid.
Remedial Review the reaction curves. Repeat the test with
Action freshly prepared materials.
*Reference Value is set to 0

6.3.8 DMS Errors

Error message Possible explanation


Data base full More than 1000 Sample IDs in the
DMS. Sample IDs must be deleted to
allow space for programming.
More than 30 tests Trying to program test # 31 for a
programmed per sample sample. Tests must be deleted to allow
space for programming.
Duplicated sample ID A duplicate sample ID has been
entered when editing a loadlist.
Duplicate sample ID must be deleted.
Control ID already used ID already used for a QC material.
Sample ID must be changed.
Control ID already used ID already used for another patient
for patient sample. Sample ID must be changed.
Invalid range selection One of the two IDs in the selected
range does not exist.
Sample ID not found ID requested does not exist in the
database.

6.36 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

6.3.9 Other Miscellaneous Errors

Error message Possible explanation


Unidentified sample in Sample does not have an associated
position X ID in the loadlist.
Check sample tray Material is missing from the sample
tray.
Low Sample was found missing during
aspiration or liquid level detection
check.
Test X is not calibrated Test does not have a calibration
associated with it.
Added sample in position A sample that was not in the previous
X loadlist was found during the sample
tray check.
Used rotor Rotor is partially used. Enter the
unused cuvette positions (open the
rotor cover to check the first available
empty cuvette number).
Load rotors Rotor is insufficient to perform the
requested analysis. Add more rotors to
the rotor stack.
AR out of range NP out of range (± 9% for PT, ± 15%
for APTT or ± 20% for FIB-PT based).
QC out of range QC material out of range according to
the selected SD limit in the QC setup.

6.4 “Classic Data Reduction Error”


“Error” appears when there are anomalies in the data generated during the clotting of
the sample. The number that accompanies the error - 6, 7 or 13 - refers to the criteria
algorithm that detected the problem.
For additional details, refer to the diagram in Section 6.6 that graphically describes
the data reduction process.

Error 6
Failing criteria: The clot curve does not pass the first threshold before the end of the
acquisition time.

Possible causes: The sample may not have clotted during the acquisition time, or
the variation in the turbidity is insufficient to trigger the reading of the clotting point.
Run it in extended acquisition time.

Instrumentation Laboratory 6.37


Troubleshooting

Coag Error 7
Failing criteria: The clot curve passes the first threshold, but not the second
threshold, before the end of the acquisition time.
Possible causes: The sample may not have clotted during the acquisition time, or
the variation in the turbidity is insufficient to trigger the reading of the clotting point.
Run it in extended acquisition time.

Error 13
Failing criteria: When the initial slope of the reaction curve is too high, the criteria
used to decide the clotting point is the Maximum of the Second Derivative. If the limit
of the Maximum of the Second Derivative is not passed, it means that the
acceleration of the reaction is not significant enough.
Possible causes: The reaction curve may not be a real clotting curve, likely
indicating a curve that exhibits an unusual biphasic shape.

6.5 Sample ID Errors (using the internal barcode reader)


When using barcoded samples and sample identification is done with the ACL
internal barcode reader, the following errors may be generated:

- No_R = Sample ID missing

- Dpl = duplicated Sample ID

- No_C = truncated Sample ID

- Inv = invalid Sample ID

If any of these errors occur, the operator may enter the sample ID manually into the
system.

6.38 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

6.6 Data Reduction Diagram for PT, APTT and TT

CLOT CURVES
(after smoothing)

Below 1st threshold Threshold Algorithm Between


(part 1) 1st and 2nd
thresholds
ERROR 6 ERROR 7
Above 2 nd threshold

( above∆ time)
∆ time in seconds

Below ∆ time

Slope check control

Above limit Below limit

2nd derivative Threshold


algorithm Algorithm
(part 2)

Below limit ERROR 13 Above 2nd threshold


Above D2 limit Result (#)
Result (*)

(#) Time is calculated at the correspondence of the Maximum Second Derivative of


the clotting curve.
(*) Time is calculated at the intersection between the clotting curve and the first
threshold.

Instrumentation Laboratory 6.39


Assay and Instrument Specifications
7.0 Introduction
This Section includes specifications related to many assays performed on the ACL
Elite/Elite Pro system, as well as specifications related to the instrument and its
accessory items.
The following abbreviations are used throughout this Section:
• D-D h D-Dimer high
• APCR-V Activated Protein
• FPS Free Protein S
C Resistance - Factor V test
• LAC LAC Screen and
• AT Antithrombin
Confirm
• PLG Plasminogen
• SCT Silica Clot Time
• PCX Pro-IL-Complex*
• VWF von Willebrand
• HPX Hepatocomplex*
Factor
• PCL ProClot
• F8 chr H/L Factor VIII
• PC Protein C
chromogenic
• PS Protein S
High/Low
• FIB-C Fibrinogen Clauss
• DP Deficient Plasma
• FIB-C h Fib Clauss High
• AR Analytical
• FIB-C l Fib Clauss Low
Reference
• HEP Heparin
• PI Plasmin Inhibitor
* Not currently available in the U.S.
Note: The ACL Elite/Elite Pro and the ACL8, 9 and 10000 use identical analytical
systems. Reagents, Calibrators, Controls and their assigned values are
interchangeable between the two systems.
The information provided in this Section is organized as follows:

Measured Parameters Section 7.1

Calculation of Results Section 7.2


Coagulometric Tests 7.2.1
Chromogenic Tests 7.2.2

Samples/Reagents Configuration and Specifications Section 7.3


Sample Requirements and Positions 7.3.1
Sample Positions in the Rotor 7.3.2
Coagulometric Test Volumes 7.3.3
Chromogenic Test Volumes 7.3.4
Special Test Volumes 7.3.5

Data Processing Features, Parameters and Analytical Specifications


Section 7.4
Flagging Limits 7.4.1
Results Format: VDU and Printer 7.4.2
Dealing with Result Messages 7.4.3

Instrumentation Laboratory 7.1


Assay and Instrument Specifications

Calibration Curve Slope (m) 7.4.4


Calibration Curve Intercept (q) 7.4.5
Ranges for Calibration Plasma Values 7.4.6
Reaction Times 7.4.7
Coagulometric and Special Tests
Chromogenic Tests
Test Algorithms 7.4.8

Assay Performance Characteristics Section 7.5


Assay Precision Performance, Linearity and Method Comparison Studies
7.5.1
Assay Calibration Stability 7.5.2

Analytical Limitations Section 7.6


Carryover 7.6.1
Assaying a contaminating sample
Assaying a contaminated sample
Cephalin: needle self-conditioning 7.6.2
Lipemic Samples 7.6.3

Container Specifications Section 7.7


Primary Tubes 7.7.1
Cup and Reagent Containers 7.7.2

Instrument Specifications Section 7.8


Hardware and Operational Specifications 7.8.1
Dimensions 7.8.2
Data Bases Specifications 7.8.3

Ambient Specifications Section 7.9

Electrical Specifications Section 7.10

Hazards Section 7.11


General Warning 7.11.1
Shock Hazards 7.11.2
Electrical Hazards 7.11.3
Biohazards 7.11.4
Mechanical Hazards 7.11.5

Addendum: Method Comparison Studies

Note: Please refer to the individual test definitions in the Setup menu
on the analyzer for the latest test library settings for each assay.

7.2 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.1 Measured Parameters


This section describes the parameters that are measured by the ACL Elite/Elite Pro
assays to determine the test results. The tests are grouped according to their common
methodology. A brief explanation (text and graphics) of the methods is given.
Some of these parameters may also be one of the reporting units used by the ACL,
such as “seconds” for the coagulometric tests. All measurements are used in the
internal calculation of test results, either related to calibration curves or processed in
various ways to report other useful parameters as described in Section 7.2.
All parameters are measured on the ACL Elite/Elite Pro at 37oC ± 1 oC, provided the
ambient temperature is kept within the range of 15oC to 32oC.

COAGULOMETRIC TESTS: PT, APTT, TT, Factors, Pro-IL-Complex*,


Hepatocomplex*,SCT, ProClot, and Protein S
The ACL monitors clot formation by light scatter (LS), measuring the time (t)
expressed in seconds (s) required to reach a selected point in the clot formation
curve.

* Not currently available in the U.S.

Instrumentation Laboratory 7.3


Assay and Instrument Specifications

FIBRINOGEN (PT-Based)
This Fibrinogen test is based on clot monitoring measurements as it records the light
scattered before and after the formation of the clot and calculates the difference
between the two readings (delta light scatter = ∆LS).

CHROMOGENIC and LATEX TESTS: Antithrombin, Heparin, Plasmin


Inhibitor, Plasminogen, Protein C (Chromogenic), D-Dimer,vWF and Free
Protein S
The ACL monitors photometrically the color development of the reaction, and
calculates the difference between the light absorbed at the beginning of the reaction
and the light absorbed at a defined point during the reaction (∆OD).

7.4 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

FIBRINOGEN-C
This Fibrinogen test is measured by photometry, measuring the time in seconds that it
takes for the absorbance to change by a predefined amount; this time is then further
related to Fibrinogen concentration.
In case of patient results higher than 600 mg/dL (6 g/L), the test can be executed
using the FIB-C h. In case of patient results lower than 100 mg/dL (1 g/L), the test can
be executed using the FIB-C l. The FIB-C h test will automatically dilute the sample 2
fold and the FIB-C l test will concentrate the sample by half using a reduced volume.

7.2 Calculation of Results


This Section describes the ACL choices for calculation of results from the parameters
measured for each test. Some parameters are reported directly, such as “seconds” for
the coagulometric tests. For other tests, such as the chromogenic ones, the results
are calculated based on the fit of optical measurements to calibration curves, built by
performing similar measurements on calibrators. The ACL offers unit result choices
for many of the tests, as it is capable of using the basic measurements for one sample
and processing them in different ways to derive several other values which are
clinically significant (i.e. ratios).
The table below summarizes the tests, the ACL measured parameters and the result
formats that can be reported by the ACL. The choice of the reported results is
dependent on the instrument and analytical conditions (i.e. pre-calibration, presence
of AR in the run, units selection) as seen in the table below.

Tests Measured parameters Reported Results


PT Seconds s, %, R or INR
FIB (PT-based) Delta Light Scattering mg/dL or g/L
APTT Seconds s, R
Silica Clotting Time Seconds S, offset, final
TT Seconds S, R
Single Factor Seconds s, %
Antithrombin ∆ O. D. %
Heparin ∆ O. D. U/mL
Plasminogen ∆ O. D. %
Plasmin Inhibitor ∆ O. D. %
Pro-IL-Complex* Seconds s, %, R or INR
Hepatocomplex* Seconds s, %, R or INR
ProClot Seconds s, %, R
FIB-C Seconds mg/dL or g/L
Protein C (Chromogenic) ∆ O. D. %

*Not currently available in the U.S.

Instrumentation Laboratory 7.5


Assay and Instrument Specifications

Tests Measured parameters Reported Results


Protein S Seconds s, %
Free Protein S ∆ O. D. %
LAC Screen and Confirm Seconds S, R
VWF ∆ O. D. Offset #, Max, %
F8 Chromogenic High/Low ∆ O. D. %
D-Dimer ∆ O. D. ng/mL, Offset #
APCR-V Seconds (S and Sa) s, R or INR

* Initial average absorbance reading for the reaction

Test Normal Plasma Stored calibration Not calibrated


(AR) in run
PT (Correct ON) with AR s, %, R, INR * s, R/INR *
without AR seconds seconds
PT (Correct OFF) with AR s, %, R, INR * seconds
without AR seconds, % ** seconds
Fibrinogen with AR mg/dL, g/L test must be
without AR calibrated

APTT with AR this test does not seconds, Ratio


without AR require calibration seconds **
TT with AR this test does not seconds, Ratio
without AR require calibration seconds **
Silica Clotting Time this test does not seconds
require calibration
LAC Screen/Confirm this test does not seconds, Ratio
require calibration
Antithrombin % , ∆ OD ∆ OD
Heparin Xa U/mL, ∆ OD ∆ OD
Plasmin Inhibitor %, ∆ OD ∆ OD
Plasminogen % , ∆ OD ∆ OD
Protein C Chromogenic % , ∆ OD ∆ OD
D-Dimer ng/mL, ∆ OD ∆ OD
F8 Chromogenic H/L % , ∆ OD this test MUST be
calibrated each run
Free Protein S % , ∆ OD ∆ OD
Factors s, % seconds
ProClot s , %, R seconds
Fib-C s, mg/dL or g/L seconds
Protein S s,% this test MUST be
calibrated each run
Pro-IL-Complex *** s, %, INR seconds
Hepatocomplex *** s, %, INR seconds
APCR-V # this test does not seconds (s and sa),
require calibration R, NR

* Thromboplastin ISI value is entered in Liquid Setup ** only in case R = S/AR


*** Not currently available in the U.S. # AR is required for NR calculation

7.6 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.2.1 Coagulometric Tests

PT (Prothrombin Time)
PT is measured in seconds. If Normal Plasma (AR) or a calibration curve is
run, the ACL can perform different calculations in order to report results in
other formats: % activity, R (ratio using AR) or INR (International Normalized
Ratio).
In the example below, the (100% calibrator) is measured at 11 seconds
(R=1), the 50% dilution of Calibration Plasma measured at 15 seconds
(R=1.36) and the 25% dilution is measured at 21 seconds (R=1.9).
The Calibration Plasma (100% calibrator) value - in seconds - is used as
denominator to calculate the Ratio (R).

100% NP : 11 s → 11 ÷ 11 = 1 (R)
50% NP : 15 s → 15 ÷ 11 = 1.36 (R)
25% NP : 21 s → 21 ÷ 11 = 1.9 (R)

1/A
PT

0.04

0.02
0.01
R
1 1.36 1.9

NOTE: If the PT test is run with “Correct with AR in Analysis” checked 4, the
Analytical Reference value in seconds is used to modify the calibration curve.
The modified curve is used for the calculation of the sample value.
If the PT test is run with “Correct with AR in Analysis” not checked, the
Calibration Plasma value in the original calibration curve (100% point) is used
for the calculation of the sample value.
Recalibrate the PT test when the lot of Wash-R or rotor lot (alpha character)
changes.

For more details, refer to Section 4 -Test Setup

Instrumentation Laboratory 7.7


Assay and Instrument Specifications

• Result as % activity: The prothrombin activity of the sample is expressed


as % calculated from the calibration curve based on the R-value.
• Result as R: R is the ratio between the sample value in seconds and the
value in seconds for either the AR, the Reference Value or one of the
calibration standards (see NOTE above).

Sample PT (in seconds)


R (ratio) = ———
AR or Reference Value or Calibration Standard (in seconds)

• Result as INR: is the R-value normalized according to the ISI (Sensitivity


Index). To obtain this value, the ISI must be entered in the ACL software.

INR = RISI

APTT, TT
APTT and TT are measured in seconds. These tests do not require
calibration. Normal Plasma may be placed along with the samples in each
analysis run, or a reference value may be stored in the software. For
additional information, refer to Section 4 (Test Setup).
• Result as R: R is the ratio between the sample value in seconds and the
value in seconds for AR or a Reference Value.

Sample APTT/TT in seconds


R (ratio) = —
AR or Reference Value (in seconds)

APCR-V
This test is measured in seconds. Sa is the “activated time” and S is the “base
time”.
• Result as R: R is the ratio between the value in seconds for Sa and the
value in seconds for S.

Sa in seconds
R (ratio) = ———————
S in seconds
• Result as NR: NR is the normalized ratio, the sample ratio value divided by
the Normal Plasma (AR) ratio value.

Sample Ratio value


NR = ————————
AR Ratio value

7.8 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

FACTORS
Factors are measured in seconds; the ACL also calculates the % activity
based on a calibration curve.
The calibration curves for Factor assays are composed of three segments:
one High Curve segment with higher concentration calibrators; one Low
Curve segment with lower concentration calibrators and one Medium segment
which connects the high curve 25 % calibration point with the Low curve
6.25% calibration point.
The Calibration Plasma (100% calibrator) value - in seconds - is used as the
denominator to calculate the Ratio (R).

- For the High Calibration Curve segment:

100% NP : 40 s → 40 ÷ 40 = 1 (R)
50% NP : 50 s → 50 ÷ 40 = 1.25 (R)
25% NP : 60 s → 60 ÷ 40 = 1.50 (R)

The curve is constructed with Ratios (from seconds) on the x-axis and %
Activity on the y-axis, using a log-log scale.

Lg A
2.0
HIGH CURVE SEGMENT
1.69

1.39
Lg R
0 0.09 0.18

Instrumentation Laboratory 7.9


Assay and Instrument Specifications

- For the Low Calibration Curve segment:


6.25% NP (log = 0.80) : 70 s → 70 ÷ 40 = 1.75 (R)
3.12% NP (log = 0.50) : 80 s → 80 ÷ 40 = 2.00 (R)
1.56% NP (log = 0.20) : 90 s → 90 ÷ 40 = 2.25 (R)

Lg A
0.80 LOW CURVE SEGMENT

0.50

0.20 Lg R
0.24 0.30 0.35

The MEDIUM SEGMENT connects the 25% and the 6.25% points.

• Result as % activity: for the whole range of Multilinear Calibration Curve


the ratio between the sample value in seconds and the Calibration Plasma
100% value in seconds is calculated and then used to read the value of
Activity from the calibration curve.
Refer to section 3.4 for preparation of 6.25% dilution used to calibrate low
curve.

Note: All samples run for factor analysis are automatically diluted (x5) by the
ACL system during the analysis.

7.10 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Pro-IL-Complex*
Pro-IL-Complex is measured in seconds; the ACL also calculates the %
Activity based on a calibration curve.
Below are some typical calibration data and a graphical example of a Pro-IL-
Complex calibration curve – 25% - 6.25 segment.

Lg A
1.40
PCX

1.10

0.80
0.21 0.38 0.57 Lg R

Ratio values are calculated using the 100% Standard as denominator.


Therefore the Calibration plasma must be placed on the sample tray when the
Pro-IL-complex calibration is run.
100% NP : 40s → 40 ÷ 40 = 1
25% NP (log = 1.40) : 65s → 65 ÷ 40 = 1.63 (log = 0.21)
12.5% NP (log = 1.10) : 95s → 95 ÷ 40 = 2.4 (log = 0.38)
6.25% NP (log = 0.80) : 150s →150 ÷ 40 = 3.75 (log = 0.57)

The 100% - 25% segment is constructed with Ratios (from seconds) on the
x-axis and 1/% Activity on the y-axis, using a linear scale.
The 25% - 6.25% segment is constructed with Ratios (from seconds) on the
x-axis and % Activity on the y-axis, using a log-log scale.
The sample activity is obtained by calculating the ratio between the sample
value in seconds and the 100% Calibration Plasma in seconds. This value is
then read off of the calibration curve to obtain the value of % Activity.

* Not currently available in the U.S.

Instrumentation Laboratory 7.11


Assay and Instrument Specifications

HEPATOCOMPLEX *
Hepatocomplex is measured in seconds; the ACL also calculates the %
Activity based on a calibration curve.
Below are some typical calibration data and a graphical example of a
Hepatocomplex calibration curve.

100% NP : 18 s → 18 ÷ 18 = 1 (R)
50% NP : 27 s → 27 ÷ 18 = 1.5 (R)
25% NP : 36 s → 36 ÷ 18 = 2 (R)

The Calibration curve is constructed with Ratio on the x-axis and 1/Activity on
the y-axis, on a linear scale.
1/A
0.04
HPX

0.02

0.01

1 1.5 2.0

The sample activity is obtained by calculating the ratio between the sample
value in seconds and the 100% Calibration Plasma in seconds. This value is
then read off of the calibration curve to obtain the value of % Activity.

* Not currently available in the U.S.

7.12 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Silica Clotting Time –Screen and Confirm


SCT is measured in seconds. These tests do not require calibration. Normal
Plasma may be placed along with the samples in each analysis run, or a
reference value may be stored in the software. For additional information,
refer to Section 4 (Test Setup).
• Result as R: R is the ratio between the sample value in seconds and the
value in seconds for a Reference Value.

Sample screen result in seconds


Screen R (ratio) = —
Mean of Screen Normal Range (in seconds)

Sample confirm result in seconds


Confirm R (ratio) = —
Mean of confirm Normal Range (in seconds)

Sample screen ratio


Normalized SCT (ratio) = —
Sample confirm ratio

ProClot
ProClot is measured in seconds; the ACL also calculates the ProClot %
Activity based on a calibration curve.
Below are some typical calibration data and a graphical example of ProClot
calibration curve.

100% NP : 165 s → 165 ÷ 60 = 2.75 (R)


50% NP : 120 s → 120 ÷ 60 = 2.0 (R)
0% NP : 60 s → 60 ÷ 60 = 1.0 (R)
The calibration curve is constructed with squared Ratio on the x-axis and
Activity on the y-axis, on a linear scale.

A PCL
100.0
50.0

0.00

1.00 4.0 7.6 R

The sample activity is obtained using the squared Ratio (calculated using the
sample value in seconds and 0% calibrator value in seconds) to read the %
Activity off the calibration curve.

Instrumentation Laboratory 7.13


Assay and Instrument Specifications

FIBRINOGEN (PT-Based)
The ACL records the light scattered before and after the formation of a clot
and calculates the difference (∆LS) between the two readings.

The ACL calculates the fibrinogen value of the sample in mg/dL using a
calibration curve. The curve correlates the fibrinogen concentration of 3
calibrators with their ∆LS Ratios.
Below is some typical fibrinogen calibration data and the calibration curve
constructed with them.

Cal. Conc. (mg/dL) Delta LS Ratio (R)


300 60 60 ÷ 60 = 1
150 30 30 ÷ 60 = 0.5
75 15 15 ÷ 60 = 0.25

The Calibration curve is constructed with Ratio on the x-axis and Fibrinogen
concentration on the y-axis, on a linear scale.

C(mg/dL)

300

150

75

0.25 0.5 1.0 R


The ACL calculates the ratio between the fibrinogen sample values (in delta
LS) and the first point of Calibration Plasma (in delta LS) to obtain the
corresponding value in mg/dL from the calibration curve.

7.2.2 Chromogenic Tests


Antithrombin, Plasmin Inhibitor, Plasminogen,
Protein C (Chromogenic)
For these chromogenic tests, the ACL measures the difference between the
light absorbed at the beginning and at a defined point during the reaction
(∆OD). The % activity of the sample is calculated from a calibration curve
built with 3 calibrators of known activity and measured ∆OD. Below are

7.14 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

examples of calibration curves for Antithrombin, Plasmin Inhibitor


Plasminogen and Protein C.

A% AT/Plasmin Inhibitor A% Plasminogen/Protein C


100 100

50 50
25 25
OD OD

Instrumentation Laboratory 7.15


Assay and Instrument Specifications

Heparin
For Heparin, the ACL calculates the concentration of the samples in U/mL
based on a calibration curve. The calibration curve is built with 3 calibrators of
known concentration and measured ∆OD.

An example of a Heparin Calibration Curve is shown below.

U/mL Heparin High Curve


0.8

0.4
0.0 ∆OD

1.05 1.45 1.86

NOTE: For Antithrombin and Heparin, the delta OD is measured throughout


the reaction acquisition time of 30 seconds. For Plasmin Inhibitor,
Plasminogen and Protein C (Chromogenic) the acquisition time is 60
seconds.

D-Dimer
For the D-Dimer test, the ACL measures the difference between the light
absorbed at the beginning and at a defined point during the reaction (∆OD).
The concentration of D-Dimer in the sample, in ng/mL, is calculated from a
calibration curve constructed by correlating the calibrator’s delta OD values
and their respective concentrations in ng/mL.
In case of patient results higher than 1050 ng/mL, the test can be rerun using
the D-Dimer high (D-D h) test which has a linearity from 1000 to 5250 ng/mL.

Note: The D-Dh test should only be run on patients with a D-Dimer sample
concentration greater than 1000 ng/mL.

7.16 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

An example of D-Dimer Calibration curve is shown below:


D-Dimer (ng/mL)

1000

500

250

0.12 0.24 0.48 OD

Free Protein S
For the Free Protein S test, the ACL measures the difference between the
light absorbed at the beginning and at a defined point during the reaction
(∆OD). The concentration of Free Protein S in the sample, in %, is calculated
from a calibration curve constructed by correlating the calibrator’s delta OD
values and their respective concentrations in %. The calibration curve for the
Free Protein S is constructed of 3 segments:

Segment 1: 100% to 50%


Segment 2: 50% to 25%
Segment 3: 25% to 12.5%

An example of Free Protein S Calibration curve is shown below:

98.0
49.9

24.5

12.25

0 .06 0.10 0.20 0.34

Instrumentation Laboratory 7.17


Assay and Instrument Specifications

7.3 Samples/Reagents Configuration


and Specifications
7.3.1 Sample Requirements and Positions
The following tables indicate the materials that must be placed on the ACL
Elite/Elite Pro sample tray in order to perform each test, along with their
respective positions. The tables group the different types of tests.
In the Tables, Ax indicates the material map positions on the sample tray for
positions A1 to A10 to be used for Calibrators, Diluents, Buffer, Deficient
Plasma, etc. The default positions are defined in the Setup submenu of the
ACL Elite/Elite Pro software.
For details, refer to Section 4 and Appendix C of this Manual.

COAGULOMETRIC TESTS
Test POSITIONS
Ax Ax Ax Ax 1-40
PT-FIB CAL Normal Factor -- -- --
Pool Diluent
PT-FIB Normal -- -- -- Samples
Pool
APTT Normal -- -- -- Samples
Pool
TT Normal -- -- -- Samples
Pool
PT-FIB/APTT Normal -- -- -- Samples
Pool
SCT Normal -- -- -- Samples
Pool
FACTORS Normal Factor Diluted Deficient Samples
(Calibration + Pool Diluent Normal Plasma
Analysis) (100%) Pool*
(6.25%)

DOUBLE TESTS
Test POSITIONS
Ax Ax Ax Ax 1-40
DOUBLE TEST Normal -- -- -- Samples
(PT-FIB, APTT, TT) Pool

Normal Pool = Calibration Plasma


* Diluted Normal Pool is prepared by placing 300ul of Factor Diluent + 20ul of
Calibration Plasma in a 0.5mL cup. Mix cup well prior to use.

7.18 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

CHROMOGENIC and SPECIAL TESTS


Test POSITIONS
Ax Ax Ax Ax Samples
AT Normal Factor Empty Empty empty cups
Calibration Pool Diluent cup cup in positions
1-12
AT Analysis -- Factor -- -- 1 – 20;
Diluent empty cups
positions
21-40
AT * Normal Factor Empty Empty --
Calibration Pool Diluent cup cup
AT* -- Factor -- -- 1 - 40
Analysis Diluent
Heparin Empty Calibrator Calibrator Working
Calibration Cup Dil.
Heparin -- -- -- Working 1 – 40
Analysis Dil.
PI Normal Diluted -- -- 1 - 40
Pool Buffer
PLG Normal Factor Substrate -- 1 - 40
Pool Diluent
PCX Cal.** Normal Factor DP # Empty --
Pool Diluent cups
PCX Anal.** -- -- DP # -- 1 - 40
HPX Cal.** Normal Factor Empty cups DP # --
Pool Diluent
HPX Anal.** -- -- DP # 1 - 40
PCL Normal Working Protein C Empty 1 - 40
Pool Diluent DP # cup
FIB-C Cal. Normal Factor -- -- --
Pool Diluent
FIB-C Anal. -- Factor -- -- 1 – 40
Diluent
PS Normal PS Activated PS 50% 1 - 40
Pool DP # DP # Std.
PC Normal Diluted Substrate -- 1 - 40
Pool Diluent
FPS Cal. Normal Factor Empty -- --
Pool Diluent Cups
FPS Anal. -- Factor -- -- 1 - 40
Diluent
F8 chr H Normal Empty Cup Empty Cup F8 Chr 1 – 20;
Cal/Anal. Pool Buffer empty cups
positions
21-40
F8 Chr L Empty Empty Cup Diluted F8 Chr 1 – 20;
Cal/Anal. Cup Normal Pool Buffer empty cups
positions
21-40
LAC Screen & Normal 1- 40
Confirm Pool
vWF Cal Normal Factor Dil Empty Cups vWF --
Pool Buffer
vWF Anal. -- Factor Dil vWF
Buffer

Instrumentation Laboratory 7.19


Assay and Instrument Specifications

D-Dimer Calibrator Buffer Factor -- --


Calibration Pool diluent
D-Dimer -- Buffer -- -- 1 - 40
Analysis
APCR-V Normal Factor V -- -- 1 - 40
Pool DP #

* Liquid Antithrombin
** Not currently available in the U.S.
# = Deficient Plasma

The Normal Pool can either be the IL Calibration Plasma or a


laboratory’s pooled plasma.

7.3.2 Sample Positions in the Rotor (unused case)


The following table indicates, for each different test (or test combination in the
case of double tests), the positions occupied in the rotor by the materials
needed to perform the assay. A maximum of 19 samples are used.

TEST Cal Curve NP Samples Reference Optical


Emulsion Reference
PT-FIB Cal. 100% 1-6 -- -- 19 --
50% 7-12
25% 13-18
PT /APTT -- 1 2 - 19 20 --
SCT -- -- 1 - 19 20 --
TT -- 1 2 - 19 20 --
FACTOR 100% 1 -- 7 - 19 20 --
(Cal+Anal) 50% 2
25% 3
6.25% 4
3.12% 5
1.56% 6
FACTOR -- -- 1 - 19 20
Analysis
DOUBLE -- 1 2 - 19 20 --
TEST
(PT-FIB,
APTT, TT)
Liquid - AT 100% 2-5 -- -- 14 1
Cal. 50% 6-9
25% 10-13
Liquid - AT -- -- 2-9 20 1
Analysis
AT Cal. 100% 2-5 -- -- 14 1
50% 6-9
25% 10-13
AT. Analysis -- -- 2 - 19 20 1
Heparin 0.8 2-5 -- -- 14 1
Calibration 0.4 6-9
0.0 10-13
Heparin -- -- 2 - 19 20 1
Analysis
PI / PLG 100% 2 -- 5 - 19 20 1
50% 3
0%4
7.20 Instrumentation Laboratory
ACL Elite/Elite Pro Operator’s Manual

TEST Cal Curve NP Samples Reference Optical


Emulsion Reference
PCX 25% 5-8 -- -- 17 --
Calibration *. 12.5% 9-12
6.25% 13-16
100% 1-4
PCX Analysis * -- -- 1 – 19 20 --
HPX 100% 1-4 -- 13 --
Calibration *. 50% 5-8
25% 9-12
HPX* Anal. -- -- 1 - 19 20 --
PCL 100% 1 -- 4 - 19 20 --
50% 2
0% 3
FIB-C Cal. 150% 2-5 -- -- 14 1
100% 6-9
50% 10-13
FIB-C Anal. -- -- 2 - 19 20 1
PROTEIN-S 100% 1 -- 4 - 19 20 --
50% 2
0% 3
PROTEIN-C 100% 2 -- 5 - 19 20 1
50% 3
0% 4
FPS Cal. 100% 2-4 -- 14 1
50% 5-7
25% 8-10
12.5% 11-13
FPS Analysis -- -- 2 - 19 20 1
F8 Chr H/L 100% 2 -- 5-19 20 1
Cal./Anal. 50% 3
25% 4
LAC Screen/ -- 1 2 - 19 20 --
Confirm
vWF Cal. 100% 2-5 -- -- 18 1
50% 6-9
25% 10-13
12.5% 14-17
vWF Anal. -- -- 2 - 19 20 1
D-Dimer Cal. 1000 2 - 5 -- -- 14 1
ng/mL 500 6 - 9
250 10 - 13
D-Dimer -- -- 2 - 19 20 1
Anal
APCR-V -- 1 and 2 3 - 10 (s) 19 --
11-18 (Sa)

In the chromogenic cycles, the Reference Emulsion serves as a check to


verify complete washing between samples and from rotor to rotor.
* Not currently available in the U.S.

Instrumentation Laboratory 7.21


Assay and Instrument Specifications

7.3.3 Coagulometric Test Volumes


The following tables summarize the sample and reagent volumes aspirated
and dispensed for each coagulometric test, including “head” volumes.

PT-FIB Cal
100% PT-FIB APTT & SCT TT
50% Analysis
25%
Sample 10 µL/sample 10 µL/sample 10 µL/sample 10 µL/sample
Head 0
0
Sample 50 µL 50 µL 53 µL 75 µL
Dispensed 25 µL
12.5 µL
Diluent -- -- -- --
Head 10 µL/sample
10 µL/sample
Diluent -- -- -- --
Dispensed 25 µL
37.5 µL
Reagent 10 µL 10 µL/sample 10 µL reagent 50 µL
Head 10 µL per sample per rotor
10 µL 50 µL CaCl 2 /rotor
Reagent 100 µL 100 µL 53 µL reagent 75 µL
Dispensed 100 µL 50 µL CaCl 2
100 µL

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ACL Elite/Elite Pro Operator’s Manual

NOTE: Conditioning of the needle for cephalin (APTT)


When the APTT based test is proceeded by a cycle using thromboplastin -
PT, Factors of Extrinsic Pathway, Pro-IL-Complex*, Hepatocomplex* and
Protein S, the internal needle aspirates 90 µL of cephalin or Clean A followed
by an 80 µL air bubble. The cephalin or Clean A is then dispensed into the
waste reservoir. This step is repeated three times.

EXTRINSIC PATHWAY INTRINSIC PATHWAY


FACTORS FACTORS
Sample NP Std 1 - 6 10 µL NP Std. 1 - 6 10 µL
Head Samples 10 µL Samples 10 µL
Sample NP Std 1,4** 8 µL NP Std 1,4** 8 µL
Dispensed NP Std 2,5 4 µL NP Std 2,5 4 µL
NP Std 3,6 2 µL NP Std 3,6 2 µL
Samples 8 µL Samples 8 µL
Diluent NP Std 1 – 6 10 µL NP Std 1 – 6 10 µL
Head
Diluent NP Std 1,4 32 µL NP Std 1,4 32 µL
Dispensed NP Std 2,5 36 µL NP Std 2,5 36 µL
NP Std 3,6 38 µL NP Std 3,6 38 µL
Reagent 10 µL 50 µL 10 µL 50 µL 50 µL
Head Standards DP Standards CaCl2 DP
and samples Per each and samples per rotor per each factor
Factor
Reagent 80 µL 40 µL 40 µL 40 µL 40 µL
Dispensed Thrombopl. DP Cephalin CaCl2 DP
Per sample per sample

• NP is the abbreviation for Normal Plasma.


• Std. is the abbreviation for Standard.
* Not currently available in the U.S.
** Std 4 to be prepared manually (20ul Cal plasma + 300ul factor diluent).

Standards for Single Factor assays


For Single Factor assays of the Extrinsic and Intrinsic Pathways, the
Standards are as indicated below:
HIGH CURVE segment LOW CURVE segment
st
1 Standard 100% 6.25%
nd
2 Standard 50% 3.12%
3rd Standard 25% 1.56%

The MEDIUM SEGMENT connects the 25% and the 6.25% points.

Instrumentation Laboratory 7.23


Assay and Instrument Specifications

7.3.4 Chromogenic/405 filter Test Volumes


The following table lists the tests use the 405nm filter on the ACL Elite/Elite
Pro. Details for each test can be either viewed on the screen or printed. The
test information can be obtained under the Setup, Tests, View Define menu.
Once you highlight the test you can either print the information by pressing
the print Icon or you can press the detail Icon to view the test.
The test volumes can be found in the Calibration Setup and Analysis Setup
sections for each test. The volume listed defined for each test do not include
any header volumes. The head volumes are as follows:
Sample Head: 10ul/Sample
Reagent Head: 10ul/cuvette when pipetted along with
the sample (i.e. APTT Cephalin).
Reagent Head: 50ul/rotor when pipetted by itself into the
rotor (i.e. APTT Ca/Cl).

Chromogenic/405 filter
Channel Tests

Test Abbreviation Test Name Test Code Number

PLG Plasminogen 212

PI Plasmin Inhibitor 213

PC Protein C 214

F8 Chr H Chromogenic VIII High 220

D-D D-Dimer 250

AT Anti-Thrombin 200

AT* Anti-Thrombin Liquid 199

HepXa Heparin-UHF 210

Fib-C Fibrinogen Clauss 202

vWF Von Willebrand Factor 400

Free PS Free Protein S 160

Note: The “Optical Reference” is the reference for the chromogenic tests. It
consists of 80 µL diluted buffer + 80 µL enzyme.

7.24 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.3.5 Special Test Volumes

The following table list the Special tests on the ACL Elite/Elite Pro. Details for
each test can be either viewed on the screen or printed. The test information
can be obtained under the Setup, Tests, View Define menu. Once you
highlight the test you can either print the information by pressing the print Icon
or you can press the detail Icon to view the test.
The test volumes can be found in the Calibration Setup and Analysis Setup
sections for each test. The volume listed defined for each test do not include
any header volumes. The head volumes are as follows:
Sample Head: 10ul/Sample
Reagent Head: 10ul/cuvette when pipetted along with
the sample (i.e. APTT Cephalin).
Reagent Head: 50ul/rotor when pipetted by itself into the

rotor (i.e. APTT Ca/Cl).

Special Tests

Test Abbreviation Test Name Test Code Number

APCR-V Activated Protein C 225


Resistance

LAC-S, LAC-C LAC Screen/Confirm 410/411

SCT-S, SCT-C SCT Screen/Confirm 155/156

PCX* Pro-IL Complex 150

HPX* Hepatocomplex 151

P-ClotSP Proclot SP 153

PS Protein S 159

* Not currently available in the U.S.

Instrumentation Laboratory 7.25


Assay and Instrument Specifications

7.4 Data Processing Features, Parameters and


Analytical Specifications
7.4.1 Flagging Limits
When results are outside acceptable limits, Low or High, the ACL flags them
by displaying them as --- / *** respectively or in a different color. There are
three types of results that are flagged in this manner:

1. test results outside the instrument numeric reading scale capabilities


2. linearity of calibration curves outside acceptable limits
3. percent CV (%CV) for calibration cycles outside relative acceptable limits.

1. Tests Results Outside the Instrument Reading Scale


Capabilities
These limits are imposed by the instrument electro-mechanical capabilities
they are not necessarily the same as the limits of the assay range.

NOTE: Check the Instrument settings and package insert included with the
assay’s reagents to obtain information about the range and the limitations of
the assay, and the procedure to follow when the assay results are outside the
linear range.
The table below indicates, for each test, which results are displayed in Black
and which results are outside the limits and therefore displayed in Red.

7.26 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

TEST Red Black Red --- / ***


PT < 15% 15-150% > 150% <0 - >500%
Fibrinogen < 40 mg/dL 40-800 mg/dL > 800 mg/dL <0 - >3000
< 0.4 g/L 0.4-8.0 g/L > 8.0 g/L mg/dL
<0 - >30 g/L
Factors < 1% 1-150% > 150% <0 ->900%
Lyophilized < 15% 15-150% > 150% <0 ->900%
Antithrombin
Liquid < 15% 15-150% > 150% <0 ->900%
Antithrombin
PI < 10% 15-150% > 150% <0 ->500%
PLG < 10% 15-150% > 150% <0 ->500%
PC < 15% 15-150% > 150% <0 ->500%
Heparin <0.1 U/mL 0.1-1 U/mL > 1 U/mL <0 ->90 U/mL
Pro-IL-Complex* < 4% 4-150% > 150% <0 ->900%
Hepatocomplex* < 8% 8-120% > 120% <0 ->500%
ProClot < 10% 10-150% > 150% <0 ->500%
Protein S < 10% 10-150% > 150% <0 ->500%
FIB-C < 60 mg/dL 60-550 mg/dL >550 mg/dL <0 ->900 mg/dL
< 0.6 g/L 0.6-5.5 g/L >5.5 g/L <0 ->9.0 g/L
Free Protein S < 10 % 10- 140% > 140% <0 ->999%
F8 Chr H < 10 % 10- 120% > 120% <0 ->500%
F8 Chr L <0% 0- 10% > 10% <0 ->500%
LAC S/C < 12 s 12.0- 165.0 s > 165 s 10- 999 s
< 0.5 R 0.5- 5.0 R > 5.0 R <0 ->99.0 R
SCT S/C <6.640 s 24 – 35 s >247.5 s <0 - >300
vWF < 10% 10- 150% > 150% <0 ->999%
D-Dimer <200 ng/mL 200-1050 ng/mL >1050 ng/mL <0 ->9999
ng/mL
* Not currently available in the U.S.
*** Represents the operating limit of the system (scale range)

2. Linearity of calibration curves outside acceptable limits


The most reliable results are obtained when the linearity coefficient r2 of a
calibration curve is close to 1.000. The ACL offers helpful “visual” help by
flagging r2 outside relative acceptable limits. For example, If a test had the
acceptable limit set as > 0.980, results outside the limit would display as:

• r2 < 0.980 - displayed in Red

• 0.980 < r2 ≤ 1.000 - displayed in Black


Refer to the Calculation setup parameters for specific limits on each
test.

Instrumentation Laboratory 7.27


Assay and Instrument Specifications

3. Percent CV (%Coefficient of Variation) for calibration


cycles
When the calibration replicates %CV values are greater than programmed
acceptable limits, they are flagged in red. The table below lists the acceptable
limits for each test.

NOTE: for PT and Fibrinogen, calibrations are considered acceptable by the


system if the %CV is no more than 1% higher than the limit and the r2 is within
the acceptable limits.

TEST Calibrator %CV limit


PT NP (100%) 1.5
NP (50%) 2.0
NP (25%) 2.0

FIB NP (100%) 8.0


NP (50%) 12.0
NP (25%) 12.0

Lyophilized AT NP (100%) 8.0


NP (50%) 6.0
NP (25%) 4.0

Liquid AT NP (100%) 8.0


NP (50%) 6.0
NP (25%) 4.0

Heparin NP (100%) 8.0


NP (50%) 6.0
NP (25%) 4.0

HPX* NP (100%) 1.5


NP (50%) 2.0
NP (25%) 6.0

PCX* NP (100%) 2.0


NP (25%) 3.0
NP (12.5%) 4.0
NP (6.25%) 6.0

FIB-C NP (150%) 1.5


NP (100%) 2.0
NP (50%) 2.5

FPS NP (100%) 8
NP (50%) 8
NP (25%) 8
NP (12.5%) 20

vWF NP (100%) 5
NP (50%) 5
NP (25%) 7
NP (12.5%) 10

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ACL Elite/Elite Pro Operator’s Manual

D-Dimer NP (1000 ng/mL) 4.0


NP (500 ng/mL) 6.0
NP (250 ng/mL) 10.0

* Not currently available in the U.S.

7.4.2 Results Format: VDU and Printer


The format used to display and print numerical fields is dependent upon the
value obtained. The format cannot be changed. The following rules are used:

Value Range Format Example


X<1 x.yyy (3 decimal places) Concentration (U/mL)
1 ≤ X < 10 x.yy (2 decimal places) Time
10 ≤ X < 100 xx.y (1 decimal place) Activity

X ≥ 100 XXX (or greater, Concentration (mg/dL)


depending on field size)

7.4.3 Dealing with Result Messages


One table is presented below which is related to result messages that appear
on the VDU or printer.

• This table contains a list of the most common messages that may appear
on the ACL in place of results, ordered by test, along with explanation and
suggestions to obtain a numerical result.

Instrumentation Laboratory 7.29


Assay and Instrument Specifications

General Messages Table

TEST MESSAGE Possible Explanation


PT Error 6 The sample does not clot within the
programmed acquisition time.
Read the sample in Extended Time
Error 7 Fibrinogen< 60 mg/dL
Clotted sample analyzed
Normal plasma value Normal Plasma out of range with respect
displayed in violet to the reference data (range ± 9% of the
reference value). Results are flagged
depending on calculation setup.
FIB *** on the sample The FIB value exceeds the high scale
range limit.
Dilute the sample 1:2 with Factor DIL for
high samples and repeat.
value > 800 mg/dL on Dilute the sample 1:2 to fit into the
the sample, in red instrument operating range.
Normal Plasma value Normal Plasma out of range (Range ±
displayed in violet 20% of the reference value).
Error 10 The clot may not be completely
stabilized. Read the sample in the
Extended Acquisition Time
No FIB is given for the Light scatter exceeds the maximum
sample. readable limit of the amplifier.
1. Analysis mixture is very turbid and
initially exceeds the readable limit.
2. During clot formation the curve
exceeds the readable limit.
Dilute the sample 1:2. to fit into the
instrument operating range and multiply
results by 2.

7.30 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

TEST MESSAGE Possible Explanation


APTT Error 6 The sample does not clot within the
maximum end time. Read the sample in
Extended Acquisition Time
Error 7 - Fibrinogen < 60 mg/dL
- Clotted sample analyzed
Normal Plasma value Normal Plasma out of range with respect
displayed in violet to the reference data (range ± 15% of the
reference value).
Results are flagged depending on
calculation setup.
TT Error 6 The sample does not clot within the
acquisition time. Read the sample in
Extended Acquisition Time
Error 7 - Fibrinogen < 60 mg/dL
- Already clotted sample
Normal Plasma value Normal Plasma out of range with respect
displayed in violet to the reference data (range ± 20% of the
reference value). Results are flagged
depending on calculation setup.

Instrumentation Laboratory 7.31


Assay and Instrument Specifications

7.4.4 Calibration Curve Slope (m)


The table below lists the expected slopes (m) for the calibration lines.

TEST range of slope m


PT 0 - 0.2
FIB - mg/dL 0 – 1000
- g/L 0 – 10
Factors 100% - 25% -20 – 0
25% - 6.25% -30 – 0
6.25% - 1.56% -30 – 0
Lyophilized Antithrombin -2000 – 0
Liquid Antithrombin -2000 – 0
Plasmin Inhibitor -2000 – 0
Heparin -200 – 0
Plasminogen 0 – 1000
Pro-IL-Complex* -12 – 0
25%-6.25% segment
Pro-IL-Complex* 0 - 0.17
100%-25% segment
Hepatocomplex* 0 - 0.35
ProClot 0 – 200
FIB-C -10 – 0
PC 0 – 1000
Protein-S 0 – 10
Free Protein S 0 – 1000
vWF: Ag 0 – 1000
D-Dimer 0 – 6000

* Not currently available in the U.S.

7.4.5 Calibration Curve Intercept (q)


In tests that require calibration (PT-FIB, Factors, Chromogenic Tests and
Special Tests), the calibration curve is best fitted to the measured points such
that the first point (first dilution) lays on the calibration line.
The following graphs illustrate the situation before and after the fitting to the
first point.
The equation for a line is: Y = mX + q
Therefore: q = Y - mX
The graph displayed uses this first intercept “q”, as seen below.


q

7.32 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

The curve is then transported so it passes through the first point, and a new
intercept q’ is calculated: q’ = Y’ - mX’
The sample results for these calibrated tests are calculated from this new
calibration curve, which has an identical slope to the original one, but a
different intercept.

q’ •←


7.4.6 Ranges for Calibration Plasma Values


Before analyzing samples, the ACL Elite/Elite Pro requires the user define the
corresponding value of the Calibration Plasma for each test. This is done in
the Liquid setup area of the software (for details refer to Section 4).
When this area is accessed, a default value is displayed; the user enters the
corresponding value for the lot of Calibration Plasma in use.

7.4.7 Reaction Times


This section contains information about the different timings within the
reactions for each test measured by the ACL Elite/Elite Pro, including the
details of the data acquisition process. The tests have been divided into two
groups which are treated separately: Coagulometric/Special tests and
Chromogenic tests.

COAGULOMETRIC TESTS and SPECIAL TESTS


The following diagram represents the general reaction for a Coagulometric
and a Special test:

INTER-RAMP DATA

INTERVAL DELAY ACQUISITION

TIME TIME

RAMP RAMP RAMP

0.4 s 0.4 s # 0.4 s

Instrumentation Laboratory 7.33


Assay and Instrument Specifications

The table below shows the specific reaction times for coagulometric and
special test. Please refer to the individual tests on the system for more details.

NOTES related to table below:


1. BLANKING TIME = RAMP + INTER-RAMP INTERVAL (seconds)
2. TOTAL ACQUISITION TIME = BLANKING TIME + ACQUISITION TIME
(seconds) or BLANKING TIME + DELAY + ACQUISITION TIME (seconds)

3. EXTENDED time is available for PT-FIB, APTT and TT in single and


double tests mode.

COAGULOMETRIC Blank. Acq. Acq. Total Acq.


Time time per time time
TESTS (sec) point (sec) (seconds)§
(msec)
PT/FIB Calibration* 4 100 58 62
PT/FIB Analysis*
(single, double)
standard 4 100 58 62
extended 4 150 165 169
APTT (single, double)*
standard 4 100 115 119
extended 4 250 245 249
SCT S/C
4 250 245 245
TT 2 mL
standard 2 100 58 60
extended 2 150 165 167
TT 5 mL
standard 4 100 58 62
extended 4 150 165 169
TT 8 mL
standard 4 100 58 62
extended 4 150 165 169
FACTORS
Extrinsic Pathway
Calibration + Analysis 4 150 165 169
FACTORS
Intrinsic Pathway
Calibration + Analysis 4 150 165 169
FACTORS -
Ext.Pathway Analysis 4 150 165 169
FACTORS -
Int.Pathway Analysis 4 150 165 169
*Check individual test definitions in the system for specific values

7.34 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

SPECIAL Blank. time Acq. time Acq. time Total Acq.


(sec) per point (sec) time
TESTS Ramp, delay (msec) (seconds)
Pro-IL-Complex # 4 + 20 250 275 299
Hepatocomplex # 4 200 220 224
ProClot 4 + 20 250 275 299
Protein-S 4 200 220 224
APCR-V 4 200 220 224

# Calibration and Analysis; not currently available in the U.S.

CHROMOGENIC TESTS
The following diagram represents the reaction for a chromogenic assay:

ACQUISITION TIME

RAMP RAMP

0.4 s 0.4 s 0.4 s

The table below summarizes the reaction times:

CHROMOGENIC TESTS Blank. time Acq. time Acq. Time Total Acq. time
(sec) per point
Ramp, delay (msec) (seconds) (seconds)

Antithrombin 1 100 30 31
Liquid Antithrombin 1 50 20 21
Heparin 1 100 30 31
Plasminogen 1 100 60 61
Plasmin Inhibitor 1 100 60 61
Protein C (Chromogenic) 0 100 90 90
Fibrinogen-C 2 100 90 92
Factor VIII (chromogenic) 1 100 120 121
vWF : Antigen 1 250 300 301
Free Protein S 1 250 300 301
D-Dimer 2+1 250 300 303

Instrumentation Laboratory 7.35


Assay and Instrument Specifications

7.4.8 Test Algorithms


The following table shows the algorithms that relate the Y-axis and X-axis for
the parameter measurements done on the ACL Elite/Elite Pro.

TEST CORRELATION Y X
PT Linear 1/Activity Ratio
FIBRINOGEN Linear C (mg/dL or g/L) Ratio
FACTORS Log Activity Ratio
AT, PLG, PC, PI Linear Activity ∆OD
HEPARIN Linear C (U/mL) ∆OD
PRO-IL-Complex* Log/Log Activity R
(25%-12.5%-6.25%)
PRO-IL-Complex* Linear 1/Activity R
(100% -25%)
HEPATOCOMPLEX* Linear 1/Activity R
PROCLOT Quadratic Activity R2
FIBRINOGEN-C Log-Log/Log C (mg/dL or g/L) seconds
PROTEIN-S Linear Activity seconds
D-DIMER Linear 1/C (ng/mL) ∆OD
VWF Linear Activity ∆OD
Free Protein S Linear Activity ∆OD
* Not currently available in the U.S.

7.36 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.5 Assay Performance Characteristics

7.5.1 Assay Precision Performance, Linearity and Method


Comparison Studies
This section contains information about the analytical precision performance
of several assays on the ACL Elite/Elite Pro. The tables displayed below
include data obtained during performance studies (for the purpose of system
evaluation) conducted at IL laboratories or in the field.
The data presented should be used as an example of typical precision
performance of the assays on the ACL Elite/Elite Pro.
Precision studies
The table below shows the within-run precision data obtained for 2 or 3 levels
of controls, during studies performed at IL on an ACL Elite/Elite Pro for the
following IL reagents.

Within Run Precision


Within run precision assessed over multiple runs (10) using multiple levels of
control plasma gave the following results:

Instrumentation Laboratory 7.37


Assay and Instrument Specifications

Precision Performance

Reagent Control Level n Mean %CV


Normal 30 112.3 2.33
Antithrombin Abnormal 1 30 58.3 3.23
(%) Abnormal 2 30 25.7 3.42
Level1 40 0.98 1.82
APCR-V Level 2 40 0.62 1.96
(Normalized Ratio)
Normal 60 29.3 1.27
APTT-SP Abnormal 1 60 49.2 0.98
(seconds) Abnormal 2 60 61.3 1.72
Level 1 90 263 6.54
D-Dimer Level 2 90 673 3.00
(ng/mL)
Normal 40 78.9 3.32
Factor VII (%) with Abnormal 1 40 55.7 3.01
PT-Fibrinogen Abnormal 2 40 24.4 4.04
Normal 40 77.0 8.39
Factor VIII (%) with Abnormal 1 40 84.0 6.67
APTT-SP Abnormal 2 40 39.2 6.67
Normal 80 269.3 3.20
Fibrinogen-C Low Fibrinogen 80 97.2 2.09
(mg/dL)
0.85 LMW Heparin 30 0.8 2.02
Heparin Low Heparin 30 0.3 4.33
(U/mL) High Heparin 30 0.7 2.65
Normal 50 110 1.21
Plasmin Inhibitor Abnormal 1 50 68.4 2.52
(%) Abnormal 2 50 35.3 3.82
Normal 50 106.2 2.78
Plasminogen
Abnormal 1 50 69.2 2.94
(%) Abnormal 2 50 31.3 3.31
ProClot (%) Normal 80 83.0 3.71
APTT-SP Abnormal 80 48.6 5.12
Normal 40 95.4 1.68
Protein -C (%) Abnormal 1 40 51.1 1.77
Abnormal 2 40 22.8 3.31
Normal 70 103.1 2.60
Protein -S (%) Abnormal 2 70 50.7 4.36
Normal 60 12.8 1.30
PT Abnormal 1 60 19.2 1.75
(seconds) Abnormal 2 60 29.1 2.07
Normal 90 243.0 7.06
PT-FIB Low Fibrinogen 90 106.4 7.14
(mg/dL)
Normal 90 17.9 3.39
TT 8 mL Heparin sample 90 22.8 3.57
(seconds)

7.38 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Linearity Studies
Linearity studies were performed over multiple sample levels with each level
run in duplicate on an ACL Elite/Elite Pro. Results are shown in the table
below:

Reagent No. of Slope Intercept r Sample


Levels Range
Antithrombin 7 0.94 5.958 0.999 14-140
(%)
D-Dimer 10 0.97 6.229 0.998 56-1192
(ng/mL)
Factor VII (%) with 9 1.01 -4.036 0.997 1.9-132
PT-Fibrinogen
Factor VIII (%) with 9 0.87 -0.508 1.000 2.3-127.5
APTT-SP
Fibrinogen-C 7 1.10 -25.713 0.999 91-528
(mg/dL)
Heparin 7 0.97 -0.007 0.999 0.00-1.07
(U/mL)
Plasmin Inhibitor (%) 7 0.94 6.677 0.997 0-115
Plasminogen (%) 7 0.95 3.500 0.994 0-137
ProClot (%) 8 0.92 -0.129 1.000 0-171
APTT-SP
Protein -C 7 1.04 -0.338 1.000 0.5-173.5
(%)
Protein -S 11 1.00 -0.221 1.000 0-120
(%)
PT 6 0.96 0.565 1.000 12-35
(seconds)
PT-Based Fibrinogen 9 0.95 15.621 0.997 0-567
(mg/dL)

Instrumentation Laboratory 7.39


Assay and Instrument Specifications

Method Comparison Studies

In method comparison studies evaluating citrated plasma samples, the ACL


Elite/Elite Pro results were similar to the predicate device’s (ACL 9000) results
as supported by the summary of linear regression statistics below. The graphs
are reported in the Addendum at the end of this chapter.

Reagent No. of Slope Intercept r Sample


Sample Range
Levels
Antithrombin 48 1.08 -3.031 0.995 14-125
(%)
APCR-V 57 0.97 0.021 0.993 0.457-1.105
(Normalized Ratio)
APTT-SP 54 1.04 -1.471 0.998 27.5-96.2
(seconds)
D-Dimer 46 0.91 86.596 0.996 56-1083
(ng/mL)
Factor VII (%) with 48 1.02 -2.605 0.996 2.4-170
PT-Fibrinogen
Factor VIII (%) with 47 0.96 0.6184 0.990 0.96-199.2
APTT-SP
Fibrinogen-C 54 1.10 -14.032 0.998 74-766
(mg/dL)
Heparin 50 1.03 -0.002 0.996 0.00-1.21
(U/mL)
Plasmin Inhibitor 57 0.91 8.642 0.990 49.6-125.0
(%)
Plasminogen 57 0.99 3.525 0.989 18.4-150.8
(%)
ProClot (%) 54 0.98 1.912 0.995 10.7-199.1
APTT-SP
Protein -C 52 1.10 -5.781 0.998 22-317
(%)
Protein -S 54 0.92 2.935 0.993 12-117
(%)
PT 52 1.07 -0.838 0.999 10.4-25.1
(seconds)
PT-Based Fibrinogen 51 0.93 35.038 0.990 49.7-844.7
(mg/dL)
Thrombin Time-8 mL 54 1.01 1.010 0.998 15.5-43.5
(seconds)

Please refer to the end of this chapter for the Method Comparison Graphs.

7.40 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.5.2 Assay Calibration Stability


Calibration stability studies were done at IL with a full range of controls in
order to determine the minimum amount of time that a calibration curve can
be used for each assay. The results are shown in the table below.

TEST Calibration Stability


Factor II 5 days
Factor V 5 days
Factor VII 5 days
Factor VIII 5 days
Factor IX 5 days
Factor X 5 days
Factor XI 5 days
Factor XII 5 days
Fibrinogen-C 5 days
Antithrombin 5 days
Liquid Antithrombin 30 days
Heparin 5 days
Plasminogen 5 days
Plasmin Inhibitor 5 days

These time intervals should be used as guideline only. Use of Quality Control materials
is the best determinant of stability in your laboratory.

Instrumentation Laboratory 7.41


Assay and Instrument Specifications

7.6 Analytical Limitations


7.6.1 Carryover
Studies performed on all members of the ACL family have shown sample
carryover to be less than 0.5% by volume.
In most cases, the inaccuracy contributed by the carryover factor is well within
the expected imprecision of the method; therefore, it is not statistically or
clinically significant.
The following exception cases were found to be statistically significant,
although not clinically significant (the amount of contamination will not shift an
abnormal sample result into the normal range):
1. When testing a plasma sample (PT or APTT) from a patient with a severe
Factor Deficiency (factor < 10%) immediately after a normal sample.
2. When testing an unusually high heparinized sample (> 10 U/mL) or
samples from patients undergoing aggressive factor replacement therapy,
immediately after a normal sample.

Assaying a Contaminating Sample


The following procedure is recommended in order to deal with a sample that
is suspected of containing high levels of Factors or Heparin and avoid
carryover into others:
Testing mode for APTT or PT/FIB: place the suspect sample in cup #1. Place
Reference Emulsion or Factor Diluent in the pool position. Place Hydrochloric
Acid (HCl 0.1 N) in cup positions #2 and #4. Place deionized water in
positions #3 and #5. Use cups in positions 6-9 to place the other samples to
be assayed.

Note: No calculated results will be reported in this situation (i.e. Ratio,


INR, % activity or fibrinogen).

Assaying a Contaminated Sample


The following procedure is recommended in order to re-assay samples which
are suspect of having been contaminated by the sample preceding them in
the run (with high Factors or Heparin):
Note: because the contamination is caused by carryover, it affects
mostly the aspirated sample and has minimal effect on the sample
remaining in the cup.
Testing mode for APTT or PT/FIB: place the sample to be re-assayed in cup
#1. Use cups in positions 2-9 to place the other samples to be assayed.

7.42 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.6.2 Cephalin: needle self-conditioning


The reagent aspiration/dispensing needle does its own “self-conditioning”
prior to using the cephalin reagent.
When a test which uses cephalin is preceded by a cycle using thromboplastin
(i.e. PT, Single Factors of the Extrinsic Pathway, Pro-IL-Complex*,
Hepatocomplex* or Protein-S), the following procedure is repeated three
times before aspirating the cephalin:
- the internal needle aspirates 90 µL of reagent or Clean A, followed by
an 80 µL air bubble;
- the liquid is discarded into the waste reservoir.
* Not currently available in the U.S.

7.6.3 Lipemic Samples


If a lipemic sample is tested on the ACL Elite/Elite Pro, the turbidity caused by
the lipemia may interfere with the fibrinogen measurement that is done by
light scattering.
Lipemic specimens should preferably be cleared before testing on the ACL.
However, since studies have shown that there is a linear relationship between
turbidity and fibrinogen values, a correction factor has been introduced in the
calculation of fibrinogen results based on the initial offset of the sample in
order to compensate for lipemic interference.

7.7 Container Specifications


7.7.1 Primary Tubes
The ACL Elite/Elite Pro sample tray accepts several kinds of primary tubes, in
different sizes and filling volumes, as specified in the table below.

Primary glass Anticoagulant Drawn Blood Total Volume


tube size (mm) Volume (mL) Volume (mL) (mL)
13 x 75 - Type a 0.50 4.5 5.0
13 x 75 - Type b 0.35 3.15 3.5
13 x 64 0.30 2.7 3.0
11.5 x 64 0.30 2.7 3.0
11.5 x 92 0.50 4.5 5.0
13 x 100 0.50 4.5 5.0

Instrumentation Laboratory 7.43


Assay and Instrument Specifications

Specifications for ACL drawing from Types a and b primary tubes


Type a
For drawn blood volumes of 4.5 mL (nominal value), the ACL can aspirate
plasma with tolerances of +10 to -20%.
For maximum sample collection (4.5 mL + 10%), the ACL can aspirate the
correct amount of sample if the hematocrit is ≤ 70%.
Type b
For drawn blood volumes of 3.15 mL (nominal value), the ACL can aspirate
plasma with tolerances of +10 to -20%.
For maximum sample collection (3.15 mL + 10%), the ACL can aspirate the
correct amount of sample if the hematocrit is ≤ 70%.

NOTE:
The specifications above may be affected by the following variables:
- Lot and manufacturer variations of internal tube diameter.
- Time remaining to expiration date (level of vacuum decreases close to the
end of the tube life).

7.7.2 Cup and Reagent Containers


The following charts detail the specifications for the sample cups and reagent
containers that may be used on the ACL Elite/Elite Pro.
Sample Tray
Container Usable Volume Usable Volume
Type Volume Diameter Positions 1-40 Positions A1-A10
Sample Cup 0.5 mL 14 mm 0.4 mL In cup dilution only
Sample Cup 2 mL 14 mm 1.8 mL 1.9 mL
Sample Cup 4 mL 14 mm 3.8 mL 3.9 mL
Reagent Vial 4 mL 18 mm NA 3.6 mL
Reagent Vial 10 mL 23 mm NA 9.2 mL

Reagent Area
Container Usable Volume Usable Volume
Type Volume Diameter Stirred Reagents Non-Stirred
Reagents
Reagent Vial 4 mL 18 mm NA 3.5 mL
Reagent Vial 10 mL 23 mm 8.3 mL 9.4 mL
Reagent Vial 16 mL 28 mm 13.2 mL 14.1 mL

NOTE: The reagent vials partially filled with PT-FIB and APTT reagents may
be topped with fresh reagent ONLY IF the reagent in the vial is still within the
on-board stability at 15 oC and the ratio between old reagent and fresh
reagent does not exceed 1:2 (suggestion is to use one part of old reagent
plus two parts of new reagents).

7.44 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.8 Instrument Specifications


7.8.1 Hardware and Operational Specifications
Temperature of the reagent reservoirs: 10 - 16 oC
Temperature of the analysis area: 37 ± 1 oC at ambient temperatures
from 15 to 32oC
Coagulometric channel light source: Light emitting diode, λ=660 nm
Chromogenic channel light source: Halogen lamp, λ=405 nm w/filter
Chromogenic channel optical path: 0.5 cm
Analytical cuvettes: rotor units contain 20 cuvettes/each
Number of rotors in rotor stack: 12 maximum
Sample trays available:
1. for cups and primary tubes (13x75 mm - 5 mL & 13x64 mm - 3 mL)
2. for cups and primary tubes (13x100 mm - 5 mL)
3. for cups and Sarstedt primary tubes (11.5x64 mm - 5 mL and
11.5x92 mm - 3 mL)
Sample tray adapters: for 4 mL reagent containers and
cups
Reagent containers: 4 mL, 10 mL and 16 mL vials, cups
Reagent reservoir adapters: for 10 mL vial with stirrer (gray)
for 10 mL vial w/o stirrer (pink)
for 4 mL vial w/o stirrer (green)
Stirrer magnet reagent R1-R4: size - 10x5 mm diameter
rotation speed - 250 rpm
Sample/reagent dispensing: stainless steel pistons contained in
an acrylic structure
Waste tube: PVC, 12 mm diameter
Cooling fans: two, with five blades and dust filter
Fuses: Two, T 6.3 A (for 100-240 Vac nom.)
PC keyboard: Standard
Video Display Unit: 12.1” color LCD, with touch screen
Interface for data transmission to Host: RS 232C
Additional interfaces: one for optional Barcode Scanner
one for optional External Printer
Instrument structure: expanded polyurethane designed for
direct mounting of internal elements

Instrumentation Laboratory 7.45


Assay and Instrument Specifications

7.8.2 Dimensions
Total height: 60 cm
Height of analysis surface: 33 cm
Width: 100 cm
Depth: 60 cm
Weight: 63 Kg

7.8.3 Data Base Specifications


The table below provides specifications related to the maximum size of all
Data Bases included in the ACL Elite/Elite Pro software.

7.46 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Description Maximum Type of


Size Handling
N° of Patient IDs in Data Base 1000 FIFO
Number of Tests per Patient * 30 N/A
Number of Reaction Curves in Patients Data Base 800 FIFO
Number of Results in Each Single QC file 500 FIFO
Total number of QC Results in each Statistic file 65536 FIFO
Number of Reaction Curves in QC Data Base 200 FIFO
Total Number of QC Materials 50 N/A
Number of IL QC Materials 30 N/A
Number of Customized QC Materials 20 N/A
Number of Tests for each Single QC Material 20 N/A
N° of QC results in QC Data base 100 FIFO
Number of Results in AR Data Base 10-50-100- Selectable
500-1000
Number of Reaction Curves in AR Data Base 100 FIFO
Total Number of Operators 100 N/A
Total Number of Profiles 30 N/A
Number of Tests in a Single Profile 20 N/A
Total Number of Tests in the Library 300 N/A
Number of IL Tests in the Library 200 N/A
Number of Customized Tests in the Library 100 N/A
Total Number of Test Groups 60 N/A
Number of IL Test Groups 30 N/A
Number of Customized Test Groups 30 N/A
Number of Tests in a Single Test Group 6 N/A
Total Number of Materials (Liquids) in the Data Base 300 N/A
Number of IL Materials (Liquids) in the Data Base 200 N/A
Number of Customized Materials (Liquids) in the Data Base 100 N/A
Number of Definable Loadlist 20 N/A
Number of Sample IDs in a Loadlist 40 N/A
Number of Steps used in a Test Application 30 N/A
Number of Materials (Liquids) used in a Test Application 36 N/A
Number of Reflex Rules 60 N/A
Number of Criteria in each Single Reflex Rule 3 N/A
Number of Tests that can be generated by each Single Reflex Rule 10 N/A
Number of Calibrations for Dedicated Session 1 FIFO
Number of Calibrations for In Session and In Run 5 FIFO
Number of Messages in the Session Error History 200 FIFO
Number of Messages in the File Error History 100 FIFO
Number of Messages in the Logbook 200 FIFO
Number of Messages in the Trace file Up to 1.4 MB Automatic
* Test in duplicate count for 3 results (first result, second result and mean)
FIFO = First In First Out

Instrumentation Laboratory 7.47


Assay and Instrument Specifications

7.9 Ambient Specifications


The ACL Elite/Elite Pro pertains to the following class of instruments:
CATEGORY: II
POLLUTION DEGREE: 2
USE: indoors
The following ambient conditions apply to the ACL Elite/Elite Pro:
• Ambient conditions for transport and storage
Temperature: 4 - 45 oC
RH: maximum 95%, non-condensing
• Functional ambient conditions
Temperature: 15 - 32 oC

RH: maximum 85%, non-condensing


BP: 500 to 1060 mbar
Altitude: maximum 2000 meters

• Safety limit ambient conditions


Temperature: 5 - 40 oC
RH: maximum 95%, non-condensing

BP: 500 to 1060 mbar


Altitude: maximum 2000 meters

7.10 Electrical Specifications


FREQUENCY: 50 and 60 Hz (nominal)
Frequency range: 50 - 60
VOLTAGE: 100 V to 240 V
Voltage tolerance: ± 10%
Power Consumption: 350 VA
Fuses: 2 x T 6.3 A

7.48 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

7.11 HAZARDS

7.11.1 General Warnings


The ACL Elite/Elite Pro analyzer can be used with a main voltage of 90 to 240
VAC (50/60 Hz). An automatic power supply unit is provided with the
instrument which allows the use of the local 90-240 V power supply.
The analyzer must be plugged into a grounded power outlet.
In order to allow proper cooling around the analyzer, allow at least 15 cm (6
inches) of clearance on the sides, back and top of the unit.
The ACL Elite/Elite Pro has been tested and found to comply with national
and international EMC and RFI requirements. These requirements are
designed to provide reasonable protection against harmful interference when
the equipment is operated in a commercial environment. This instrument
generates, uses and can radiate radio frequency energy. If harmful
interference is produced as a result of installation and use other than that
recommended by the manufacturer, the user will be required to correct the
interference at his own expense.

7.11.2 Shock Hazards


Operators and maintenance personnel of the ACL Elite/Elite Pro analyzer are
urged to follow sound electrical safety practices when using the instrument.
Although all exposed metal parts of the analyzer are at ground potential (0
volts), it should never be touched with one hand while the other hand is
touching a plumbing fixture, radiator, AC operated device or other grounded
object.

7.11.3 Electrical Hazards


• Unplug the analyzer from the power outlet before opening the body of the
analyzer.

• Turn the analyzer OFF before replacing components or attempting any


repair.
• Do not operate the analyzer in an atmosphere containing explosive
gases, as the components of the analyzer may generate sparks.

Earth Ground: Identifies an Protective Ground: Identifies


Earth Ground terminal any terminal intended for connection
to an external conductor

Instrumentation Laboratory 7.49


Assay and Instrument Specifications

7.11.4 Biohazards
Since the ACL is used to work with products derived from human blood, all
operator-accessible parts of the analyzer should be considered potentially
bio-hazardous. For this reason, gloves and protective clothing should be worn
during system operation.
When carrying sample trays loaded with samples, exercise caution to avoid
spillage of samples. Also avoid spilling fluids on the analyzer, and clean
immediately if this occurs.
The surface of the analyzer should be inspected frequently for visible spills
and decontaminated if necessary following the instructions in Section 5.
Follow the recommendations given in Section 5 for preventive and routine
maintenance of the instrument.
For additional information, refer to NCCLS document 117-P No. 15:
Protection of Laboratory Workers from Instruments Biohazards, 1991.

Instrumentation Laboratory complies with the Directive 2002/96/EC of the


European Parliament on Waste, Electrical and Electrical equipment (WEEE) .
For instructions on End of Life Disposal please contact your local distributor
for further details.

7.11.5 Mechanical Hazards


The operator should pay attention to the moving parts of the instrument during
normal operation.
In particular the sample tray area should be accessed only in Ready state or
using the STAT (Pause) function to avoid mechanical hazard due to the
needles arm movement.

Disclaimers
Instrumentation Laboratory, Inc. (IL) is responsible for the safety and electrical
performance of this equipment if and only if:
• Assembly operations, extensions, adjustments, modifications or repairs
are carried out by persons authorized by IL;
• The electrical installation of the room complies with the local, state or
national requirements (including a power supply circuit with independent
grounding);
• The equipment is used in accordance with these instructions for use.

Bibliography
For additional information, refer to NCCLS document 117-P No. 15:
Protection of Laboratory Workers from Instruments Biohazards, 1991.

7.50 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

ADDENDUM: Method Comparison Studies

Note: Analytical performance for the ACL 8/9/10000 and ELITE/ ELITE
PRO are comparable
Antithrombin(%):

Antithrombin: ACL 9000 (Test)


vs. ACL 6000 (Reference)

140
ACL 9000 (AT% Activity)

120 y = 1.0817x - 3.0311


100 r = 0.9947
n = 48
80

60

40

20

0
0 20 40 60 80 100 120 140
ACL 6000 (AT% Activity)

APC Resistance V
(Normalized Ratio):

APCR V: ACL 9000 EM5 (Test)


1,2 vs. ACL 6000 (Reference)
1,1
Normalized Ratio)
ACL 9000 EM5

1 y = 0.9725x + 0.0214
0,9 r = 0.9934
0,8 n = 57
0,7
0,6
0,5
0,4
0,4 0,5 0,6 0,7 0,8 0,9 1 1,1 1,2
ACL 6000 (Normalized Ratio)

Instrumentation Laboratory 7.51


Assay and Instrument Specifications

APTT-SP
(Seconds):

APTT: ACL 9000 (Test)


vs. ACL 6000 (Reference)

110
100 y = 1.0416x - 1.4706
ACL 9000 (seconds)

90 r = 0.9979
80 n = 54
70
60
50
40
30
20
20 30 40 50 60 70 80 90 100
ACL 6000 (seconds)

D-Dimer
(ng/mL):

D-Dimer: ACL 9000 EM6 (Test)


vs. ACL 6000 (Reference)

1200
1000 y = 0.9114x + 86.596
ACL 9000 EM6

r = 0.9955
800
n = 46
(ng/mL)

600
400
200
0
0 200 400 600 800 1000 1200
ACL 6000 (ng/mL)

7.52 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Factor VII (%)


with PT-Fibrinogen:

180 Factor VII: ACL 9000 EM5 (Test)


160 vs. ACL 6000 (Reference)
140
y = 1.0194x - 2.6046
ACL 9000 EM5

120
(% Activity)

r = 0.9961
100 n = 48
80
60
40
20
0
0 20 40 60 80 100 120 140 160 180
ACL 6000 (% Activity)

Factor VIII (%)


with APTT-SP:

Factor VIII: ACL 9000 EM3 (Test)


250 vs. ACL 6000 (Reference)

200
y = 0.9598x + 0.6184
ACL 9000 EM3
(% Activity)

r = 0.9896
150 n = 47

100

50

0
0 50 100 150 200 250
ACL 6000 (% Activity)

Instrumentation Laboratory 7.53


Assay and Instrument Specifications

Fibrinogen-C
(mg/dL):

Fib-C: ACL 9000 EM6 (Test)


800 vs. ACL 6000 (Reference)

600 y = 1.0994x - 14.032


ACL 9000 EM6

r = 0.9982
(mg/dL)

n = 54
400

200

0
0 200 400 600 800
ACL 6000 (mg/dL)

Heparin

Heparin: ACL 9000 EM3 (Test)


1,4 vs. ACL 6000 (Reference)
1,2
y = 1.0286x - 0.0017
ACL 9000 EM3

1 r = 0.9961
(U/mL)

0,8 n = 50
0,6
0,4
0,2
0
0 0,2 0,4 0,6 0,8 1 1,2 1,4
ACL 6000 (U/mL)

(U/mL):

7.54 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Plasmin Inhibitor
(%):

Plasmin Inhibitor: ACL 9000 (Test)


vs. ACL 6000 (Reference)

140
130
120
y = 0.9084x + 8.6423
ACL 9000 (% Activity)

r = 0.9899
110
n = 57
100
90
80
70
60
50
40
40 50 60 70 80 90 100 110 120 130 140
ACL 6000 (% Activity)

Plasminogen
(%):

Plasminogen: ACL 9000 EM3 (Test)


160 vs. ACL 6000 (Reference)
140
120 y = 0.9864x + 3.525
ACL 9000 EM3
(% Activity)

r = 0.9894
100
n = 57
80
60
40
20
0
0 20 40 60 80 100 120 140 160
ACL 6000 (% Activity)

Instrumentation Laboratory 7.55


Assay and Instrument Specifications

ProClot (%)
with APTT-SP:

Proclot (with APTT-SP): ACL 9000 EM5 (Test)


vs. ACL 6000 (Reference)
250

200
ACL 9000 EM5

y = 0.982x + 1.9116
(% Activity)

150 r = 0.9954
n = 54
100

50

0
0 50 100 150 200 250
ACL 6000 (% Activity)

Protein-C
(%):

Protein C: ACL 9000 EM7 (Test)


vs. ACL 6000 (Reference)
350
300
ACL 9000 EM7

y = 1.095x - 5.7806
(% Activity)

250
r = 0.9982
200 n = 52
150
100
50
0
0 50 100 150 200 250 300 350
ACL 6000 (% Activity)

7.56 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Protein S (%):

Protein S: ACL 9000 (Test)


vs. ACL 6000 (Reference)

140
ACL 9000 (% Activity)

120
y = 0.923x + 2.9345
100
r = 0.9930
80 n = 54
60
40
20
0
0 20 40 60 80 100 120 140
ACL 6000 (% Activity)

PT (Seconds):

PT: ACL 9000 (Test)


vs. ACL 6000 (Reference)

30
ACL 9000 (Seconds)

25 y = 1.0659x - 0.8383
r = 0.9985
20
n=52
15
10
5
0
0 5 10 15 20 25 30
ACL 6000 (Seconds)

Instrumentation Laboratory 7.57


Assay and Instrument Specifications

PT-Based Fibrinogen (mg/dL):

PT-Based Fibrinogen: ACL 9000 EM7 (Test)


vs. ACL 6000 (Reference)
1000

800 y = 0.9331x + 35.038


ACL 9000 EM7

r = 0.9901
(mg/dL)

600 n = 51
400

200

0
0 200 400 600 800 1000
ACL 6000 (mg/dL)

Thrombin Time - 8 mL
(Seconds)

TT - 8 mL: ACL 9000 (Test)


vs ACL 6000 (Reference)

50
45
y = 1.0103x + 1.0097
40 r = 0.998
ACL 9000 (Seconds)

35 n = 54

30
25
20
15
10
5
5 10 15 20 25 30 35 40 45 50
ACL 6000 (Seconds)

7.58 Instrumentation Laboratory


8 Sample Collection and Storage

8.0 Introduction
Given the importance of coagulation tests in making diagnostic and therapeutic
decisions, it is essential to follow a detailed procedure for the collection and transport
of blood specimens as well as for the preparation of plasma used for these tests.
Many variables such as the type of anticoagulant, the storage of the sample, and the
type of container used to draw blood will have an effect on the analytical results.
The general procedures described below - which concern the collection of human
blood samples from the patient, their transport from the collection site to the
laboratory, and their handling and storage in the laboratory - are considered standard
for any coagulation test.

8.1 Sample Collection


Venous blood must be drawn with minimal stasis using a plastic syringe or a vacuum
filled test tube, as recommended by CLSI Document H21-A3.
For all tests concerning control of hemostasis, with the exception of the platelet count,
the preferred anticoagulant is trisodium citrate at the concentration recommended in
CLSI Document H21-A3, using a ratio of 1 volume of citrate to 9 volumes of blood.
The correct concentration of the anticoagulant is of utmost importance for precision of
the results. The Document mentioned above must be referenced when adjustments
to the citrate concentration are required.

Instrumentation Laboratory 8.1


Sample, Collection and Storage

8.2 Plasma Handling

8.2.1 Plasma Separation


The samples should be centrifuged at 2500 g for 15 minutes as soon as
possible after collection.
Hemolysis must be avoided during collection and centrifugation of the sample
due to the presence of red cells, which have phospholipid surfaces with
thromboplastin activity that will affect clotting times.

8.2.2 Plasma Transport


For recommendations on transporting plasma, please refer to CLSI
Document H21-A3.

8.2.3 Plasma Storage


For recommendations on storage of plasma, please refer to CLSI Document
H21-A3.

8.3 Calibration Plasma

8.3.1 Description
The operative conditions of the ACL Elite/Elite Pro system use a reference plasma
pool (calibration plasma) to check the system as a whole (analyzer plus reagents).
The IL Test Calibration Plasma consists of a lyophilized pool of normal plasma,
having the same characteristics of a fresh pool of normal human plasma. The
lyophilized material offers the advantages of easier storage and longer stability.
The ACL Elite/Elite Pro uses the Calibration Plasma as follows:
1. To generate a calibration curve as needed.
2. To check and follow assay conditions during sample analysis within the entire
system (optional for certain assays).
For the PT, PT-based Fibrinogen, APTT and TT assays, the Calibration Plasma value
should be within the reference range stored in the ACL memory. If this is not the
case, message flags will be given to the operator. Result flagging is optional.

8.2 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

8.3.2 Preparation
Please refer to the printed package insert sheet that accompanies each product.

8.3.3 Value assignment


The Calibration Plasma differs from normal control plasma in that it is used to
generate a calibration curve and to monitor the precision and accuracy of the system
(analyzer plus reagents).
This means that the Calibration Plasma has a known target value – or reference
value - for the tests. Normal control plasma may have a range of acceptable values,
not a single target value, for the tests.
The Calibration Plasma should have an activity close to 100% of expected values,
while the normal control plasma activity should only be within an assigned reference
range.
The normal and abnormal control plasmas can be used randomly as part of an
internal quality control program to verify the analytical performance of the system.
The target value of the Calibration Plasma indicated on the package insert sheet is
assigned by using a number of determinations carried out on different instruments.

In order to eliminate any possible laboratory-to-laboratory variation, it is advisable to


calculate PT, APTT and TT times (in seconds) for each lot of Calibration Plasma,
which can then be used as the reference value for the laboratory’s own conditions.

IL suggests the following procedure to determine your laboratory’s value for the
Calibration Plasma:

• For APTT and TT, perform a minimum of 5, and a maximum of 10


determinations. Calculate the mean value for each assay and enter it in the
ACL’s Test Setup “checks” frame.

• For PT, the titer will correspond to the value, in seconds, of the 100% solution.
Once the calibration is accepted, enter the value obtained for the 100%
standard in the Test Setup “checks” frame.

• For Fibrinogen, when performing a Fibrinogen calibration, enter the value


reported in the Calibration Plasma package insert sheet. Enter this value also
in the Test Setup “checks” frame.

NOTE: The procedure outlined above should be performed any time there is a
change - such as new Calibration Plasma lot, new reagent lot, new rotor lot, etc.
- requiring a new calibration of the ACL Elite/Elite Pro system.

Instrumentation Laboratory 8.3


Sample, Collection and Storage

References
1. CLSI Document (latest revision) Collection, Transport and Processing of
Blood Specimens for Coagulation Testing and General Performance of
Coagulation Assays.
2. ECCLS Vol. No. 1 Standard for Specimen Collection
3. CLSI Document (latest revision. Procedure for the Collection of
Diagnostic Blood Specimens by Venipuncture.

8.4 Instrumentation Laboratory


9 Parts and Expendables

9.0 Introduction
This section contains information about the expendable materials that are available for
use with the ACL Elite/Elite Pro System. These items may be ordered from IL or its
representative whenever they are needed using the Catalog Numbers as shown in the
table, Section 9.2. One or more of these items are shipped in the “Startup Kit” included
with the ACL Elite/Elite Pro system, as indicated in Section 9.1.

9.1 Startup Kit


The following expendable materials are contained in the Startup Kit that is shipped with
the ACL Elite/Elite Pro System:

Sample Trays
Three types of sample trays are available as shown below. The startup kit includes two of
them. The user chooses the desired system configuration between the Short and Tall
configuration. Trays for the Sarstedt tubes must be ordered separately..

Tray type Used for


Short Primary tube, 3 or 3.5 mL total volume (13x75 mm)
Tall Primary tube, 5 mL total volume (13x75 or 13x100 mm)
S 11.5 Sarstedt type tube, 3 mL (11.5x66 mm) or 5 mL (11.5x92 mm)

Sample Tray Adapters

- for plastic cups - 4 pieces


- for 4 mL glass vials - 6 pieces
Reagent Vial Adapters

- for 10 mL vials, reagents requiring magnetic stirring (gray) - 4 pieces


- for 10 mL vials, reagents not requiring magnetic stirring (pink) - 6 pieces
- for 4 mL vials, reagents not requiring magnetic stirring (green) - 4 pieces

Instrumentation Laboratory 9.1


Parts and Expendables

Magnetic Stirrers
- for reagent stirring - one package containing 6 pieces
Small Sample Cups
- 0.5 mL sample cups - one package containing 1000 pieces
Large Sample Cups

- 2.0 mL sample cups - one package containing 1000 pieces


Diluent/Buffer/Reagent Cups
- 4.0 mL cups, with labels - one package containing 100 pieces

Diluent/Buffer/Reagent Glass Vials


- 10 mL glass vials - one package containing 10 pieces
Block and Probes Assembly
- an assembly consisting of an acrylic block with the sample and reagent needles and
their associated liquid sensors
Sample and Reagent Tubing
- a 1.5 meter piece of tubing to be cut and used as needed
Insertion Tool for Sample and Reagent Tubing
- a tool to be used when replacing sample and reagent tubing

Wash/Reference Emulsion
- a 1-liter bottle of Emulsion
Waste/Rinse Reservoir

- a reservoir for needle wash and rinse


Waste Bottle
- a 5-liter bottle to collect ACL waste
Waste Tubing
- a 1.5 meter piece of tubing to be used for collection of liquid waste
Adjustment Tool for Aspiration/Dispensing Needles

- a tool to be used to adjust the position of the needles in the arm


Rotors
- 20-Cuvette Rotors - package containing 100 pieces

9.2 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Rotor Insertion Tool


- a tool used to insert rotors into the system
Rotor Waste Container
- a removable container used inside the system to hold the used rotors
Molded Air Filter

- One air filter for the analyzer body


Fuses 6.3 AT
- 2 fuses for the system

Power Cord
- a power cord for the system: the cord included is consistent with the voltage with
which the system will be used, either 100-115 V or 220-240 V

External Printer Cable


- a cable to connect the optional external printer
Host Computer Cable
- a cable to connect the optional host computer
Software System Disk Kit
- kit containing the main system software

Test Library Disk Kit


- kit containing the test library software
Operator’s Manual

- the Operator’s Manual for the use of the ACL Elite/Elite Pro system
Two-Button mouse pointing device

External Barcode Reader (ACL Elite Pro Only)

Compliance Certificate
- a specific system compliance certificate

Instrumentation Laboratory 9.3


Parts and Expendables

9.2 Order Information for Expendables

Catalog Item Description # Pieces in


Number Package Unit
181108-90 * Sample Tray for 13x75 mm, (3-3.5 mL) tubes 1
181108-98 * Sample Tray for 13x75 & 13x100 mm, (5 mL) tubes 1
181812-85 Sample Tray for Sarstedt 11.5x66 mm (3 mL) 1
& 11.5x92 mm (5 mL) tubes
190764-00 Sample Tray adapter for plastic cup 4
190763-00 Sample Tray adapter for 4 mL vials 6
181812-65 Adapter for 10 mL reagent vials with magnetic 4
stirring (gray)
190762-00 Adapter for 10 mL reagent vials without magnetic 6
stirring (pink)
190761-00 Adapter for 4 mL reagent vials without magnetic 4
stirring (green)
97466-06 Magnetic Stirrer 6
189241-00 Glass Vials, 10 mL 10
67992-00 Sample Cups, 0.5 mL 1000
55751-00 Sample Cups, 2 mL 1000
67994-00 Cups, 4 mL, plus Labels 100
68000-00 Rotors- 20 cuvettes 100
181812-77 Rotor Refill Tool 1
181108-97 Rotor Waste Container 1
181108-43 Block Probe Assembly 1
181039-41 Needles Adjustment Tool 1
73289-01 Sample and Reagent Tubing, 1.5 m 1
181080-65 Sample and Reagent Tubing Extractor Tool 1
181812-72 Waste Reservoir, for needles wash 1
181057-69 Liquid Waste Bottle 1
99095-03 Waste Tube, 1.5 m 1
181812-71 Air Filter, molded 1
68931-02 Fuses 6.3 AT 2
148821-00 Power Cord, 100-115 V 1
71992-00 Power Cord, 220-240 V 1
84864-50 External Printer Cable 1
181812-74 Host Computer Cable (9 pin – 9 pin) 1
200024-00 Wash/Reference Emulsion, 1 liter 1
181951-XX Software System Disk Kit 1
181963-XX Test Library Disk Kit 1
97627-50 Compliance Certificate 1
181121-11 Operator’s Manual, English version 1

* 2 sample trays are included in each start-up kit


XX = depending on software revision

9.4 Instrumentation Laboratory


10 Warranty

10.0 General Warranty Conditions


IL declares to the original Purchaser that each instrument manufactured and/or sold
by IL shall be free from defects in material workmanship and, under normal and
proper use conditions, warrants it for a period of one year from installation and no
more than 13 months from the shipping date.
IL's obligation is limited to repairing, replacing or modifying (at IL's undisputed
judgment) at IL's factory - or elsewhere - the material whose defects have been
verified, on condition that the Purchaser has informed IL of any defects found within 8
days from receipt or from discovery in case of defects which may not be identified in
the normal inspection.

Damages caused by or connected to transport are excluded. Transport to and from


IL’s Factory will be at Purchaser's charge and risk and shall be paid also for
reshipment.

These replacements, repairs or alterations will in no case determine extension to the


above specified warranty period.
This warranty does not cover those parts which deteriorate or which are considered
consumables or those parts or items which by their nature are normally required to be
replaced periodically consistent with normal maintenance (including without limitation
lamps, and tubes).

Those instruments or accessories, which are supplied by IL but are not of IL


manufacture will only benefit from the warranty conditions offered by the
manufacturer.

It's also understood that, following the purchase and delivery of the instrument, the
Purchaser shall be deemed liable for any losses, damages or complaints concerning
persons or things incurred by the use or misuse of the instrument on behalf of the
Purchaser, his employees, co-operators or others.
IL does not assume any obligation or warranty engagement concerning precision
and/or accuracy of the measurements as well as for any damage to the instrument
directly or indirectly resulting from the use of reagents and/or consumables different
from those produced by IL specifically for its own instruments on the same properly
tested.

Instrumentation Laboratory 10.1


Warranty

Warranty will not apply to those defective instruments or materials showing defects or
damage arising from the following causes:
a. Insufficient or negligent care by the Purchaser.
b. Insufficient or negligent maintenance by the Purchaser in relation to the instructions
contained in the Manuals prepared by IL for this purpose, tampering or alterations of
the instruments or in any case intervention or repairs made by any person not duly
authorized by IL.
c. Misuse due to carelessness, negligence or inexperience.

d. Employment of materials under heavier conditions than those for which they had
been designed and manufactured and use of the same in combination with
incompatible or dangerous products.

e. Non-observance of regulations relative to installation, power supply and operation


of the instruments (with particular regard to the regulations for accident prevention).

10.1 Disclaimer regarding non-IL brand products


IL brand reagents, consumable and expendable supplies (including, for example,
wash reference emulsion and rotors) were developed specifically for the ACL's
centrifugal, nephelometric clot detection system. IL's ACL system products are tested
to assure proper performance when using plasma samples in accordance with the
protocol described in Section 8. Each lot of IL brand ACL reagents is tested against
these criteria. Verification of other brands of reagent or supplies to ascertain their
suitability for the ACL's methodology or their level of performance on the IL ACL
instruments is not performed. The use of non-IL brand reagents or supplies for testing
which is not done in accordance with IL protocols may cause a clinically significant
degradation of performance and results.
IL does not assume any obligation or warranty engagement concerning precision
and/or accuracy of the measurements as for any damage to the instrument directly or
indirectly resulting from the use of reagents, consumables and expendable supplies
different from those produced by IL.

10.2 Instrumentation Laboratory


THIS WARRANTY IS GIVEN EXPRESSLY AND IN LIEU OF ALL OTHER
WARRANTIES, EXPRESSED OR IMPLIED. PURCHASER AGREES THAT THERE
IS NO WARRANTY OR MERCHANTABILITY AND THAT THERE ARE NO OTHER
REMEDIES OR WARRANTIES, EXPRESSED OR IMPLIED, WHICH EXTEND
BEYOND THE CONTENTS OF THIS AGREEMENT.
No agent or employee of IL is authorized to extend any other warranty or to assume
for IL any liability except as above set forth.
IL does not test other manufacturer reagents to ascertain their suitability for the ACL's
methodology or their level of performance on the IL ACL instruments.
ACL Warranty
The following items are considered as consumable parts:

Fluidic Tubing

Sample Probe

Instrumentation Laboratory 10.3


11 IL Worldwide Locations
Instrumentation Laboratory
Corporate Headquarters
Aragón 90 - 08015 Barcelona, Spain
P.O. Box 35027 (08080)
Telephone: 34-3-4010101
Fax: 34-3-4513745

US, Canada, Latin America,


Headquarters
Instrumentation Laboratory Company
101 Hartwell Avenue - P.O. Box 9113
Lexington, MA 02421-3125 U.S.A.
Telephone: (781) 861-0710
Fax: (781) 861-1908

Mexico
Instrumentation Laboratory Diagnostics, S.A. DE C.V.
Londres 47 - Colonia Juarez - Mexico, D.F. 06600
Telephone: 525-8639
Fax: 525-8539

Pacific Headquarters
Instrumentation Laboratory
Yoshiu Building 1F
6-7-5 HigashiKasai
Edogawa-ku, Tokyo 134 - Japan
Telephone: 81-3-5658-3041
Fax: 81-3-5658-3043

Japan
Instrumentation Laboratory
Yoshiu-Sangyo Building 1F
6-7-5 Higashi-Kasai
Edogawa-ku, Tokyo 134 - Japan
Telephone: 81-3-5658-3041
Fax: 81-3-5658-3043

Instrumentation Laboratory 11.1


Worldwide Location

Europe, Middle East, Africa


Headquarters
Instrumentation Laboratory SpA
Viale Monza 338 - 20128 Milan, Italy
Telephone: 39-2-25221
Telex: 330112 ILSpA I
Fax: 39-2-2575250

Austria
Instrumentation Laboratory Ges. m. b. H.
Business Park Vienna - Wienerbergstraβe 3
A-1100 Vienna, Austria
Telephone: 43-1-60213300
Fax: 43-1-6022317

Belgium
Instrumentation Laboratory (Belgium) N.V. / S.A.
Excelsiorlaan 81 bus 1
1930 Zaventem (Brussel) - Belgium
Telephone: 32-2-7252052
Fax: 32-2-7212409

Federal Republic of Germany


Instrumentation Laboratory GmbH
Klausnerring 4
D-85551 Kirchheim bei München
Federal Republic of Germany
Telephone: 49-89-909070
Telex: 5215032 ILFD
Fax: 49-89-90907116

France
Instrumentation Laboratory
32, avenue de Saint- Mandé
B.P. 35 - 75562 Paris Cedex 12 France
Telephone: 33-1-43461144
Telex: 670652 PULMO-PARIS
Fax: 33-1-43460701

11.2 Instrumentation Laboratory


ACL Elite/Elite Pro Operator’s Manual

Italy
Instrumentation Laboratory SpA
Divisione Commerciale Italia
Viale Monza 338 - 20128 Milan, Italy
Telephone: 39-2-25221
Telex: 330112 ILSpA I
Fax: 39-2-2575250
Switzerland
Instrumentation Laboratory AG
Giessenstrasse 15 - Postfach
CH-8952 Schlieren (ZH), Switzerland
Telephone: 41-1-7423030
Fax: 41-1-7423035

The Netherlands
Instrumentation Laboratory (Netherlands) B.V.
Moskesbaan 2
4823 AH BREDA - The Netherlands
Telephone: 31-76-5480100
Fax: 31-76-5480102

United Kingdom
Instrumentation Laboratory (U.K.) Ltd.
Kelvin Close - Birchwood Science Park
Warrington, Cheshire WA3 7PB England
Telephone: 44-01925-81-0141
Fax: 44-01925-826708

Instrumentation Laboratory 11.3


ACL Elite/Elite Pro TECHNICAL BULLETIN IMPORTANT INR NOTICE

INR FORMULA
INR = (PT Patient / PT Normal) ISI

PT PATIENT = Patient’s PT in seconds

PT NORMAL = Mean* of the Normal Range (on the ACL Elite/Elite Pro this is called the Reference Value)

ISI value = International Sensitivity Index from the current lot # of thromboplastin reagent being used.

To assure appropriate reporting of INR results, you must follow these steps:

1. Make sure instrument is in the READY mode. From the SET UP MENU select the LIQUIDS
SUBMENU, then select the appropriate THROMBOPLASTIN REAGENT (LIQUID ID) from the list
in the left upper part of the screen.
2. Select the PT TEST that uses this Thromboplastin reagent and click on ASSIGN VALUE.
3. Enter the ISI VALUE of the Thromboplastin Lot in use and select Confirm twice to enter value.
Make sure that all PT tests using the same Thromboplastin import the proper ISI assignment.
Several PT TESTS using the same Thromboplastin may be present such as PT extended, PT
duplicate standard and PT duplicate extended acquisition time. These tests will import the value
from the standard test.
NOTE: The ISI value is specific for the lot number of prothrombin time reagent being used.
4. From the SET UP MENU select TESTS VIEW/DEFINE. Select the appropriate PT test and click on
details.
5. Select CALCULATION SETUP and the instrument will show in the right part of the screen the
selection of the REFERENCE VALUE. This represents the Mean of Normal Population value in
SECONDS, which is used as the DENOMINATOR in the RATIO and INR CALCULATION.
6. Make sure that the value entered in this field represents the MEAN NORMAL POPULATION
RANGE of the local PT population. This value is editable and can be modified to reflect the
laboratory established mean normal range.
7. Confirm all PT Tests using the very same thromboplastin lot for Ratio/INR will be calculated using
the same value in seconds as the denominator (Mean Normal Population Range).
8. The instrument uses the following formula for RATIO CALCULATION.

RATIO CALCULATION = PATIENT PLASMA (seconds)


REFERENCE VALUE (seconds)

Reference Value means MEAN OF NORMAL POPULATION (seconds).


MEAN OF THE NORMAL POPULATION RANGE = Mean Normal PT Time = Mean of Patient
Normal Range in seconds as recommended in the CLSI Document C28-A, Vol. 15, No.4.
9. The INR will then be calculated as follows:

INR = (PT Patient/PT of Reference Value)ISI

Using the Reference Value feature the denominator used in the Ratio and INR calculation will
accurately reflect the Mean of Normal Population Range.
*or Geometric mean
IMPORTANT WARNINGS:
• If the INR calculation is not properly setup, then erroneous patient results may be reported.
• If the product lot number changes, then the new ISI value from the package insert must be
entered.
• In the ACL Elite/Elite Pro both screen and printout show/report Ratio and INR units separately

CO# 400342 P/N 181121-12 Rev.00


Appendix A

ACL Elite/Elite Pro

Host Communication Protocol

Revision 2.3
Dec 2005
Appendix A

Revision Date Comments


December 07-2002 Added transmission examples
Specified ASTM field numbers
Add Notes for information
Total number of pages
Reviewed Test Codes
December 16-2002 Review some Notes

April 2004 Error code update

December 2005 Elite/Elite Pro update

Instrumentation Laboratory 2 of 33
ELITE/ELITE PRO Operator’s Manual

Index

1.0 Introduction 4
1.1 Purpose 4
2.0 General Description 5
2.1 Product Perspective 5
3.0 Specific Requirements 6
3.1 Protocol Specification 6
3.2 Low Level Interface 6
3.3 Data Link and Logical Layer 6
3.4 Sessions 6
3.4.1 Message Header and Message Terminator Records 7
3.5 Test Order Downloading 8
3.5.1 Receive Session from DMS 8
3.5.1.1 Test Request Message 9
3.5.1.2 Test Order Message 10
3.5.1.2.1 Patient Information Record 10
3.5.1.2.2 Test Order Record 12
3.5.2 Host Query 14
3.5.3 Test Request Message 15
3.5.4 Test Order Message 16
3.6 Rejected Test Order 17
3.7 Download Session Volumes 18
4.0 Test Results Uploading 19
4.1 Test Result Message 20
4.1.1 Patient Information Record 20
4.1.2 Test Order Record 21
4.1.3 Result Record 22
4.1.4 Comment Record 23
4.1.5 Error Codes 24
4.2 Upload Session Volumes 26
5.0 Not Supported Records 27
6.0 Transmission Abort 27
7.0 Appendix - ACL Elite/Elite Pro Test Codes 28
8.0 Appendix - ACL Elite/Elite Pro Supported Characters 31
8.1 Supported Characters for Sample ID 31
8.2 Supported Characters for Patient name and Department 31
8.3 Supported Characters for delimiters 31
9.0 Appendix - ACL Elite/Elite Pro Supported Units 32

Instrumentation Laboratory 3 of 33
Appendix A

1.0 Introduction

1.1 Purpose

This document is a guide to integrate a Laboratory Information Management system with the
Instrumentation Laboratory ELITE/ELITE PRO family instruments using the ASTM (American
Society for Testing and Materials) specification to transfer information between clinical instruments
and computer systems.

ASTM specification E-1394-91 Standard Specification for Transferring Information between Clinical
instruments and Computer Systems and E-1381-91 Standard Specification for the Low Level
Protocol to transfer Messages between Clinical Laboratory Instruments and Computer Systems
have been used as standard to develop ELITE/ELITE PRO Host Communication Protocol.

Specification E-1394 defines the logical layer of ASTM standard; all significant information for
ELITE/ELITE PRO instruments application can be found in chapters Specific Requirements and
following.

Specification E-1381 refers to low level protocol; significant information for ELITE/ELITE PRO
family instruments application can be found later on in this document.

Instrumentation Laboratory 4 of 33
ELITE/ELITE PRO Operator’s Manual

2.0 General Description

2.1 Product Perspective

Communication sessions with host computer can be started on ELITE/ELITE PRO family
instruments by operator request or automatically at session completion.
If the operator requires a manual download session, the instrument will open communication with
the host computer that will provide transmission of all test orders.
If the operator requires an upload session, the instrument will transmit a subset of sample results
(identified by the user) stored in the instrument patient database or QC database or Analytical
Reference database.

If the instrument is properly configured, automatic downloading or uploading sessions can be


started by ELITE/ELITE PRO instrument.
Automatic downloading will occur at session start if host query is configured. In this condition the
instrument will request test orders for specific sample IDs recognized on the sample tray.

The second condition will occur, if automatic uploading has been requested, at session completion.

In case the communication session is not generated from the instrument, any host computer
message is ignored.

All information received by the host computer must be associated with a Sample ID which is the
primary key of the database. In addition to programmed tests a certain amount of information can
be associated with a Sample ID (patient data) and stored in ELITE/ELITE PRO database. This
information is optional.

The sample ID is the primary key to access information in the database.


If the checks fail, any downloading operations will be aborted. See Test Order Downloading
section.

At most 1000 samples can be stored in ELITE/ELITE PRO database; each sample can have a
maximum of 30 tests associated (double tests are considered as 3 tests).
The system behavior when these limits are exceeded is explained in the paragraph Test Order
Downloading.

If 1000 samples are present in the database, the FIFO (First In First Out) will not accept additional
samples during a Manual Downloading.

The test ordering operation, to identify the type of ordered test, by host computer must refer to a
computer code that is instrument specific. Refer to Test Order Downloading for further details and
to the Appendix at the end of this document for the test codes table.

Note: for the downloading the Host should send to the ELITE/ELITE PRO string information in
single frame (single line) during the transmission or up to 240 bytes maximum during the
transmission.
.

Instrumentation Laboratory 5 of 33
Appendix A

3.0 Specific Requirements

3.1 Protocol Specification

3.2 Low Level Interface

Low level interface conforms to ASTM specification E-1381-91. The following characteristics are
supported and are configurable by Operator Interface:

Baud Rate 2400, 4800, 9600, 19200, 38600

Character Length 8 bit

Parity No parity

Stop Bits 1

3.3 Data Link and Logical Layer

For the Data Link and Logical Layer the ASTM specification E-1381-91 has been maintained as a
reference. Protocol limits and constraints are those declared by the standard.
To mention some of them, the data part of the frames exchanged between the instrument and the
host computer should be done as single frame. As a consequence during transmission sessions
specific routines provide the ability to divide large records into multiple frames and during a
reception session they re-build partial frames in a single record. The application level has no
evidence of this mechanism.

According to ASTM standard the following characters cannot be part of data records: <SOH>,
<STX>, <ETX>, <EOT>, <ENQ>, <ACK>, <DLE>, <NAK>, <SYN>, <ETB>, <LF>, <DC1>,
<DC2>, <DC3>, <DC4>.

Timeout and retry logic are those specified by the standard; the Low Level Clinical Message State
Diagram representing the implemented automatic is the reference.
In interrupt request status the instrument accept remote EOT.

3.4 Sessions

There are two types of sessions that the instrument handles with the ASTM interface: the test
orders download and the test results upload. These sessions can be initiated by the operator or
automatically activated by the instrument.

When the user/operator requests a download operation (Receive Command), the instrument will
send a request to the host for available test orders (all) or for test orders requested for specific
samples, and the host will answer with the test orders available for the instrument.

Test results upload (Transmit Command) are initiated by the user or automatically by the
instrument at the same way. The host is not allowed to transmit unsolicited messages, any type of
inquiries or test orders not explicitly required by the instrument.

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3.4.1 Message Header and Message Terminator Records

Following ASTM specification, each type of transaction between the instrument (DTE) and the host
computer (DCE) has two common records that are the Message Header record and the Message
Terminator record. These records open and close data transmission between ELITE/ELITE PRO
instruments and host computer.
Their fields are described in the following:

Message Header Record:

Record Type ID Always set to ‘H’


Delimiter Definition The 5 ASCII characters composing this field define the type
of delimiters that will be used in the following records. See
Appendix B for supported delimiters.
Message Control ID Not provided
Access Password Not provided
Sender Name or ID Set to ‘ACL9000’ when transmitting to host or receiving. As
an option, the ability to identify univocally the instrument by
means of an extension to the instrument name is also
supported: the name syntax becomes ‘ACL9000-xx’ where
xx is a two digit code in the range 01-99.
The extension to the instrument name is user configurable in
the set-up environment.
The instrument ID is always ACL9000 independently from
the model; ELITE/ELITE PRO.
Sender Street Address Not provided
Reserved Fields Not provided
Sender Telephone Number Not provided
Characteristics of Sender Not provided
Receiver ID Must be set to ‘ACL9000’ when receiving from host.
Depending on the instrument set-up, the ability to identify
univocally the instrument by means of the extension to the
instrument name is also supported: the name syntax
becomes ‘ACL9000-xx’ where xx is a two digit code in the
range 01-99.
If the ID is different from the expected one, the session is
interrupted.
Comment or special Instructions Not provided
Processing ID Always set to ‘P’ meaning Production
Version No. Set to the current ASTM standard version = ‘1’
Date and Time of Message Format is YYYYMMDDHHMMSS

Example of message sent from the ELITE/ELITE PRO :

H|\^&|||ACL9000|||||||P|1|20021205123956<CR>

Example of message sent from Host:

H|\^&||||||||ACL9000||P|1|20021205123956<CR>

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Appendix A

Message Terminator Record:

Record Type ID always set to ‘L’


Sequence Number always set to ‘1’
Termination Code set to ‘N’ for normal termination and to ‘E’ for abnormal
termination while transmitting to host;
not considered for received data

Example of Terminator:

L|1|N<CR>

3.5 Test Order Downloading

Test order downloading is used to request test orders available on the host and to have them on
the instrument. This operation can be obtained in two ways: manually opening a download session
from the DMS environment or enabling on the instrument the host query function.

In the first case the host will have to transmit to the instruments all pending test requests; in the
second case the instrument will automatically require specific information for the samples placed
on the sample tray and without any test requests.

Details for both modalities are explained in Receive Session from DMS and Host Query
paragraphs.

3.5.1 Receive Session from DMS

The operator manually initiates the test order download from the DMS environment.
The host will provide to the instrument all available test requests. The host can send zero or more
test orders in one or more messages, but all messages will be part of the same transmission
session.
During a transmission session more test orders can be required for the same sample.
The host sends usually all test orders for which it has not yet received results even if they have
been previously transmitted.

ELITE/ELITE PRO instruments will process each received test order to validate fields supported;
some information will be extracted from the received record while other information will be ignored.
Only test orders related to patient samples are considered, if the required sample ID does not exist
in the patient database and the required sample ID is not used in the QC database, a new record is
created. If the database is full, the transmission session will be aborted.

If the test orders are for a sample already existing in the sample data base, the new orders will be
added to the existing tests but all tests already ordered or performed will remain unchanged.

If a test order with more than the maximum number of programmable tests is sent, the request is
rejected. The limit is 30 single tests or 10 double tests.

If the test order is not recognized as one of those supported by ELITE/ELITE PRO family
instruments, it is rejected. The instrument will inform the host computer using a record containing
the list of rejected test orders.

During a downloading session the listed error conditions can be detected, the associated
instrument behavior and actions are listed as well:
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Error Condition Action User Message

Sample ID used in the QC data base Abort communication Sample ID already used
in the QC data base
Bad Sample ID (long, unsupported Abort communication Invalid Sample ID
characters)
Data Base full Abort communication Patient Data Base is full

Patient record has no associated test Abort communication Not identified sample ID
order record for patient data
Test order has no associated patient Abort communication No patient record for
record ordered tests
Instrument Identifier different from Abort communication Invalid instrument
ACL9000 or extended name identifier
Too many test requests for the same Reject test order -
sample ID
Unknown test request Reject test order -
Bad Test Reject test orders -

Illegal record format Abort communication Incorrect record format


in host messages

All abort conditions imply that ELITE/ELITE PRO family instruments will send to the host computer
a message with the reason for transmission interruption (see Reject Test Order) while a message is
presented to the user on the instrument. When transmission abort is not implied, at transmission
completion one or more records will follow (see Reject Test Order) with an indication of rejected
test orders.

Information rejected is typically unknown test requests or test requests exceeding the sample
record size in ELITE/ELITE PRO Data Management System. It must be observed that if any of this
information is rejected, it does not imply that all sample data have been rejected.
The set of legal test requests are normally stored while the illegal requests for the same sample ID
will be rejected.

It also must be underscored that ELITE/ELITE PRO limits the size of handled records
(independently from the record type supported by ASTM) to 1024 byte during downloading session.

Note: for the downloading the Host should send to the ELITE/ELITE PRO string information in
single frame (single line) during the transmission or up to 240 bytes maximum during the
transmission.

3.5.1.1 Test Request Message

The Test Request Message is used by ELITE/ELITE PRO to start the test order download session.
It is composed from a Message Header record, a Request Information record and a Message
Terminator record.
The “Request Information record” requests from the host ALL test orders available for the specific
instrument.

Following the ASTM specification the fields composing the Request Information are described in
the following.

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Appendix A

Request Information Record:

Record Type ID always set to ‘Q’


Sequence Number as defined by the standard set to ‘1’ when query is sent
Starting Range ID Number set to the string ‘ALL’
Ending Range ID Number not provided
Universal Test ID not provided
Nature of Request Time Limit not provided
Beginning request Results Date and Time not provided
Requesting Physician Name not provided
User Field #1 not provided
User Field #2 not provided
Request Information Status Code always set to ‘O’ (requesting test orders and
demographics only)

An example for the complete message (composed by header message, request information record
and message terminator record) is given by:

H|\^&|||ACL9000|||||||P|1|19960210103227<CR>
Q|1|ALL||||||||O<CR>
L|1|N<CR>

3.5.1.2 Test Order Message

To answer the ELITE/ELITE PRO Test Request Message, the host computer sends the Test Order
Message. It contains the records specifying which tests are being requested for each specified
sample. The host computer may answer with one or more message; each one contains one or
more test order specifications. The test order specification consists of a Patient Information record
followed by one or more Test Order records.
The host can send for the same sample ID a Patient Information record followed by many Test
Order records or, for each test to be ordered, a pair composed by the Patient Information record
followed the Test Order record.
Comment Record messages during downloading operations are ignored by ELITE/ELITE PRO.

3.5.1.2.1 Patient Information Record

The fields characterizing this record are specified in the following:

Patient Information Record:

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ELITE/ELITE PRO Operator’s Manual

Record Type ID Must be ‘P’


Sequence Number Must begin with ‘1’ and then must increment by
one for each new Patient Information record
Practice Assigned Patient ID Ignored
Laboratory Assigned Patient ID Stored, if available, as a string in the Patient ID
field of the sample record.
No checks are performed for this field and the
string will be truncated to 15 characters.
Patient ID #3 Ignored
Patient Name Stored, if available, as a unique string in the
‘name’ field of sample record considering only the
first two sub fields in this data field (second and
first name). The string will be truncated to 30
characters. If a character not supported is found
(see Appendix for supported characters), the
patient name and all the other strings in the same
patient record will be ignored.
If the patient name is not available 4 separators
must be transmitted: ^^^^.
Mother’s maiden Name Ignored
Birth date Stored, if available. The data will be converted and
displayed in the following in according to
ELITE/ELITE PRO supported format.
Expected format, conforming to ASTM standard, is
YYYYMMDD
Patient Sex Stored if available. Allowed characters are ‘M’, ‘m’,
‘F’, ‘f’, ‘U’, ‘u’; any other character is interpreted as
‘U’.
Patient Race-Ethnic Origin Ignored
Patient Address Ignored
Reserved Field Ignored
Patient Telephone Number Ignored
Attending Physician ID Ignored
Special Field #1 Ignored
Special Field #2 Ignored
Patient Height Ignored
Patient Weight Ignored
Patient’s Known or Suspected Diagnosis Ignored
Patient Active Medications Ignored
Patient’s Diet Ignored
Practice Field #1 Ignored
Practice Field #2 Ignored
Admission and Discharged Dates Ignored
Admission Status Ignored
Location Stored if available as a free string in the
‘department’ field of sample record. The string will
be truncated to 30 characters. See Appendix B for
supported characters.
Nature of Alternative Diagnostic Code Ignored
and Classifiers
Alternative Diagnostic Code and Ignored
Classifiers
Patient Religion Ignored
Marital Status Ignored

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Appendix A

Isolation Status Ignored


Language Ignored
Hospital Service Ignored
Hospital Institution Ignored
Dosage Category Ignored

3.5.1.2.2 Test Order Record

The fields characterizing this record are specified in the following:

Test Order Record:

1. Record Type ID Must be ‘O’ (letter)


2. Sequence Number Must begin with ‘1’ and then must increment
by one for each new test order record for the
same patient
3. Specimen ID This is the ELITE/ELITE PRO sample ID; the
field must be less than or equal to 15
characters and must be consistent with rules
on sample ID (ID already in use for QC
database are not legal). Non conforming
sample IDs will cause an abort of the
download process.
See Appendix B for ELITE/ELITE PRO
supported characters.
4. Instrument Specimen ID Ignored
5. Universal Test ID The field is composed of 4 parts; only the
Manufacturer’s Code component is used as a
4 character code (user configurable on board);
unknown test ID will be rejected.
6. Priority If the field contains in any of the sub fields the
S char the sample ID will be considered a
priority sample; any additional flag will be
ignored. If the field does not contain the S char
or it is empty, the sample will be identified as a
routine sample.
7. Requested/Ordered Date and Time Ignored
8. Specimen Collection Date and Time Ignored
9. Collection End Time Ignored
10. Collection Volume Ignored
11. Collector ID Ignored
12. Action Code Ignored
13. Danger Code Ignored
14. Relevant Clinical Information Ignored
15. Date/Time Specimen Received Ignored
16. Specimen Descriptor Ignored both fields
17. Ordering Physician Stored if available as a free string in the
‘physician’ field of sample record. The string
will be truncated to 30 characters. See
Appendix for supported characters.
18. Physician’s Telephone Number Ignored
19. User Field No. 1 Ignored
20. User Field No. 2 Ignored
21. Laboratory Field No. 1 Ignored

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ELITE/ELITE PRO Operator’s Manual

22. Laboratory Field No. 2 Ignored


23. Date/Time Results Reported or Last Ignored
Modified
24. Instrument Charge to Computer System Ignored
25. Instrument Section ID Ignored
26. Report Types Set to O (letter); other codes will cause
records rejection
27. Reserved Field Ignored
28. Location of Ward of Specimen Collection Ignored
29. Hospital Information Flag Ignored
30. Specimen Service Ignored
31. Specimen Institution Ignored

An example for a complete test ordering is given by:

H|\^&||||||||ACL9000||P|1|19982110134700<CR>
P|1||PTNT1||ROSSI^MARIO^^^||19391127|M|||||||||||||||||DEP
1||||||||||<CR>
O|1|SMP01||^^^0001|S||||||||||^|DR. VERDI||||||||||O||||||<CR>
O|5|SMP02||^^^0001|||||||||||^|||||||||||O||||||<CR>
P|2||PTNT2||GIALLI^LUCA^^^||19551028|F||||||||||||||||||DEP
2||||||||||<CR>
O|1|SMP10||^^^0001|||||||||||^|||||||||||O||||||<CR>
L|1|N<CR>

Example of download without patient name:

H|\^&||||||||ACL9000||P|1|20021205123956<CR>
P|1||||^^^^|||||||||||||||||||||||||||||<CR>
O|1|LAURA01||^^^0001|||||||||||^|||||||||||O||||||<CR>
L|1|N<CR>

Note: Separators are always expected from Host and are always transmitted independently from
the information contained in the string.

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Appendix A

3.5.2 Host Query

Host query is automatically activated by the instrument each time the system is properly
configured. Beginning the pre-analysis phase of a single test or profile or test group, one or more
samples have no type of test requests associated.

The instrument will send, using the requested information record, the sample IDs requiring test
programming and will accept only test orders for those sample IDs.
The instrument will accept for the queried samples any test orders independently by the type of test
which will be executed in the starting session.

The mechanism supported by ASTM requires sending to the host a Request Information record for
each sample ID or sending to the host a range of queried sample IDs. The mechanism supported
by ELITE/ELITE PRO is the first option, so will be independent of the sorting system used by
instrument or host computer on the samples.

As a consequence the instrument will send a query for the first sample, will wait for the host
information and will send later a new query for the next samples (if any). All the host query
sessions will be organized in this manner.

Because the instrument is asking for information regarding a specific sample ID, it will reject any
type of information associated with different sample IDs.

The host will provide to the instrument all available test requests. The host can send zero or more
test orders in one or more messages, but all messages will be part of the same transmission
session.
During a transmission session more test orders can be required for the same sample.

ELITE/ELITE PRO will process each received test order validating the fields that ELITE/ELITE
PRO supports; some information will be extracted from the received record while other information
will be ignored.

If the test order is not recognized as one of those supported by ELITE/ELITE PRO it will be
rejected. The instrument will inform the host computer using a record containing the list of rejected
test orders.

Host Query is only performed if the Sample ID is not located in the database for the ACL system.

During a download session the listed error conditions can be detected, the associated ELITE/ELITE
PRO action is listed as well:

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Error Condition Action User Message

Sample ID used in the QC data base Abort communication Sample ID already used
in the QC data base
Bad Sample ID (long, unsupported Abort communication Invalid Sample ID
characters)
Data Base full Abort communication Patient Data Base is full

Patient record has no associated test Abort communication Not identified sample ID
order record for patient data
Test order has no associated patient Abort communication No patient record for
record ordered tests
Instrument Identifier different from Abort communication Invalid instrument
ACL9000 or extended name identifier
Too many test requests for the same Reject test order -
sample ID
Unknown test request Reject test order -
Bad Test Reject test orders -
Illegal record format Abort communication Incorrect record format
in host messages

All abort conditions imply that ELITE/ELITE PRO family instruments will send to the host computer
a message with the reason of transmission interruption (see Reject Test Order) while a message is
presented to the user on the instrument. When transmission abort is not implied, at transmission
completion one or more records will follow (see Reject Test Order) with an indication of rejected
test orders.
Information rejected is typically unknown test requests or test requests exceeding the sample
record size in ELITE/ELITE PRO Data Management System. It must be observed that if any of this
information is rejected, it does not imply that all the sample data have been rejected.
The set of legal test requests are normally stored while the illegal requests for the same sample ID
will be rejected.

It also must be underscored that ELITE/ELITE PRO limits the size of handled records
(independently from the record type supported by ASTM) to 1024 byte during downloading session.

Note: If the Sample ID is not present at the Host level during the Host Query, the Host will return
only the Header and the terminator.

H|\^&||||||||ACL9000||P|1|20021205123956<CR>
L|1|N<CR>

Note: If the Host requests a test that is disabled on the ELITE/ELITE PRO, the test will not be
programmed on the ELITE/ELITE PRO and a reject message of this type will be returned back to
the Host.

C|1|I|UKNOWN_T|PatientID^0080|I<CR>

3.5.3 Test Request Message

The Test Request Message is used by ELITE/ELITE PRO to require information for each specific
sample that has no test orders in the instrument database. It is composed from a Message Header,
a Request Information and a Message Terminator record.

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Appendix A

The Request Information record requests in this case information for one specific ID at time. The
ASTM protocol limits the number of Request Information records to one. As a consequence the
instrument will wait for the host answer before sending a second Request Information record for a
second sample.

Following the ASTM specification the fields composing the Request Information are described in
the following.

Request Information Record:

Record Type ID always set to ‘Q’


Sequence Number as defined by the standard set to ‘1’ when query is
sent
Starting Range ID Number set to the specific sample ID to require information on;
the meaningful component is the second one
Ending Range ID Number not provided
Universal Test ID not provided
Nature of Request Time Limit not provided
Beginning request Results Date and Time not provided
Requesting Physician Name not provided
User Field #1 not provided
User Field #2 not provided
Request Information Status Code always set to ‘O’ (requesting test orders and
demographics only)

An example for the complete message (composed by header message, request information record
and message terminator record) is given by:

H|\^&|||ACL9000|||||||P|1|19960210103227<CR>
Q|1|^S001^||||||||O<CR>
L|1|N<CR>

Answer from Host:

H|\^&||||||||ACL9000||P|1|19960210103256<CR>
P|1||||ROSSI^MARIO^^^||19391127|M|||||||||||||||||DEP 1||||||||||<CR>
O|1|S001||^^^0001|||||||||||^| DR. VERDI ||||||||||O||||||<CR>
O|5|S001||^^^0002|||||||||||^|||||||||||O||||||<CR>
L|1|N<CR>

3.5.4 Test Order Message

As an answer to the ELITE/ELITE PRO Test Request Message the host computer sends the Test
Order Message. It contains the records specifying which tests are being requested for the queried
Sample ID.

See Test Order Message for details.

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3.6 Rejected Test Order

At completion of download operations, or at completion of the download operation for a single


sample in the host query mechanism, ELITE/ELITE PRO can transmit a message to inform host
computer about rejected test orders and samples or about the reasons for transmission interrupt.

The Rejected Test Order Message consists of a Message Header record followed by one or more
Comment records and completed by the Message Terminator Record. A comment record will be
transmitted for each rejected information.

It must be observed that if no legal information has been received, the download process is
interrupted and the rejected test order message will signal the reason for the interruption.
If the download process has been completed normally, the possible following rejected test order
message will report no legal test orders.

Comment Record structure is described in the following table:

Record Type ID Always set to ‘C’


Sequence Number Must begin with ‘1’ and then it will increment by one for each new
comment record
Comment Source Always set to ‘I’ (as ASTM: clinical instrument system)
Comment Text This field indicates the reason of the test order rejection. It is a string with
two components, each one can assume the reported values:
Rejection Reason:
BAD_TEST: the transmitted test code is invalid
QC_MA_ID: the specified ID is already used as a material in the QC
data base
BAD_S_ID: the specified ID is invalid
WRONG_ID: the host is sending information for a sample ID different
from the expected one
PDB_FULL: patient data base is full
M_TEST_E: more tests than expected
UKNOWN_T: unknown test requested
INSTR_ID: invalid instrument identifier
NO_TESTS: no test ordered for patient record
NO_PATIE: no patient record for ordered test
BAD_RECO: incorrect record format
Identification: This string contains the identification of the sample causing
the problem; if a test order caused the problem the sample ID and test ID
are transmitted sequentially. The character used to separate the rejection
reason, and the two strings used for the identification field is ‘|‘.
Lacking information will be signaled as “UNKNOWN”.
If BAD_RECO is the reason of the rejection the field will contain the
record number and the field number caused the failure.
Comment Type Always set to ‘I’ (as ASTM: instrument flag comment)

To summarize the possible values for the rejection reason and identification fields are reported in
the following table:

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Appendix A

Rejection Reason Transmission Identification: first sub_field Identification: second sub_field


Interrupted
QC_MA_ID yes sample ID (causing the problem) UNKNOWN
BAD_S_ID yes sample ID (causing the problem) UNKNOWN
PDB_FULL yes sample ID (causing the problem) test_ID
NO_TESTS yes UNKNOWN UNKNOWN
NO_PATIE yes sample ID (causing the problem) test_ID
INSTR_ID yes UNKNOWN UNKNOWN
M_TEST_E no sample ID test ID (causing the problem)
UNKWOWN_T no sample ID test ID (causing the problem)
BAD_TEST no sample ID test ID (causing the problem)
BAD_RECO yes Record No. (debug purpose) Field No. (debug purpose)

An example for a complete rejection phase is given by:

H|\^&|||ACL9000|||||||P|1|19982110103227<CR>
C|1|I|M_TEST_E|SMP01 ^010|I<CR>
C|2|I|BAD_TEST|SMP01 ^000|I<CR>
L|1|N<CR>

3.7 Download Session Volumes

Approximate data volumes for download sessions is provided as a guide for estimating the time
required completing typical sessions. System latencies (both in ELITE/ELITE PRO and host
computer) are not considered.

The minimal session would occur if the host has no test orders available for ELITE/ELITE PRO. In
this condition ELITE/ELITE PRO sends the test request message, the host would respond with a
message containing no test orders (only message header and message terminator record).
In conditions in which the host has test orders for the instrument, the estimated data volume is:

Test Request Message = Message Header (41) +17 + Message Terminator Record (6) = 64

Test Order Message = Message Header (41) +


Number of patient records (82 + 55 *number of ordered test)
+ Message Terminator Record (6)

Test Order Rejected = Message Header (41) +


+ 41 * number of rejected records
+ Message Terminator Record (6)

So considering the following situation: the host has 50 sample IDs to be download, each one with 4
tests, consider 10 rejected records the data volume can be estimated in:

Test Request Message = 64


Test Order Message = 41+ 50 (82 + 55 *4) + 6 = 15147
Test Order Rejected = 41 + (41 * 10) + 6 = 457
Total = 15668 characters

At 9600 “baud rate” and with no system overhead it would take approximately 17 seconds and
considering a system efficiency of 60% it becomes about 27 seconds.

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All estimations have been done using the maximum expected length for string fields.

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Appendix A

4.0 Test Results Uploading


Test Result Uploading allows transmission of results of the tests performed on ELITE/ELITE PRO
to the host computer. Results, related to patient, QC samples and Analytical Reference materials,
are transmitted on explicit user request or automatically at session completion.
In the first case the user must require the transmission command in the DMS or in the QC or in the
AR environment, select the patient samples or QC samples or AR set of data to be transmitted (in
according with one of the supported selection criteria) and start operation.
In the second case the transmission will happen automatically at session completion and the
instrument will provide to upload patient and/or QC samples data and/or AR data.
The type of data to be transferred during an automatic upload session depends upon the
instrument set-up (the automatic data transmission can be set to “patient samples only” or “QC and
patient samples” or “QC and AR patient samples”).

If upload is manually requested, all data are transmitted independently from the transmission flag.
If transmission is performed automatically at session completion, the instrument will upload for
patient samples all the data available for the sample IDs just analyzed and will upload, for QC
data, the results just obtained.

From a general point of view the automatic data transmission of the patient samples is equivalent
to the manual data transmission, requested in DMS, of patient samples belonging to a specific
load-list. While the automatic data transmission of the QC data or AR data is equivalent to the
manual data transmission, requested in QC database or AR database, or the data in a specified
interval for the QC material present in the load-list.

Considering that ELITE/ELITE PRO fills the strings used for Sample ID, department and patient
name with space characters (to align data), the host computer must ignore space characters on the
right of these fields.

If uploading is completed successfully for patient, QC samples and AR data, the transmission flag
associated to the single record will be updated from ‘L’ to ‘T’ (transmitted).

It must also to be underscored that on ELITE/ELITE PRO, modifications to sample data already
transmitted (such as adding of a new test result or modifications of sample data) cause the
transmission flag to change from ‘T’ to ‘L’.
It does not apply to QC or AR data because the only modification the user can request on these
data is to omit or to clear statistic. The effect of omit operation is to exclude the data from the
statistic but the data is not modified.
Modifications in the set-up values and note field do not modify the transmission status of QC data
and AR data.

While transmission is in progress the user will be updated on the number of the sample being
transmitted.

ELITE/ELITE PRO does not accept inquiries for test results.

Instrumentation Laboratory 20 of 33
ELITE/ELITE PRO Operator’s Manual

4.1 Test Result Message

The Test Result Message is used by ELITE/ELITE PRO to transmit any available test results for a
sample. All available test results will be transmitted for patient samples even if data have been
already transmitted partially.
The message consist of a Message Header record, a Patient Information record, one or more pair
Test Order records followed by one or more Results records (depending upon the number of
available test results and the number of results for each specific test).
The Result record can be completed with a Comment record containing flags associated to the
executed test.
Tests are uploaded using the same sorting used on board. The complete set of available test
results is globally uploaded to the host computer independently by the set of results defined as to
show in the sample list.
In some conditions, depending by the instrument status (i.e. calibrated, not calibrated, AR used,
etc.) only a subset of the results supported by the test will be transmitted to the host computer.

The Message Terminator record completes the transmitted data.

The same structure is used also to upload QC and AR data. In the following paragraphs any
differences in the way to treat patient, QC and AR data will be underlined.

4.1.1 Patient Information Record

This information is transmitted to the host only if available on the instrument. The Patient
Information structure is:

Patient Information Record:

File Type Patient Sample QC Sample or AR

Record Type ID Must be ‘P’ must be ‘P’


Sequence Number Must begin with ‘1’ and then must must begin with ‘1’ and
increment by one for each new then must increment by
Patient Information record one for each new Patient
Information record
Practice Assigned Patient ID Not provided not provided
Laboratory Assigned Patient ID Provided if defined as a string not provided
containing up to 15 characters.
Patient ID #3 Not provided not provided
Patient Name Provided if known as a single not provided
string containing up to 30
characters
Mother’s Maiden Name Not provided not provided
Birth date Provided if known as a single not provided
string without any checks
Patient Sex Provided if known as a single not provided
character
Patient Race-Ethnic Origin Not provided not provided
Patient Address Not provided not provided
Reserved Field Not provided not provided
Patient Telephone Number Not provided not provided
Attending Physician ID Not provided not provided
Special Field #1 Not provided not provided
Instrumentation Laboratory 21 of 33
Appendix A

Special Field #2 Not provided not provided


Patient Height Not provided not provided
Patient Weight Not provided not provided
Patient’s Known or Suspected Not provided not provided
Diagnosis
Patient Active Medications Not provided not provided
Patient’s Diet Not provided not provided
Practice Field #1 Not provided not provided
Practice Field #2 Not provided not provided
Admission and Discharged Not provided not provided
Dates
Admission Status Not provided not provided
Location Provided if known as a 30 not provided
characters free string

Nature of Alternative Diagnostic Not provided not provided


Code and Classifiers
Alternative Diagnostic Code and Not provided not provided
Classifiers
Patient Religion Not provided not provided
Marital Status Not provided not provided
Isolation Status Not provided not provided
Language Not provided not provided
Hospital Service Not provided not provided
Hospital Institution Not provided not provided
Dosage Category Not provided not provided

4.1.2 Test Order Record

The fields characterizing this record are specified in the following:

Test Order Record:

File Type Patient Sample QC Sample or AR data

Record Type ID Must be ‘O’ Must be ‘O’


Sequence Number Must begin with ‘1’ and then Must begin with ‘1’ and then
must increment by one for each must increment by one for
new test order record for the each new test order record for
same patient the same patient
Specimen ID Provided, is the ELITE/ELITE Provided, is the ELITE/ELITE
PRO sample ID. PRO QC material ID for QC
See Appendix for ELITE/ELITE data; or is the ‘AR’ keyword for
PRO supported characters. AR data. See Appendix for
ELITE/ELITE PRO supported
characters.
Instrument Specimen ID Not provided Not provided
Universal Test ID The field is composed of 4 The field is composed of 4
parts, only the Manufacturer’s parts; only the Manufacturer’s
Code component is used as a 4 Code component is used as a
character code (host codes are 4 character code (host codes
user configurable on board). are user configurable on
board).
Priority Provided if set as a ‘S’ char for Not provided

Instrumentation Laboratory 22 of 33
ELITE/ELITE PRO Operator’s Manual

priority samples.
Requested/Ordered Date/Time Not provided Not provided
Specimen Collection Date and Not provided Not provided
Time
Collection End Time Not provided Not provided
Collection Volume Not provided Not provided
Collector ID Not provided Not provided
Action Code Not provided Set to ‘Q’
Danger Code Not provided Not provided
Relevant Clinical Information Not provided Not provided
Date and Time Specimen Not provided Not provided
Received
Specimen Descriptor Not provided both fields Not provided both fields
Ordering Physician Provided, if available, as a Not provided
string containing up to 30 chars
Physician’s Telephone Not provided Not provided
Number
User Field #1 Not provided Not provided
User Field #2 Not provided Not provided
Laboratory Field #1 Not provided Not provided
Laboratory Field #2 Not provided Not provided
Date/time Results Reported or Not provided Not provided
Last Modified
Instrument Charge to Not provided Not provided
Computer System
Instrument Section Not provided Not provided
Report Type Set to F Set to F
Reserved Field Not provided Not provided
Location of Ward of specimen Not provided Not provided
Collection
Hospital Information Flag Not provided Not provided
Specimen Service Not provided Not provided
Specimen Institution Not provided Not provided

4.1.3 Result Record

The fields characterizing this record are specified in the following table.
A result record is send to the host computer for each available test result. For double tests all
available single values will be transmitted to the host computer (no mean values). Each result
record will contain one of available test results.

Result Record:

File Type Patient Sample QC Sample or AR data

Record Type ID Set to ‘R’ Set to ‘R’


Sequence Number Must begin with ‘1’ and then Must begin with ‘1’ and then
must increment by one for must increment by one for
each result record for the each result record for the
same patient test record for same patient test record for
the same patient record the same patient record
Universal Test ID The field is composed of 4 The field is composed of 4
parts, only the Manufacturer’s parts, only the Manufacturer’s

Instrumentation Laboratory 23 of 33
Appendix A

Code component is used as a Code component is used as a


4 character code (host codes 4 character code (host codes
are user configurable on are user configurable on
board). board).
Data or Measurement Value The field contains the obtained The field contains the obtained
numeric value or qualitative numeric value or qualitative
message (Error xx). All message (Error xx). All
numerical results are sent. * numerical results are sent. *
Units Provided if the previous field Provided if the previous field
is a numeric value; is a free is a numeric value; is a free
string (see Appendix C for string (see Appendix C for
standard units) maximum standard units) maximum
number of characters is 8). number of characters is 8).
Reference range Not provided Not provided
Result Abnormal Flag Not provided Not provided
Nature of Abnormality Flag Not provided Not provided
Result Status Set to ‘F’ Set to ‘F’
Data of Change in Instrument Not provided Not provided
Normative Values or Units
Operator Identification Not provided Not provided
Date/Time Test Started Not provided Not provided
Date/Time Test Completed Execution time, string of the Execution time, string of the
type YYYYMMDDHHMMSS type YYYYMMDDHHMMSS
Instrument Identification Not provided Not provided

* Specific ranges must be set at the Host level.

4.1.4 Comment Record

The Comment record allows integration of the transmitted test results with possible error
messages.
One or more comment records can follow the result records. Fields characterizing this record are
specified in the following.

Comment Record:

Record Type ID set to ‘C’


Sequence Number must begin with ‘1’ and then must increment by one for
each comment record
Comment Source set to ‘I’
Comment Text this field specifies the instrument errors (see table) as a
numeric code (2 characters) plus the associated message
Comment Type set to ‘I’

Instrumentation Laboratory 24 of 33
ELITE/ELITE PRO Operator’s Manual

4.1.5 Error Codes

TEMPERATURE WARNING

ROTOR STACK TEMPERATURE Out of Range = 41,


SLIDER TEMPERATURE Out of Range = 43,
REAGENT TEMPERATURE Out of Range = 45,
INCUBATION TEMPERATURE Out of Range = 49,

MECHANICAL WARNING

AUTOSAMPLER WARNING = 50,


ROTOR MOTOR WARNING = 51,
HORIZONTAL MOTOR WARNING = 52,
VERTICAL MOTOR WARNING = 53,
REAGENT DILUTOR WARNING = 54,
SAMPLE DILUTOR WARNING = 55,
PHOTOMETRIC COVER WARNING = 56,
STIRRER1_FAIL = 57,
STIRRER2_FAIL = 58,
STIRRER3_FAIL = 59,
STIRRER4_FAIL = 60,

LIQUID WARNING

LIQUID_SENSOR OFF (SAMPLE) = 73,


LIQUID_SENSOR OFF (REAGENT) = 74,
LIQUID_SENSOR_FAIL (SAMPLE) = 75,
LIQUID_SENSOR_FAIL (REAGENT) = 76,
MATERIAL_SHORT = 77,
MANDATORY_MATERIAL_SHORT = 78,
FLUSH_PRE_WARNING = 79,
FLUSH WARNING = 80,
CLEANING_NOT_PERFORMED = 83,

MISCELLANEOUS WARNING

COVER_OPEN_DURING_LOADING_OR_INCUBATION = 86,
TIMEOUT_EXPIRED_DURING_LOADING = 87,

ERRORS ON RESPONSE

OUTSIDE SCALE RANGE LOW = 98


OUTSIDE SCALE RANGE HIGH = 99
SATURATION_ERROR = 205,
FIRST_THRESHOLD_ERROR = 206,
SECOND_THRESHOLD_ERROR = 207,
DELTA_ERROR = 208,
INITIAL_SLOPE_ERROR = 209,
FINAL_SLOPE_ERROR = 210,
FINAL_REACTION CURVE ERROR = 211,
FIRST_DERIVATIVE_ERROR = 212,
SECOND_DERIVATIVE_ERROR = 213,
FIRST_PART_REACTION CURVE ERROR = 214,

Instrumentation Laboratory 25 of 33
Appendix A

ERRORS ON CALIBRATION CURVES

INSUFFICIENT_STANDARD POINTS IN ONE_SEGMENT = 215,


INVALID CURVE INSUFFICIENT DATA = 216,
NUMBER OF_STANDARD OUT OF RANGE = 217,
INVALID_TRANSLATION_OR_MANDATORY_STANDARD = 219,
INVALID_STD_INSUFFICIENT_REPLICATES = 220,
INSUFFICIENT_REPLICATES = 221,
INVALID_REPLICATES = 222,
CV_OUT_OF_RANGE = 223,
SLOPE OUT OF RANGE: INVALID CALIBRATION CURVE = 225,
R2_OUT_OF_RANGE = 226,
NOT MONOTONIC CURVE = 228,

ERRORS ON ANALYTICAL REFERENCE, QC, RATIO AND NORMALIZED RATIO

AR_INVALID = 229,
AR_OUT_OF_RANGE = 230,
AR_NOT_CHECKED = 233,
DUPLICATE OUT OF RANGE = 239,
QC_INVALID = 240,
QC_OUT_OF_RANGE = 242,
RATIO_CALCULATION_ERROR = 249,
RATIO_CALCULATION_ERROR: S/Sa out of range = 250,
NORMALIZED RATIO ERROR: AR/Ara out of range = 251,
NORMALIZED RATIO: CALCULATION ERROR = 252,
STD_NOT_FOUND = 253,
AR_NOT_FOUND = 254,
ACTIVATE SAMPLE NOT_FOUND = 255,
ARa_NOT_FOUND = 256,
RATIO_NOT_FOUND = 257,
AR_OUT_OF_RANGE = 258,
AR_NULL = 259,
STD_NULL = 260,
SAMPLE_NULL = 262,
REF_NULL = 263,
AR_RATIO_ NULL_ = 264,
ACTIVATED_AR NULL_ = 265,
NULL_DIFFERENCE = 266,

Out of range indications referring to normal or test ranges are not transmitted to the host computer.
The * symbol (outside Normal Range) is presented only on the Cumulative and Sample Reports.

An example for a complete test uploading sequence is given by:

Instrumentation Laboratory 26 of 33
ELITE/ELITE PRO Operator’s Manual

Sample

H|\^&||||||||ACL9000||P|1|19982110134700<CR>
P|1||PTNT1||BLU^^^^||19391127|M|||||||||||||||||DEP 1||||||||||<CR>
O|1|SMP01||^^^0001|S||||||||||^|DR. VERDI||||||||||O||||||<CR>
R|1|^^^0001|12.8|||||F||||19960119114215|<CR>
C|1|I|31^ Invalid for QC |I<CR>
P|2||PTNT1||Gialli^^^^||19391127|M|||||||||||||||||DEP 1||||||||||<CR>
O|1|SMP10||^^^0001|S||||||||||^|DR. VERDI||||||||||O||||||<CR>
R|1|^^^0001|14.5|s||||F||||19960119114215|<CR>
C|1|I|31^ Invalid for QC |I<CR>
L|1|N<CR>

QC

H|\^&|||ACL9000|||||||P|1|20021205123956<CR>
P|1||||||||||||||||||||||||||||||||||<CR>
O|1|Normal C.||^^^0001|||||||Q||||^|||||||||||F||||||<CR>
L|1|N<CR>

AR

H|\^&|||ACL9000|||||||P|1|20021205123956<CR>
P|1||||||||||||||||||||||||||||||||||<CR>
O|1|AR||^^^0001|||||||Q||||^|||||||||||F||||||<CR>
L|1|N<CR>

4.2 Upload Session Volumes

Approximate data volumes for upload sessions is provided as a guide for estimating the time
required to complete typical sessions. Obviously, system latencies (both in ELITE/ELITE PRO and
host computer) are not considered.
The minimal session would occur if ELITE/ELITE PRO has no test results to be transmitted; no
data is sent and the data volume is zero.
In conditions in which the ELITE/ELITE PRO has results to be transmitted, the data volume can be
estimated on the Test Order and Test Result record size base.

Test Order Message = Message Header (41) +


Number of patient records (82 + Results) + Message Terminator Record (6)

Results = number of ordered test (55 + 60*number of test result + 56* number of error messages)

Consider the following situation: ELITE/ELITE PRO has 50 sample IDs to be uploaded each with 4
tests, each test with 3 results and each test with 2 flags, the data volume can be estimated in:

Test Result Message = 41+ 50 (82 + 4(55 + 60*3 + 56*2)) + 6


Total = 69547 characters

At 9600 “baud rate” and with no system overhead it would take approximately 73 seconds and
considering a system efficiency of 60% it becomes about 116 seconds.

Instrumentation Laboratory 27 of 33
Appendix A

5.0 Not Supported Records

The Scientific record and the Manufacturer Information record are not supported by ELITE/ELITE
PRO protocol.

As a consequence the instrument ignores any type of information they contain.

6.0 Transmission Abort

The download or upload transmission session can be interrupted for an explicit user request
detected on the instrument, because the host computer is not responding or because the host
computer required interruption of the transmission process.

Further, as reported above, the download process can be interrupted because an illegal sample
Identifier has been received. Instrument behavior in this particular condition was defined in and
Reject Test Orders.

ELITE/ELITE PRO family instruments behavior in each of the listed conditions is described in the
following:

Condition Action

ELITE/ELITE PRO’s ELITE/ELITE PRO will signal the end of transmission to the host and
operator requested stop will discard any following messages. The host must consider the
download process interrupt request.
It must be emphasized that ELITE/ELITE PRO will signal the
transmission interruption with a message that is a rejected test order
message if any information has been rejected or with a message
header plus a message terminator record if no information has been
rejected.
ELITE/ELITE PRO ’s ELITE/ELITE PRO will complete the message in progress with the
operator requested stop message terminator and will not transmit any further test results.
upload process
Host computer is not During download and upload transmission sessions, operation by
responding ELITE/ELITE PRO is stopped. If download was in progress, no rejected
test messages will be transmitted.

A message will inform the user that the transmission has been
interrupted: “Host Computer not responding”
Host computer required Both during download and upload sessions, operation by ELITE/ELITE
EOT PRO is stopped. If download was in progress, no rejected test
messages will be transmitted.
It must be emphasized that the host computer must request the
transmission interruption with a message composed by a message
header plus a message terminator record.

A message will inform the user that the transmission has been
interrupted: “Host Computer required interrupt transmission”
Incorrect record format Transmission/reception is aborted and the user is informed:
“Incorrect format in host messages”

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ELITE/ELITE PRO Operator’s Manual

7.0 Appendix- ELITE/ELITE PRO Test Codes

Test codes are user definable. Codes from 1 to 500 are assigned to IL pre-defined tests. Codes
greater than 500 are assigned to the user definable tests. IL Library proposes the default test codes
reported in the following table.

Test Test Code Test ID Extended Test Name


Code for host (8 char. max) (15 char. max)

001 0001 PT PT
002 0002 PT e PT Extended
003 0003 PT d PT Double
004 0004 PT ed PT Ext. Db.
005 0005 PT HS PT HS
006 0006 PT HS e PT HS Extended
007 0007 PT HS d PT HS Double
008 0008 PT HS ed PT HS Ext. Db.
009 0009 PT HS + PT PLUS
010 0010 PT HS + e PTPLUS Extended
011 0011 PT HS + d PT PLUS Double
012 0012 PT HS + ed PT PLUS Ext. Db.
013 0013 R-PT Recombipl-PT
014 0014 R-PTe Recombipl-PTex
015 0015 PT R PT Rec.
016 0016 PT R e PT Rec Extended
017 0017 PT R d PT Rec. Double
018 0018 PT R ed PT Rec Ext. Db.
023 0023 R-PT d Rec-PT Double
024 0024 R-PT ed Rec-PT Ext Db

030 0030 FIB_ FIB (PT)


031 0031 FIB FIB (PT)
032 0032 FIB e_ FIB (PT e)
033 0033 FIB e FIB (PT e)
034 0034 FIB d_ FIB (PT d)
035 0035 FIB d FIB (PT d)
036 0036 FIB ed_ FIB (PT ed)
037 0037 FIB ed FIB (PT ed)
038 0038 FIB HS_ FIB (PT HS)
039 0039 FIB HS FIB (PT HS)
040 0040 FIB HSe_ FIB (PT HS e)
041 0041 FIB HSe FIB (PT HS e)
042 0042 FIB HSd_ FIB (PT HS d)
043 0043 FIB HS d FIB (PT HS d)
044 0044 FIBHSed_ FIB (PT HS ed)
045 0045 FIB HSed FIB (PT HS ed)
046 0046 FIB HS+_ FIB (PT PLUS)
047 0047 FIB HS+ FIB (PT PLUS)
048 0048 FIB HS+e_ FIB (PLUS e)
049 0049 FIB HS+e FIB (PLUS e)
050 0050 FIB HS+d_ FIB (PLUS db)
051 0051 FIB HS+d FIB (PLUS db)
052 0052 FIB+ed_ FIB (PLUS ed)
053 0053 FIB+ed FIB (PLUS ed)
054 0054 R-FIB_ Recombipl-FIB
055 0055 R-FIB Recombipl-FIB
056 0056 R-FIBe_ Recombipl-FIBex

Instrumentation Laboratory 29 of 33
Appendix A

Test Test Code Test ID Extended Test Name


Code for host (8 char. max) (15 char. max)

057 0057 R-FIBe Recombipl-FIBex


058 0058 FIB R_ FIB (Rec)
059 0059 FIB R FIB (Rec)
060 0060 FIB Re_ FIB (Rec e)
061 0061 FIB Re FIB (Rec e)
062 0062 FIB Rd_ FIB (Rec d)
063 0063 FIB Rd FIB (Rec d)
064 0064 FIB Red_ FIB (Rec ed)
065 0065 FIB Red FIB (Rec ed)
074 0074 R-Fibd_ Recombipl-FIBd
075 0075 R-Fibd Recombipl-FIBd
076 0076 R-Fibed_ Recombipl-FIBed
077 0077 R-Fibed Recombipl-FIBed

080 0080 APTT Ly APTT Ly


081 0081 APTT Lye APTT Ly Ext.
082 0082 APTT Lyd APTT Ly Db.
083 0083 APTTLyed APTT Ly Ext.Db.
084 0084 APTT-SP APTT-SP
085 0085 APTT-SPe APTT-SP Ext.
086 0086 APTT-SPd APTT-SP Db.
087 0087 APTTSPed APTT-SP Ext.Db.
088 0088 APTT-C APTT-C
089 0089 APTT-C e APTT-C Ext.
090 0090 APTT-C d APTT-C Db.
091 0091 APTT-Ced APTT C-Ext.Db.
092 0092 APTTSYS APTT SynthASil
093 0093 APTTSYSe APTT SynthASile
094 0094 APTTSYSd APTT SynthASild
095 0095 APTTSSed APTTSynthASiled
096 0096 APTTSYF APTT SynthAFax
097 0097 APTTSYFe APTT SynthAFaxe
098 0098 APTTSYFd APTT SynthAFaxd
099 0099 APTTSFed APTT SynthAFaxed

102 0102 FVIII SF FVIII SynthAFax


107 0107 FIX SF FIX SynthAFax
112 0112 FXI SF FXI SynthAFax
117 0117 FXII SF FXII SynthAFax

120 0120 TT-5 TT - 5


121 0121 TT e-5 TT Ext. 5
122 0122 TT d-5 TT Dbl. 5
123 0123 TT ed-5 TT Ext. Dbl. 5
124 0124 TT-8 TT - 8
125 0125 TT e-8 TT Ext. 8
126 0126 TT d-8 TT Dbl. 8
127 0127 TT ed-8 TT Ext. Dbl. 8
128 0128 TT-2 TT - 2
129 0129 TT e-2 TT Ext. 2
130 0130 TT d-2 TT Dbl. 2
131 0131 TT ed-2 TT Ext. Dbl. 2

150 0150 PCX Pro-IL-Complex


151 0151 HPX Hepatocomplex
152 0152 P-ClotLy Pro-Clot Ly

Instrumentation Laboratory 30 of 33
ELITE/ELITE PRO Operator’s Manual

Test Test Code Test ID Extended Test Name


Code for host (8 char. max) (15 char. max)

153 0153 P-ClotSP Pro-Clot SP


154 0154 P-ClotC Pro-Clot C
159 0159 PS Protein S
160 0160 Free PS Free Protein S
161 0161 Pro S Protein S
199 0199 AT* Antithr. Liquid
200 0200 AT Antithr. In cup

201 0201 FIB-C_ Fib. Clauss


202 0202 FIB-C Fib. Clauss
203 0203 FIB-C l_ Fib. Clauss low
204 0204 FIB-C l Fib. Clauss low
205 0205 FIB-C h_ Fib Clauss high
206 0206 FIB-C h Fib. Clauss high

225 0225 APCR-V APCR V


208 0208 HEP LMW Heparin LMW
210 0210 HEP UHF Heparin UHF
212 0212 PLG Plasminogen
213 0213 PL-IN Plasmin Inhib.
214 0214 P-C Protein C
220 0220 F8 Chr H F8Chr High
221 0221 F8 Chr L F8Chr Low
225 0225 APCR V APCR V
250 0250 D-Dimer D-Dimer
251 0251 D-Dh D-Dimer high
275 0275 F8SP-P FVIII SP Par
276 0276 F9SP-P FIX SP Par

300 0300 FVIII Ly F VIII - Ly


302 0302 FVIII SP F VIII - SP
304 0304 FVIII C F VIII – C
305 0305 FVIII SS FVIII SynthASil

310 0310 FIX Lyo F IX - Ly


312 0312 FIX SP F IX - SP
314 0314 FIX C F IX - C
315 0315 FIX FIX SynthASil

320 0320 FXI Lyo F XI - Ly


322 0322 FXI SP F XI - SP
324 0324 FXI C F XI - C
325 0325 FXI SS FXI SynthASil

330 0330 FXII Lyo F XII - Ly


332 0332 FXII SP F XII - SP
334 0334 FXII C F XII - C
335 0335 FXII SS FXII SynthASil

336 0336 FVII PT F VII - PT


338 0338 FVII HS F VII - HS
340 0340 FVII HSP F VII - HS Plus
342 0342 FVII R F VII - R
343 0343 R FVII FVII RecombPT

350 0350 FX PT F X - PT

Instrumentation Laboratory 31 of 33
Appendix A

Test Test Code Test ID Extended Test Name


Code for host (8 char. max) (15 char. max)

352 0352 FX HS F X - HS
354 0354 FX HSP F X - HS Plus
356 0356 FX R FX-R
357 0357 R FX FX RecombPT

360 0360 FV PT F V - PT
362 0362 FV HS F V - HS
364 0364 FV HSP F V - HS Plus
366 0366 FV R FV-R
367 0367 R FV FV RecombPT

370 0370 FII PT F II - PT


372 0372 FII HS F II – HS
374 0374 FII HSP F II - HS Plus
376 0376 FII R F II – R
377 0377 R FII FII RecombPT

155 155 SCT-S SCT Screen


156 156 SCT-C SCT Confirm
400 0400 VWF:Ag vWF Antigen
401 0401 vWF:AgH vWF Antigen Hig

410 0410 LAC_S LAC_S


411 0411 LAC_C LAC Confirm

Note: This table represents the situation for the IL Library 7.

Instrumentation Laboratory 32 of 33
ELITE/ELITE PRO Operator’s Manual

8.0 Appendix – ELITE/ELITE PRO Supported Characters

8.1 Supported Characters for Sample ID

The ASCII set of characters considered is in the decimal range 32 to 126, because a Sample ID
can be accepted only if it contains at least one character different from a space.

8.2 Supported Characters for Patient name, Department and Units

Is the ASCII set of characters considered in the decimal range 32 to 255.

8.3 Supported Characters for delimiters

! “ # $ %
& ‘ ( ) *
+ / : ; =
@ [ \ ] ^
_ { | } ~

ASCII character 127 is not allowed as delimiter.

Note: Separators are always expected from Host and are always transmitted independently from
the information contained in the string.

Instrumentation Laboratory 33 of 33
Appendix A

9.0 Appendix - ELITE/ELITE PRO Supported Units

Unit Abbreviation

Time s
Activity %
Ratio R
International Normalized Ratio INR
NR
Concentration mg/dL
g/L
ng/mL
U/mL
µg/L
µmol/L
IU/mL
mg/L
ug/mL

Delta Optical Absorbance ∆ Abs


Delta ∆ (∆ ASCII code is 7F)
Activated Sample Sa Sa (Hex code EC)
Curve behavior offset
min
max
Final

User defined free string containing up to 8


chars

Notes: For duplicate (d) and extended duplicate (ed) tests only the individual replicate results are
sent to the host system. The mean value is not sent from the ACL8/9/10000 system. This applies
to all sample types including patient, QC and Analytical reference.

Instrumentation Laboratory 34 of 33
APPENDIX B

ACL Elite/Elite Pro

Bar Code Label Specification


Appendix B ACL Elite/Elite Pro Operator’s Manual

Index

1. INTRODUCTION............................................................................................................... 3

1.1 PURPOSE .......................................................................................................................... 3

1.2 DEFINITIONS, ACRONYMS AND ABBREVIATIONS ..................................................................... 3

1.3 REFERENCES .................................................................................................................... 3

2. GENERAL DESCRIPTION................................................................................................ 4

2.1 SUPPORTED CODES AND CHECKSUM TYPE ........................................................................... 4

2.2 BAR CODE SYMBOL SPECIFICATIONS ................................................................................... 4

2.3 BARCODE PARAMETERS ..................................................................................................... 5

2.4 BARCODE LABEL POSITIONING ............................................................................................ 6

2.5 APPENDIX A - DECODER ZONE MAP..................................................................................... 7

2.6 APPENDIX B - BARCODE LABEL DIMENSIONS......................................................................... 8

Instrumentation Laboratory 2 of 8
Appendix B ACL Elite/Elite Pro Operator’s Manual

1.0 Introduction

In the following sections the characteristics of the bar code labels that can be read with the
Welch Allyn SCANTEAM 3700 scanner installed on ACL Elite/Elite Pro family instruments are
described.

1.1 Purpose

Purpose of this document is to give indication of the scanner characteristics in terms of readable
codes, identify the requirements the barcode labels must satisfy and define constraints in terms
of label positioning within ACL Elite/Elite Pro instrument.

1.2 Definitions, Acronyms and Abbreviations

WA Welch Allyn SCANTEAM 3700

Near Distance is the nearest distance that a scanner can accurately digitize a given
bar code.

Far Distance is the farthest distance that a scanner can accurately digitize a given
bar code.

Scan Width is the length of the widest bar code that can be successfully
interpreted by the scanner.

Quiet Zone is the blank area located just before and just after the bar space
pattern.

1.3 References

Ref. 1 SCANTEAM 3700 - Technical Manual - Welch Allyn

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Appendix B ACL Elite/Elite Pro Operator’s Manual

2. General Description

The WA is a fixed mount CCD bar code scanner with integrated decoder for easy integration into
host equipment (ACL Elite/Elite Pro family instruments in our case).

The 3700 features Welch Allyn’s time-proven decoding algorithms in a micro-processor-


controlled bar code scanner/decoder and offers configurable operating parameters.

The following mean features are available with every WA:

• High scan rate per second (100 is the standard)

• Flexible scan trigger configurations

• Decoder configurable for high security

• Scan voting to ensure bar code data integrity

• Ease of configuration through RS-322 interface

2.1 Supported Codes and Checksum type

Code Type Checksum Type Data Digits


Code 128 No checksum up to 15
Code 39 Modulus 43 up to 15
No Checksum up to 15
Interleaved 2 of 5 USS - Modulus 10 up to 15
OPCC - Modulus 10 up to 15
No checksum up to 15
Codabar AIM - Modulus 16 with start/stop digits up to 15
NW7 - Modulus 11 up to 15
NW7 - Modulus 16 with start/stop digits up to 15
No Checksum up to 15

2.2 Bar Code Symbol Specifications

All bar code symbols have to satisfy the appropriate AIM Uniform Symbology Specification.
In particular the following characteristics have to considered:

• Background substrate: the barcode symbol should be printed on a material type which is
reflective and has a matte (not glossy) finish. A background diffuse reflectance of at least
70% to 80% is suggested for optimum contrast.

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Appendix B ACL Elite/Elite Pro Operator’s Manual

• Ink color and type: the ink type must be compatible with 660 nm LEDs used in the scanner.
The barcode symbols inked bars should not exceed 10% reflectance at 660 nm which is
being used for reading, whether printed with black ink or colored ink.

• Voids and Specks: the code has to be printed clearly, free of voids, specks, blemishes and
lines which could “fool” the scanner.

• Definition: the bars in the barcode symbols should be well defined. Their edges should not
be rough or fuzzy, so that bar and spaces have the proper widths intended for the used
barcode symbology used. Definition should be sharp and consistent.

• Tolerance: the ratio of the widths and spaces in a barcode sysmbol must conform to the
appropriate AIM barcode specifications and can cause problems if not correct throughout the
barcode. Problems can occur if bar edges are smeared or rough, or when they exhibit voids.

2.3 Barcode Parameters

Parameters have to be considered in that context are:

• Density (bar code): refers to the number of cheracters in a linear inch of bar code.

• Ratio: refers to the ratio of the nominal wide element width to the nominal narrow element
width.

In order to ensure a good bar code reading (in addition to that indicated in section 2.2), the
parameters above mentioned should be as follows:

• Density: not less 10 Mils

• Ratio: not less 2.5

These values are valid for all the above mentioned bar code types.

The relationship between reading distances, scan width and bar code density are displayed in the
following:

Near Distance Far Distance Scan Width Scan Width Density


(near distance) (far distance) (bar code)
63.5 mm 114.5 mm 101.6 mm 152.4 mm 7.5 MIL
(161.29’’) (290.83’’) (258.064’’) (387.096’’)
34.3 mm 130.3 mm 82.3 mm 178.3 mm 13 MIL
(87.122’’) (330.962’’) (209.042’’) (452.882’’)

In Appendix Decoder Zone Map the attached drawing defines the “decoder zone map” for the
data displayed above. The displayed graph has been experimentally obtained from Welch Allyn
Laboratories because the WA equipped for the IL requirements does not have standard optics.

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Appendix B ACL Elite/Elite Pro Operator’s Manual

2.4 Barcode Label Positioning

In Appendix Barcode Label Dimension the attached drawing defines the barcode label
dimensions and identifies constraints in positioning labels on Vacutainers ® #. The 13x75
vacutainers have been considered. The proposed barcode label dimensions and positioning
apply to all sample tray models.

The following measurements are reported:

Barcode label feature Dimension


Maximum label length (global label size) 52.6 mm (2.071”)
Maximum barcode length (printed area) 39.6 mm (1.559”)
Quiet zone (white area before and after the printed area) 6.35 mm (0.256”)
Label position (it is identified as the label edge measured 58 mm (2.283”)
starting from the Vacutainer lower edge)

# ® Vacutainer is a registered trademark of Becton Dickinson.

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Appendix B ACL Elite/Elite Pro Operator’s Manual

2.5 Appendix - Decoder Zone Map

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Appendix B ACL Elite/Elite Pro Operator’s Manual

2.6 Appendix - Barcode Label Dimensions

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APPENDIX C

ACL Elite/Elite Pro

Special Tests Procedures

Revision 3
.

2 Instrumentation Laboratory
Specialty Testing on the ACL Elite/Elite Pro

• APCR-V Page 4 • Plasminogen Page 52

• Antithrombin (Liquid) Page 8 • Plasmin Inhibitor Page 56

• D-Dimer Page 12 • Pro-IL-Complex Page 60

• Factor Assays Page 18 • ProClot Page 64

• Chromogenic Fact. VIII Page 24 • Protein C Page 68

• Fib-C Page 28 • Pro S Page 72

• Free Protein S Page 34 • Silica Clotting Time Page 76

• Heparin Page 38 • Thrombin Time Page 80

• Hepatocomplex Page 44 • vWF Activity Page 84

• LAC- Screen/Confirm Page 48 • vWF Antigen Page 88

3 Instrumentation Laboratory
APCR-V
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test Reference


Range/Cutoff
SetupàTestsàView/Define

Setup the QC for APCR-V


QC à Setup/Review

Analyze Patient / QC Samples

4 Instrumentation Laboratory
APCR-V – ACL Elite/Elite Pro

1. Materials Needed

• APCR-V Reagent Kit Cat. No. 20008700


• Calibration Plasma Cat No. 20003700

APCR-V Reagent Kit Configuration


Kit Contents Stability Preparation
o
2 x 4mL APTT Reagent 1 Month at 2-8 C Mix Thoroughly before Use
1 Week at 15-25 oC
8 hours at 15 oC on ACL
**Note: Do Not Freeze
2 x 4 mL Factor V Reagent Plasma 8 hours at 15-25 oC Add 4.0 mL H2O.
o
24 hours at 2-8 C Swirl, let sit for 30 min at
3 months at -20 oC in original 15 – 25oC.
vial Invert. Do Not Shake!
o
(Thaw at 37 C and mix before
use. Do Not Refreeze)
2 x 2 mL APC Ca/Cl2 8 hours at 15-25 oC Add 2.0 mL H2O.
5 Days at 2-8 oC Swirl, let sit for 30 min at
Note: Default position on the 3 months at -20 oC in original 15 – 25oC.
analyzer is R7 (APC Ca Act) vial Invert. Do Not Shake!
(Do Not Refreeze)
2 x 2 mL Ca/Cl2 1 Month at 2-8oC Mix Thoroughly before Use
Note: Default position on the 1 Week at 15-25 oC
analyzer is R8 (APC CaCl2) 3 Days at 15 oC on ACL
2 x 1 mL APC Control Plasma 6 hours at 15-25 oC Add 1.0 mL H2O.
Level 1 6 hours at 2-8 oC Swirl, let sit for 30 min at
3 months at -20 oC original vial 15 – 25oC.
o
(Thaw at 37 C and mix before Invert. Do Not Shake!
use. Do Not Refreeze)
2 x 1 mL APC Control Plasma 6 hours at 15-25 oC Add 1.0 mL H2O.
Level 2 6 hours at 2-8 oC Swirl, let sit for 30 min at
3 months at -20 oC in original 15 – 25oC.
vial Invert. Do Not Shake!
(Thaw at 37 oC and mix before
use. Do Not Refreeze)

5 Instrumentation Laboratory
2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the APCR-V Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
- Press the Green Check to Save and return to main database screen.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the APCR-V test, and press the Detail Icon.
- Scroll down to the row for desired reporting units, and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- The reaction curve min and max may also be set. If the values are unknown, clear the
min and max to zoom the curve display to full scale.
- Press the Green Check to Save and return to main database screen.

4. Setting up Liquid Positions

- The liquid positions for APTT Reagent, Factor V Reagent Plasma, APC/CaCl2 and
CaCl2 are automatically assigned when the test is placed in a profile or run as a single
assay. Refer to the Materials map screen when running the assay for placement.

5. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defined The APCR-V test can utilize the following
control materials to verify assay performance:
- APC Control Plasma Level 1
- APC Control Plasma Level 2

On the ACL Elite/Elite Pro this is defined in Setup à Liquids menu. Refer to section 4.1.11 in
the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC

6 Instrumentation Laboratory
Range check button for control result flagging. Refer to the ACL Elite/Elite Pro
Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

6 . Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Results are reported in either seconds or a Ratio of the Seconds. The ratio is calculated as follows:
APCR-V = APTT (with APC) / APTT (without APC)

Each laboratory should establish its own normal cutoff value for the ratio.
Refer to the HemosIL APC Resistance V package insert sheet for a procedure to establish the
cut-off value.

7 Instrumentation Laboratory
L (Liquid)
Antithrombin
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the QC for Liquid AT


QCà Review/Setup

Calibrate the Liquid AT test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient samples

8 Instrumentation Laboratory
Liquid Antithrombin – ACL Elite/Elite Pro

1. Materials Needed

• Liquid Antithrombin Kit Cat. No. 20002500


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• HemosIL High Abnormal Unassayed Control Cat. No. 20003320
• HemosIL High Abnormal Assayed Control* Cat. No. 20003310
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
• Factor Diluent Cat. No. 09757600
• Cleaning solution (Clean A) Cat. No. 09831700

Liquid Antithrombin Reagent Kit Configuration


Kit Contents Stability Preparation
4 x 4mL Factor Xa Reagent Until Expiration when not opened Invert to mix before use.
and stored at 2-8oC
5 weeks in original vial at 2-8oC
2 Days on ACL, when opened
**Note: Do Not Freeze
2 x 2 mL Chromogenic Substrate Until Expiration when not opened Invert to mix before use.
and stored at 2-8oC
5 weeks in original vial at 2-8oC
2 Days on ACL, when opened
**Note: Do Not Freeze

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the AT* Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

9 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the AT* test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the AT* test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Factor Xa, Chromogenic Substrate, Factor
Diluent and Clean A are automatically assigned when the test is placed in a profile or
run as a single assay. Refer to the Materials map screen when calibrating or running
the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The AT* test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Chromogenic Control Plasma Level 1
- Abnormal Chromogenic Control Plasma Level 2
On the ACL Elite/Elite Pro these liquids are defined in Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on
defining new liquids.

10 Instrumentation Laboratory
- QC à QC Review and Setup
- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging. Refer to the ACL Elite/Elite Pro Operator’s
Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the AT* test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Place 2 empty 0.5 mL sample cups in the appropriate “A” positions according to the
Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 150 % activity

11 Instrumentation Laboratory
D-Dimer
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the Auto-Rerun for


D-Dimer High
SetupàTestàReflex Tests

Setup the QC for D-Dimer


QCà Review/Setup

Calibrate the D-Dimer test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient samples

12 Instrumentation Laboratory
D-Dimer / D-Dimer High – ACL Elite/Elite Pro

1. Materials Needed

• D-Dimer Reagent Kit Cat. No. 20008500


• D-Dimer Bi-level Control kit Cat. No. 20008610
• Factor Diluent Cat. No. 09757600

D-Dimer Reagent Kit Configuration


Kit Contents Stability Preparation
o
4 x 3mL Latex Reagent 1 Month at 2-8 C Add 3.0 mL H2O.
1 Day on ACL at 15 oC Swirl, let sit for 30 min at
**Note: Do Not Freeze 15 – 25 oC.
Invert. Do Not Shake!
3 x 9 mL Reaction Buffer 1 Month at 2-8oC Ready to use.
1 Day on ACL at 15 oC Invert to mix prior to placing vial
on instrument
o
2 x 1mL D-Dimer Calibrator 1 Month at 2-8 C Add 1.0 mL H2O.
3 Days at 15-25oC Swirl, let sit for 30 min at
2 Months at –20oC 15 – 25 oC.
**Freeze and thaw only 1 time. Invert. Do Not Shake!
Thaw at 37oC & mix prior to Avoid foam formation.
use.

D-Dimer Controls
Kit Contents Stability Preparation
5 x 1.0 mL Low D-Dimer 1 Month at 2-8oC Add 1.0 mL H2O.
Control 3 Days at 15-25 oC Swirl, let sit for 30 min at
Approximate Level: Border line 2 Months at –20oC 15 – 25 oC.
value **Freeze and thaw only 1 time. Invert. Do Not Shake!
Thaw at 37oC & mix prior to use.
5 x 1.0 mL High D-Dimer 1 Month at 2-8oC Add 1.0 mL H2O.
Control 3 Days at 15-25 oC Swirl, let sit for 30 min at
Approximate Level: Abnormal 2 Months at –20oC 15 – 25 oC.
value **Freeze and thaw only 1 time. Invert. Do Not Shake! Avoid
Thaw at 37oC & mix prior to use. foam formation.

13 Instrumentation Laboratory
2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the D-Dimer Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
- Repeat the above step for the D-D h test (D-Dimer High assay)
- Press the Green Check to Save and return to main database screen.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the D-Dimer test, and press the Detail Icon.
- Scroll down to the row for units in ng/mL and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- The reaction curve min and max may also be set. If the desired values are unknown,
clear both the min and the max to zoom curve display to full scale.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight D-D Cal
- Scroll down the Used by column and highlight the D-Dimer test
- Click on the Assign Value button, and enter in the value for the D-Dimer Calibrator.
This value can be found on the package insert included in the kit.
- Press the Green Check to Save and return to main database screen.

Note: The D-Dh (D-Dimer High) test uses the calibration curve for the regular D-Dimer
test. It is not necessary to enter in the calibrator value into the D-D h test.

14 Instrumentation Laboratory
5. Setting up Liquid Positions

- The liquid positions for the D-D Cal, D-Dimer Latex, Buffer reagent and Factor
Diluent are automatically assigned when the test is placed in a profile or run as a single
assay. Refer to the Materials map screen when running the assay for placement.

6. Setting up the Autorerun feature

Note: The D-Dimer assay is linear from 200 to 1050 ng/mL. The ACL Elite/Elite Pro
system can rerun patient samples that exceed the 1050ng/mL limit using the D-Dimer high
test. This will increase the linearity of the assay 5-fold up to 5250 ng/mL. Values above
5250 ng/mL from the D-D h (D-Dimer high) test will need manual dilution (1:25 or 1:125)
with factor diluent and repeated using the D-Dimer test. Multiply the printed results by 5,
25 or 125 (depending upon the number of dilution steps performed) to correct for the
dilution. Do Not run the D-Dimer high test on samples with a D-Dimer less than 1000
ng/mL

- Setup à Tests àReflex Tests


- Define a new Reflex rule for the following:
- If D-Dimer > 1050 à Add test D-Dh (D-Dimer High)
- Refer to section 4.1.8 in the ACL Elite/Elite Pro Operator’s manual for detailed
instructions on setting up Reflex rules.
- To Enable the reflex testing: Setup à System Configuration
- The drop down menu for Reflex Status provides 3 choices
1. Program Test only
2. Execute before closing session
3. Disabled
- Select either option 1 or 2 to enable the programming and/or testing.
- Press the Green Check to Save and return to main database screen

7. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defined. The D-Dimer test can utilize the following
control materials to verify assay performance:
- Low Dimer Control
- High Dimer Control

On the ACL Elite/Elite Pro this is defined in the Setup à Liquids menu. Refer to section
4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on defining new
liquids.

- QC à QC Review and Setup

15 Instrumentation Laboratory
- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging.
- Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the D-Dimer test from the drop down menu in the Test
to Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the
curve data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 200 – 1050 ng/mL

16 Instrumentation Laboratory
17 Instrumentation Laboratory
Factor XII
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test Reference


Range/Cutoff
SetupàTestsàView/Define

Setup the QC for Factors


QC à Setup/Review

Calibrate and
Analyze Patient / QC Samples

18 Instrumentation Laboratory
Factor Analysis– ACL Elite/Elite Pro

This protocol is setup for the FXII SP test. All factors are processed the same way on the ACL Elite/Elite
Pro, therefore these guidelines can be used to run any clotting factor test on the analyzer. Ordering
information for the materials needed to run additional factor tests is located at the end of the document.

1. Materials Needed

• Factor XII Deficient Plasma Cat. No. 20201200


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 2 Cat. No. 20010200
• Factor Diluent Cat. No. 09757600
• APTT SP #
Cat. No. 20006300
# Kit can also be run using other APTT formulations (refer to section 10)
* For use in selected countries
Factor Deficient Reagent Kit Configuration
Kit Contents Stability Preparation
5 x 1mL Factor XII Deficient 4 Hours at 2 - 8oC original vial Add 1.0 mL H2O.
Plasma Swirl, let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!
o
5 x 9mL APTT Reagent 1 Month at 2-8 C Shake for 15 seconds or Vortex
5 Days at 15 oC on ACL for 5 seconds before Use
**Note: Do Not Freeze
5 x 8mL Calcium Chloride 1 Month at 2-8oC Ready for Use

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the FXII SP Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

19 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the FXII SP test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the FXII SP test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The FXII SP assay is Calibrated Once per Session onboard the ACL Elite/Elite
Pro. The test calibration occurs during the analysis cycle. The test cannot be calibrated
under the Calibration Menu.
Parallelism tests utilize a Dedicated calibration and are calibrated under the Calibration
menu.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Cal Low F, FXII Def, Factor Diluent, APTTSP
and APTT Ca/Cl2 are automatically assigned when the test is run as a single assay.
Refer to the Materials map screen when running the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The FXII SP test can utilize the following
control material to verify assay performance:
- Normal Control Plasma
- Special Test Control Level 2

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on

20 Instrumentation Laboratory
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging. Refer to the ACL Elite/Elite Pro
Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

Non Parallelism Factor Assays


Calibration is performed during the Analysis Run for FXII SP. The Calibration utilizes 2
calibrators: Cal Plasma and Cal Low F. The Cal Low F is a 1:16 dilution of the cal plasma.
This is prepared by taking 20µL of Cal Plasma and diluting it with 300µL of Factor diluent in a
0.5mL cup. When the ACL Elite/Elite Pro sees both of these calibrators onboard during its pre-
analytical check it will do a complete calibration curve. The calibration curve will cover
between 100% down to 1.56% activity.
If the ACL detects only the Cal Plasma onboard during the pre-analytical
check, then it will execute a calibration and construct a curve from 100% down to 25%
activity. Low results below 25% will be extrapolated from the curve. In either case the
calibration curve will be stored and utilized again on subsequent runs if during the pre-
analytical check for FXII SP the instrument does not detect the presence of the Cal Plasma in
position A1.

Note: Do Not place the Low Cal F onboard without having Cal Plasma onboard as well.
Calibration for the Factor Parallelism tests is defined as dedicated and performed using the
Calibration Menu.

21 Instrumentation Laboratory
9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Expected Values: 50 – 150 % activity

10. Ordering information for Factor Assays

APTT Based Factors

Factor VIII Deficient Plasma Cat. No. 08466450


Factor IX Deficient Plasma Cat. No. 08466550
Factor XI Deficient Plasma Cat. No. 08466650
Factor XII Deficient Plasma Cat. No. 20201200

PT Based Factors
Factor II Deficient Plasma Cat. No. 08466050
Factor V Deficient Plasma Cat. No. 08466150
Factor VII Deficient Plasma Cat. No. 08466250
Factor X Deficient Plasma Cat. No. 08466350

Clotting Reagents
APTT SP Cat. No. 20006300
APTT Lyophilized Silica Cat. No. 08468710
PT - Fib Cat. No. 09756710
PT - Fib Recombinant Cat. No. 20005000
PT- Fib HS Cat. No. 08468210
PT- Fib HS PLUS Cat. No. 08469810
HemosIL SynthasIL Cat. No.20006800
HemosIL RecombiPlasTin Cat. No.20002900 or 20003000

22 Instrumentation Laboratory
23 Instrumentation Laboratory
Chromogenic Factor VIII
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test


Reference Range
SetupàTestàView/Define

Setup the QC
QCà Review/Setup

Run Samples/Calibrate

24 Instrumentation Laboratory
Chromogenic Factor VIII – ACL Elite/Elite Pro

The Chromogenic Factor VIII test has a High and Low tests defined in the system. The High test linear
range is 10 – 120% and the Low test is 0 – 10%.

1. Materials Needed

• Electrachrome Factor VIII Cat. No. 49730503


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 2 Cat. No. 20010200
• Factor Diluent Cat. No. 09757600
• Clean A Cat. No. 09831700

Reagent Kit Configuration


Kit Contents Stability Preparation
2 x 3mL Factor Reagent 12 Hours at 2 - 8oC original vial Add 3.0 mL H2O.
30 days at -70oC Swirl, let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!
1 x 6mL Factor VIII Chromogenic 1 Month at 2-8oC original vial Add 6.0 mL H2O.
Substrate Reagent Swirl, let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!

1 x 24mL Factor VIII Buffer 1 Month at 2-8oC (after diluting) Working buffer: dilute 2 mL
Buffer with 18 mL H2O.

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the F8 Chr H / F8 Chr L Tests. Click on the
Enable/Disable button to enable the test. A check mark will appear in the Enabled test
column for this test. You can select to run either the High test, Low test or both. The
selected test must be run in single test mode and cannot be placed in a profile.

25 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the F8 Chr H / F8 Chr L test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the F8 Chr H / F8 Chr L test.
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The FVIII SP assay is Calibrated “Each Rotor” onboard the ACL Elite/Elite Pro.
The test calibration occurs during the analysis cycle. The test cannot be calibrated under
the Calibration Menu. The assay must be calibrated each time it is run.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Cal Low F, F8 Chr Buf, F8 Chr Act, F8 Chr
Sub, Clean A, and Factor Diluent are automatically assigned when the test is run as a
single assay. Refer to the Materials map screen when running the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined.


Verify that your system has the appropriate QC liquid defined. The FVIII SP
test can utilize the following control material to verify assay performance:
- Normal Control Plasma
- Special Test Control Level 2

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids
menu. Refer to section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual
for Detailed instructions on defining new liquids.

26 Instrumentation Laboratory
- QC à QC Review and Setup
- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging. Refer to the ACL Elite/Elite Pro
Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay (performed each rotor during analysis)

All reagents and calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

The Cal Low F is a 1:16 dilution of the cal plasma.


This is prepared by taking 20µL of Cal Plasma and diluting it with 300µL of Factor diluent in a
0.5mL cup.
This calibrator is used for the F8 Chr L (Low Chromogenic Factor VIII) test.

Calibration for the Factor Parallelism tests is defined as “Each Rotor” and performed during the
analysis.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Note: When the assay is run 2 empty (0.5 mL) cups will be required in the displayed “A”
positions on the tray along with one empty (0.5 mL) cup for each sample. The empty cups in the
sample position should be placed starting with position 21. One cup per patient sample needs to
be placed.

Expected Values: 50 – 150 % activity

27 Instrumentation Laboratory
Clauss Fibrinogen
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the Auto-Rerun for


Fib-High/Low
SetupàTestàReflex Tests

Setup the QC for Fib-C


QCà Review/Setup

Calibrate the Fib-C test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient samples

28 Instrumentation Laboratory
Fibrinogen –C ACL Elite/Elite Pro

1. Materials Needed

• Fibrinogen-C Reagent Kit Cat. No. 8469110


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Low Fibrinogen Control Cat. No. 20004200
• Factor Diluent Cat. No. 09757600
• Cleaning solution Clean A Cat. No. 09831700
* For use in selected countries

Fibrinogen-C Reagent Kit Configuration


Kit Contents Stability Preparation
8 x 2mL Bovine Thrombin 3 Days at 2-8 oC Add 2.0 mL H2O.
Reagent 8 hours at 15oC on ACL Swirl, let sit for 30 min at
1 Month at –20 oC original vial 15 – 25 oC.
Invert. Do Not Shake!
o
2 x 1mL Abnormal Control 4 Hours at 15-25 C Add 1.0 mL H2O.
7 Days at –20oC original vial Swirl, let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the Fib-C_ Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
- Repeat the above step for the Fib-C h_test (Fib Clauss High assay) and the Fib-C l_
(Fib Clauss Low assay)
- Press the Green Check to Save and return to main database screen.

29 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the Fib-C_ test, and press the Detail Icon.
- Scroll down to the row for units in mg/dL and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- The reaction curve min and max may also be set. If the desired values are unknown,
clear both the min and the max to zoom curve display to full scale.
- Repeat the above steps for the Fib-C h_ test (Fib Clauss High assay) and the Fib-C l_
(Fib Clauss Low assay)
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasm
- Scroll down the Used by column and highlight the Fib-C_ test
- Click on the Assign Value button, and enter in the value for the Cal Plasma. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Note: The Fib-C h_ (Fib Clauss High) and the Fib-C l_ (Fib Clauss Low) tests use the
calibration curve for the regular Fib Clauss test. It is not necessary to enter the calibrator
value into these additional tests.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasm, FIB-C Thr., Factor Diluent, and Clean A are
automatically assigned when the test is placed in a profile or run as a single assay.
Refer to the Materials map screen when running or calibrating the assay for placement.

6. Setting up the Autorerun feature

Note: The Fib-C_ assay range is from 60 to 550 mg/dL. The ACL Elite/Elite Pro system
can rerun patient samples that exceed the lower and upper range using the Fib Clauss Low

30 Instrumentation Laboratory
and High tests. The Fib-Clauss Low test range is 30-550 mg/dL and the Fib Clauss high
test range is 60-1100mg/dL.

Setup à Tests àReflex Tests

- Define Reflex rules for the following:


- If Fib-C_ > 550 mg/dL à Add test Fib-C h_ (Fib Clauss High)
- If Fib-C_ < 60 mg/dL à Add test Fib-C l_ (Fib Clauss Low)
- Refer to section 4.1.7 in the ACL Elite/Elite Pro Operator’s manual for detailed
instructions on setting up Reflex rules.
- To Enable the reflex testing: Setup à System Configuration
- The drop down menu for Reflex Status provides 3 choices
4. Program Test only
5. Execute before closing session
6. Disabled
- Select either option 1 or 2 to enable the programming and/or testing.
- Press the Green Check to Save and return to main database screen

7. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defined. The Fib Clauss test can utilize the following
control materials to verify assay performance:
- Normal Control
- Abnormal Control (packaged in kit)
- Low Fibrinogen control

On the ACL Elite/Elite Pro these are defined in the Setup à Liquids menu.
Refer to section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for detailed instructions
on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

31 Instrumentation Laboratory
8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the Fib-C_ test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids (Fib-C Thr., Factor Diluent and Clean A) are in place
according to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Assay Ranges:
Fib-C_ : 60 – 550 mg/dL
Fib-C l_: 30 – 550 mg/dL
Fib-C h_: 60 – 1100 mg/dL

32 Instrumentation Laboratory
33 Instrumentation Laboratory
Free Protein S
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the QC for Free PS


QCà Review/Setup

Calibrate the Free PS test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient samples

34 Instrumentation Laboratory
Free Protein S – ACL Elite/Elite Pro

1. Materials Needed

• Free Protein S Reagent Kit Cat. No. 20002700


• HemosIL Calibration Plasma Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
• Factor Diluent Cat. No. 09757600
*Not available in all countries

Free Protein S Reagent Kit Configuration


Kit Contents Stability Preparation
3 x 2mL Anti PS Latex Until Expiration when not Invert to mix before use.
Reagent opened and stored at 2-8 oC Do Not Shake! Avoid Foam
o
1 Month at 2-8 C ,1 Week on Formation!
ACL, when opened
**Note: Do Not Freeze
3 x 4 mL C4BP Latex Post Reconstitution: Add 1 vial of C4BP Buffer into
1 Month at 2-8oC Latex, swirl gently 20 seconds
1 Week on ACL Let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the Free PS Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

35 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the Free PS test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the Free PS test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Anti PS Latex, C4BP Latex reagent and Factor
Diluent are automatically assigned when the test is placed in a profile or run as a single
assay. Refer to the Materials map screen when calibrating or running the assay for
placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The Free PS kit can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Special Test Control Level 1
- Special Test Control Plasma Level 2
On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on
defining new liquids.

36 Instrumentation Laboratory
- QC à QC Review and Setup
- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the Free PS test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 135 %

37 Instrumentation Laboratory
Heparin
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the QC for Heparin


QCà Review/Setup

Calibrate the Heparin test


CalibrationàCalibrate

Analyze Patient/QC samples

38 Instrumentation Laboratory
Heparin– ACL Elite/Elite Pro

1. Materials Needed

• Heparin Reagent Kit Cat. No. 20009400


• HemosIL Calibration Plasma Cat. No. 20003700
• Low Heparin Control Plasma Cat. No. 20004000
• High Heparin Control Plasma Cat. No. 20004100
• Cleaning Solution (Clean A)# Cat. No. 09831700

# Clean A is used for the automatic clean cycle incorporated into the Heparin assay test definition.

Heparin Reagent Kit Configuration


Kit Contents Stability Preparation
1 x 4mL Chromogenic Substrate 3 Months at 2-8oC Add 4.0 mL H2O.
(Hep Sub) 7 Days at 15oC original vial Swirl, let sit for 30 min at
15 – 25 oC.
Invert.
o
1 x 5 mL Factor Xa Reagent 3 Months at 2-8 C Add 5.0 mL H2O.
(Hep_F(Xa) 7 Days at 15oC original vial Swirl, let sit for 30 min at
15 – 25 oC.
Invert.
1 x 3 mL Antithrombin 3 Months at 2-8oC original vial Add 3.0 mL H2O.
Swirl, let sit for 30 min at
15 – 25 oC.
Invert.
o
1 x 8mL Buffer 3 Months at 2-8 C original vial Dilute 1:10 (1 part Buffer + 9
parts H2O)

Prepare the reagents as directed above, then prepare the working reagents for the Heparin
assay after the reagents above have reconstituted and stabilized (30 minutes)

Heparin Working Reagent Preparation


Working Buffer 7 Days at 2-8oC Add 1.0 mL Antithrombin to 24.0
(Hep W.D.) 7 Days at 15oC mL of Diluted Buffer

0.8 Calibrator Add 1.0 mL of 0.8 U/mL diluted


Heparin* to 1 vial of Lyophilized
Cal Plasma
0.0 Calibrator Add 1.0 mL of H2O to a vial of
Cal Plasma, let sit 30 minutes

39 Instrumentation Laboratory
*0.8 Heparin Calibrator Preparation

Stock Heparin Dilution Dilution


Concentration (to create a 20 U/mL heparin standard) Ratio
25,000 units/mL Step 1: 100 µL heparin +2.4 mL water 1:25
Step 2: 100 µL of Step 1 dilution + 4.9 mL 1:50
water
10,000 units/mL Step 1: 100 µL heparin + 900 µL water 1:10
Step 2: 100 µL of Step 1 dilution + 4.9 mL 1:50
water
5,000 units/mL Step 1: 100 µL heparin + 400 µL water 1:5
Step 2: 100 µL of Step 1 dilution + 4.9 mL 1:50
water
1,000 units/mL 100 µL of heparin + 4.9 mL water 1:50
50 units/mL 1.0 mL heparin + 1.5 mL water 1:2.5

Dilute 100 µL of the 20 U/mL heparin prepared above with 2.4 mL of the recommended water.
This will result in a 0.8 U/mL solution of heparin. Use 1.0mL of this solution to dilute one vial of
Cal Plasma.

Note: There are 2 Heparin assays defined within the ACL Elite/Elite Pro.
1. Hep UHFl: Unfractionated Heparin
2. Hep LMWl: Low Molecular Wt Heparin

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the desired Heparin Test (see list above). Click
on the Enable/Disable button to enable the test. A check mark will appear in the
Enabled test column for this test.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the desired Heparin test, and press the Detail Icon.
- Scroll down to the row for units in U/mL and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

40 Instrumentation Laboratory
4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight HEPCAL 0.8
- Scroll down the Used by column and highlight the desired Heparin test
- Click on the Assign Value button, and enter in the value for the Calibrator (0.8).
- Do Not enter a cal value for the HEPCAL 0.0 (zero heparin calibrator)
- Press the Green Check to Save and return to main database screen.

5. Setting up Liquid Positions

- The liquid positions for the HEP W.D., HEP_F(Xa), HEP Sub, Cleaning A, HepCal 0.0
and HEPCal 0.8 are automatically assigned when the test is either calibrated or run as
a single assay. HEPCal 0.0 and HEPCal 0.8 are only needed during the calibration
cycle. Refer to the Materials map screen when running the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The Heparin test can utilize the following
control materials, for Unfractionated Heparin testing only, to verify assay performance:
- Low Heparin Control Plasma
- High Heparin Control Plasma

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on d
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

41 Instrumentation Laboratory
7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

The Heparin assay utilizes the dedicated Calibration mode and therefore is calibrated under the
Calibration menu.

Empty cups for the calibration must be placed onboard the analyzer as follows:
- HepUHFl test: Position A1
- Hep LMWl test: Position A1

8. Sample Processing

The Hep UHFl and the Hep LMWl tests do not need empty cups during analysis.

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 0 – 1.0 U/mL

42 Instrumentation Laboratory
43 Instrumentation Laboratory
HPX
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test Normal Range


Setupà Testà View/Define
Enter in ISI and Cal Value

Setup the QC for HPX


QCà Setup/Review

Calibrate the HPX test


CalibrationàCalibrate

Analyze QC and Patient


samples

44 Instrumentation Laboratory
Hepatocomplex – ACL Elite/Elite Pro**
** Kit not available in USA

1. Materials Needed

• Hepatocomplex Reagent Kit Cat. No. 09758710


• HemosIL Calibration Plasma Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• HemosIL High Abnormal Unassayed Control Cat. No. 20003320
• HemosIL High Abnormal Assayed Control* Cat. No. 20003310
• Factor Diluent Cat. No. 09757600
• PCX/HPX Thromboplastin diluent Cat. No. 08469600
*Not available in all countries

Hepatocomplex Reagent Kit Configuration


Kit Contents Stability Preparation
5 x 7mL Rabbit Calcium Until Expiration when not Add 7mL of PCX/HPX
Thromboplastin opened and stored at 2-8 oC Thromboplastin diluent, Swirl, let
5 days in original vial at 2-8 oC sit for 30 min at 15 – 25oC.
8 Hours on ACL, when opened Invert. Do Not Shake!

5 x 3 mL Bovine Plasma Until Expiration when not Add 3.0 mL NCCLS Type II
opened and stored at 2-8 oC water.
24 hours in original vial at 2-8 oC Swirl, let sit for 30 min at 15 –
, when opened 25oC.
5 days stability at -20oC Invert. Do Not Shake!
**Note: Do Not Re-Freeze

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests

45 Instrumentation Laboratory
- Scroll down the test list and highlight the HPX Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the HPX test, and press the Detail Icon.
- Scroll down to the row for desired unit and click on the Ranges button.
- Enter in the Min and Max values for the range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Reagent ISI value

- Setup à Liquids
- Scroll down the Liquid ID column and highlight the Rabbit Calcium Thromboplastin
(HPX Thromb.)
- Scroll down the Used by column and highlight the HPX test
- Click on the Assign Value button, and enter in the ISI value. This value can be found
on the Hepatocomplex package insert.
- Press the Green Check to Save and return to the main database screen.

5. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the HPX test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

6. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, HPX Plasma, HPX Thromb (Rabbit Ca
Thromboplastin) , and Factor Diluent are automatically assigned when the test is
calibrated or run in a profile or as a single assay. Refer to the Materials map screen
when calibrating or running the assay for placement.

46 Instrumentation Laboratory
7. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The HPX test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Control Plasma Low/Level 1
- Abnormal Control Plasma High/Level 2
On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the HPX test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Place 2 empty 0.5 mL sample cups in the appropriate “A” positions (A3 and A4) according
to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 8 – 150 % activity

47 Instrumentation Laboratory
LAC Screen and/or
LAC Confirm
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test


Reference Range
SetupàTestsàView/Define

Setup the QC for LAC


QC à Setup/Review

Analyze Patient / QC Samples

48 Instrumentation Laboratory
LAC Screen/Confirm – ACL Elite/Elite Pro

1. Materials Needed

• LAC Screen Reagent Kit Cat. No. 20008000


• LAC Confirm Reagent Kit Cat. No. 20008200

LAC Screen/Confirm Reagent Kit Configuration


Kit Contents Stability Preparation
o
10 x 2mL LAC Screen Reagent 1 month at -20 C, Add 2.0 mL NCCLS Type II water.
10 x 2mL LAC Confirm Reagent 48 Hours at 2-8oC or Swirl, let sit for 30 min at 15 – 25 oC.
o
24 Hours at 15-25 C in the Invert. Do Not Shake!
original vial*

*Note: Do Not Refreeze

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the LAC* Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
* LAC-S is the LAC Screen assay and LAC-C is the LAC Confirm.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the desired LAC test, and press the Detail Icon.
- Scroll down to the row for units in seconds (S) or ratio (R) and click on the Ranges
button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

49 Instrumentation Laboratory
4. Setting up Liquid Positions

- The liquid positions for the LAC Reagent are automatically assigned when the test is
run as a single assay or in a 4.1.11 in the Operator’s manual for Detailed instructions
on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

6. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

7. Results

The following procedure should be used to calculate the LAC Screen and
LAC Confirm ratios:
1. For each new lot of LAC Screen and LAC Confirm kit a new Normal Range
should be determined according to NCCLS Document H21-A3, Vol. 18, No. 20.
2. Determine the Mean of each Normal Range in seconds.
3. The mean of each normal range will be used as a constant denominator in the calculations of
ratios.

LAC Screen

1. The patient sample result in seconds is divided by the Mean of the LAC Screen normal range.

Screen Ratio = Patient Screen results (seconds) / Mean of Screen Normal Range (seconds)

2. If test plasma LAC Screen clotting time is 20% longer than the Mean of the Screen Normal
Range (i.e. ratio >1.2), the presence of LA should be confirmed with IL LAC Confirm.

50 Instrumentation Laboratory
LAC Confirm
1. The patient sample result in seconds is divided by the Mean of the LAC Confirm normal range.

Confirm Ratio = Patient Confirm results (seconds) / Mean of Confirm Normal Range (seconds)

2. The ratio result from the LAC Screen is divided by the ratio result from LAC Confirm.

Normalized LAC Ratio = Screen Ratio / Confirm Ratio

Interpretation
1. The final result should be expressed as the Normalized LAC Ratio:
Ratio greater than 2.0 LA is strongly present.
Ratio between 1.5 - 2.0 LA is moderately present.
Ratio between 1.2 - 1.5 LA is weakly present.

2. If ratio < 1.2 and LAC Screen and LAC Confirm clotting times are prolonged, then mixing
studies should be performed to investigate factor II, V and X deficiencies or inhibitors. If the
mixing test is still prolonged, it indicates that some anticoagulant other than LA
(e.g. anti-Factor V) may be present in the test plasma.

51 Instrumentation Laboratory
Plasminogen
Reagent Preparation

Enable the test within the


analyzer
Setupà Testà View/Define

Edit the Test Normal Range


Setupà Testà View/Define

Setup the QC liquid for PLG


QCà Review / Setup

Calibrate and
Analyze Patient / QC Samples

52 Instrumentation Laboratory
Plasminogen – ACL Elite/Elite Pro

1. Materials Needed

• Plasminogen Reagent Kit Cat. No. 20009000


• HemosIL Calibration Plasma Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
*Not available in all countries

Plasminogen Reagent Kit Configuration


Kit Contents Stability Preparation
2 x 2mL Chromogenic Substrate 3 Months at 2-8oC original vial Add 2.0 mL H2O.
7 Days at 15oC original vial Swirl, let sit for 30 min at
6 Months at -20oC original vial 15 – 25 oC.
Mix before use.
2 x 2.5 mL Streptokinase 3 Months at 2-8oC original vial Add 2.5 mL H2O.
7 Days at 15oC original vial Swirl, let sit for 30 min at
o
6 Months at -20 C original vial 15 – 25 oC.
Mix before use.

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the PLG Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the PLG test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.

53 Instrumentation Laboratory
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the PLG test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The PLG assay is Calibrated Once per Session onboard the ACL Elite/Elite Pro.
The test calibration occurs during the analysis cycle. The test cannot be calibrated under
the Calibration Menu.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Streptokinase (PLG Strept) and Chromogenic
substrate (PLG Sub) are automatically assigned when the test is run. The test can be
run in the Single Test or Profile mode on the analyzer. Refer to the Materials map
screen when running the assay for proper placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The PLG test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Chromogenic Control Plasma Level 1and 2

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu.
Refer to section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed
instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging.

54 Instrumentation Laboratory
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

Calibration is performed during the Analysis Run for PLG. The calibration curve will be
saved and utilized again on subsequent runs if, during the pre-analytical check for PLG, the
instrument does not detect the presence of the Cal Plasma in position A1.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 150 % activity

55 Instrumentation Laboratory
Plasmin Inhibitor
Reagent Preparation

Enable the test within the


analyzer
Setupà Testà View/Define

Edit the Test Normal Range


Setupà Testà View/Define

Setup the QC liquid for PL-IN


QCà Review / Setup

Calibrate and
Analyze Patient / QC Samples

56 Instrumentation Laboratory
Plasmin Inhibitor – ACL Elite/Elite Pro

1. Materials Needed

• Plasmin Inhibitor Reagent Kit Cat. No. 20009200


• HemosIL Calibration Plasma Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
*Not available in all countries

Plasmin Inhibitor Reagent Kit Configuration


Kit Contents Stability Preparation
1 x 4mL Chromogenic Substrate 5 Days at 2-8 oC original vial Add 4.0 mL H2O.
5 Days at 15oC original vial Swirl, let sit for 30 min at
3 Months at -20oC original vial 15 – 25 oC.
Mix before use.
o
2 x 2.5 mL Plasmin Reagent 5 Days at 2-8 C original vial Add 2.5 mL Diluted Buffer.
5 Days at 15oC original vial Swirl, let sit for 30 min at
3 Months at -20oC original vial 15 – 25 oC.
Mix before use.
2 x 9mL Buffer Undiluted Buffer: Until Dilute as needed 1:10 by adding
(Buffer must be diluted prior to Expiration when not opened and 1 part Buffer + 9 part H2O
use) stored at 2-8oC
Diluted Buffer: 24 Hours at 15oC

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the PL-IN Test (test no. 213). Click on the
Enable/Disable button to enable the test. A check mark will appear in the Enabled test
column for this test.

57 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the PL-IN test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the PL-IN test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The PL-IN assay is Calibrated Once per Session onboard the ACL Elite/Elite Pro.
The test calibration occurs during the analysis cycle. The test cannot be calibrated under
the Calibration Menu.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, PI Buffer, PI Plasmin, and Chromogenic
substrate (PI Sub) are automatically assigned when the test is run. The test can be run
in the Single Test or Profile mode on the analyzer. Refer to the Materials map screen
when running the assay for proper placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The PL-IN test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Chromogenic Control Plasma Level 1and 2

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu.
Refer to section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed

58 Instrumentation Laboratory
instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

Calibration is performed during the Analysis Run for PL-IN. The calibration curve will be
saved and utilized again on subsequent runs if, during the pre-analytical check for PL-IN, the
instrument does not detect the presence of the Cal Plasma in position A1.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 120 % activity

59 Instrumentation Laboratory
PCX
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test Normal Range


Setupà Testà View/Define
Enter in ISI and Cal Value

Setup the QC for PCX


QCà Setup/Review

Calibrate the PCX test


CalibrationàCalibrate

Analyze QC and Patient


samples

60 Instrumentation Laboratory
Pro-IL- Complex– ACL Elite/Elite Pro**
** Kit not available in USA

1. Materials Needed

• Pro-IL-Complex Reagent Kit Cat. No. 09758810


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• HemosIL High Abnormal Unassayed Control Cat. No. 20003320
• HemosIL High Abnormal Assayed Control* Cat. No. 20003310
• Factor Diluent Cat. No. 09757600
• PCX/HPX Thromboplastin diluent Cat. No. 08469600
*Not available in all countries

Pro-IL-Complex Reagent Kit Configuration


Kit Contents Stability Preparation
5 x 7mL Bovine Calcium Until Expiration when not Add 7mL of PCX/HPX
Thromboplastin opened and stored at 2-8 oC Thromboplastin diluent, Swirl, let
5 days in original vial at 2-8 oC sit for 30 min at 15 – 25oC.
8 Hours on ACL, when opened Invert. Do Not Shake!

5 x 3 mL Bovine Plasma Until Expiration when not Add 3.0 mL NCCLS Type II
opened and stored at 2-8 oC water.
24 hours in original vial at 2-8 oC Swirl, let sit for 30 min at 15 –
when opened 25oC.
5 days stability at -20oC Invert. Do Not Shake!
**Note: Do Not Re-Freeze

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the PCX Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

61 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the PCX test, and press the Detail Icon.
- Scroll down to the row for desired unit and click on the Ranges button.
- Enter in the Min and Max values for the range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Reagent ISI value

- Setup à Liquids
- Scroll down the Liquid ID column and highlight the Bovine Calcium Thromboplastin
(PCX Thromb.)
- Scroll down the Used by column and highlight the PCX test
- Click on the Assign Value button, and enter in the ISI value. This value can be found
on the Pro-IL-Complex package insert.
- Press the Green Check to Save and return to the main database screen.

5. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the PCX test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

6. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, PCX Plasma, PCX Thromb (Bovine Ca
Thromboplastin) , and Factor Diluent are automatically assigned when the test is
calibrated or run in a profile or as a single assay. Refer to the Materials map screen
when calibrating or running the assay for placement.

7. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The PCX test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Control Plasma Low/Level 1

62 Instrumentation Laboratory
- Abnormal Control Plasma High/Level 2
On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
Section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the PCX test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Place 3 empty 0.5 mL sample cups in the appropriate “A” positions (A3, A4 and A6)
according to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 4 – 150 % activity

63 Instrumentation Laboratory
ProClot
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference


Range/Cutoff
SetupàTestàView/Define

Setup the QC for ProClot


QCà Review/Setup

Calibrate and Analyze


Patient/QC samples

64 Instrumentation Laboratory
ProClot– ACL Elite/Elite Pro

1. Materials Needed

• ProClot Reagent Kit Cat. No. 08468310


• HemosIL Calibration Plasma Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• HemosIL High Abnormal Unassayed Control Cat. No. 20003320
• HemosIL High Abnormal Assayed Control* Cat. No. 20003310
• ProClot Diluent Cat. No. 08468600
• APTT SP #
Cat. No. 20006300
# Kit can also be run using APTT-Lyophilized silica
* Not available in all countries

ProClot Reagent Kit Configuration


Kit Contents Stability Preparation
4 x 1mL Protein C Deficient 4 Hours at 15-25 oC Add 1.0 mL H2O.
Reagent 7 Days at –20oC in the original Swirl, let sit for 30 min at
vial 15 – 25 oC.
Invert. Do Not Shake!
o
4 x 1.5 mL Protein C Activator 15 Days at 2-8 C Add 1.5 mL H2O.
(Protac®) 60 Days at –20 oC in the original Swirl, let sit for 30 min at
vial 15 – 25 oC.
Invert. Do Not Shake!
Protein C Working Diluent 8 Hours at 2-8oC Mix 4.3 Parts of ProClot Diluent
with 1 Part Protein C Activator
5 x 9mL APTT Reagent 1 Month at 2-8oC Shake for 15 seconds or Vortex
5 Days at 15 oC on ACL for 5 seconds before Use
**Note: Do Not Freeze
5 x 8mL Calcium Chloride 1 Month at 2-8oC Ready for Use

2 x 1 mL Protein C Control 4 Hours at 15-25 oC Add 1.0 mL H2O.


Plasma 7 Days at –20oC in the original Swirl, let sit for 30 min at
vial 15 – 25 oC.
Invert. Do Not Shake!

65 Instrumentation Laboratory
2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the ProClotSP Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the ProClotSP test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the ProClotSP test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The ProClot assay is Calibrated Once per Session onboard the ACL Elite/Elite Pro.
The test calibration occurs during the analysis cycle. The test cannot be calibrated under
the Calibration Menu. The Calibration under analysis utilizes an empty cup for the
calibration, therefore the test must be run as a single test and cannot be run in the profile
mode.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, Protein C Deficient, Working Diluent,
APTTSP and APTT Ca/Cl are automatically assigned when the test is run as a single
assay. Refer to the Materials map screen when calibrating or running the assay for
placement.

66 Instrumentation Laboratory
6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The ProClotSP test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Control Plasma Level 1
- Protein C Control Plasma – packaged in reagent kit
On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC
setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

Calibration is performed during the Analysis Run for ProClot. The calibration curve will be
saved and utilized again on subsequent runs if during the pre-analytical check for Pro-Clot the
instrument does not detect the presence of the Cal Plasma in position A1.

The Calibration during analysis requires an empty cup to be placed in position A2 on the
sample tray.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 150 % activity

67 Instrumentation Laboratory
Protein C
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test


Reference Range
SetupàTestàView/Define

Setup the QC for Protein C


QCà Review/Setup

Calibrate and Analyze


Patient/QC samples

68 Instrumentation Laboratory
Protein C – ACL Elite/Elite Pro

1. Materials Needed

• Protein C Reagent Kit Cat. No. 20009100


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
*Not available in all countries

Protein C Reagent Kit Configuration


Kit Contents Stability Preparation
2 x 2mL Chromogenic Substrate 3 Months at 2-8oC and Add 2.0 mL H2O.
7 Days at 15oC original vial Swirl, let sit for 30 min at
15 – 25 oC.
Invert.
o
2 x 2.5 mL Protein C Activator 3 Months at 2-8 C and Add 2.5 mL H2O.
7 Days at 15oC original vial Swirl, let sit for 30 min at
15 – 25 oC.
Invert.
1 x 8mL Diluent Store at 2-8 oC in original vial Mix 1 Part of Diluent with 9 Parts
Water. Mix before use.

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the P-C Test. Click on the Enable/Disable button
to enable the test. A check mark will appear in the Enabled test column for this test.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the P-C test, and press the Detail Icon.

69 Instrumentation Laboratory
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the P-C test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

Notes: The P-C assay is Calibrated Once per Session onboard the ACL Elite/Elite Pro.
The test calibration occurs during the analysis cycle. The test cannot be calibrated under
the Calibration Menu.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, PC Activ., PC Sub., and Pchrom Dil are
automatically assigned when the test is run as a single assay. Refer to the Materials
map screen when running the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The P-C test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma
- Abnormal Chromogenic Control Plasma Level 1and 2

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.

70 Instrumentation Laboratory
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC
setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

Calibration is performed during the Analysis Run for P-C. The calibration curve will be
saved and utilized again on subsequent runs if, during the pre-analytical check for P-C, the
instrument does not detect the presence of the Cal Plasma in position A1.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 120 % activity

71 Instrumentation Laboratory
Pro S
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test Reference Range


SetupàTestàView/Define

Setup the QC for ProS


QCà Review/Setup

Calibrate the ProS test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient samples

72 Instrumentation Laboratory
ProS– ACL Elite/Elite Pro
1. Materials Needed

• HemosIL ProS Reagent Kit Cat. No. 20002800


• HemosIL Calibrator Cat. No. 20003700
• Factor Diluent Cat. No. 09757600
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• HemosIL High Abnormal Unassayed Control Cat. No. 20003320
• HemosIL High Abnormal Assayed Control* Cat. No. 20003310
• Prot S Ctrl (included in ProS Reagent Kit) Cat. No. 20002830
*For use in selected countries

ProS Reagent Kit Configuration


Kit Contents Stability Preparation
o
3 x 3mL Protein S 2 Days at 2-8 C Add 3.0 mL H2O.
Reagent 4 Hours at 15oC on board Swirl gently, let sit for 30 min at
*15 Days at –20oC original vial 15 – 25 oC.
No stirring required Invert. Do Not Shake!
5 x 1 mL Protein S After Reconstitution: Add 1.0 mL H2O.
Deficient Plasma 4 Hours at 15oC original vial Swirl gently, let sit for 30 min at
o
*7 Days at –20 C 15 – 25 oC.
Invert. Do Not Shake!
o
2 x 1 mL Protein S 4 Hours at 15-25 C original vial Add 1.0 mL H2O.
Control Plasma *7 Days at –20 oC Swirl, let sit for 30 min at
15 – 25 oC.
Invert. Do Not Shake!

* Frozen reagent and plasmas should be thawed at 37oC and gently mixed before. Before freezing they
can be aliquoted using plastic tubes and stoppers. DO NOT REFREEZE.

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests

73 Instrumentation Laboratory
- Scroll down the test list and highlight the ProS Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.

3. Editing the Test Reference Range

- Setup à Tests à View Define


- Scroll down the list, highlight the ProS test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Scroll down to the row for units in seconds (s) and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma
- Scroll down the Used by column and highlight the ProS test
- Click on the Assign Value button, and enter in the value for the Calibrator. This value
can be found on the Cal Plasma package insert.
- DO NOT enter any value for ProS 50% C.
- Press the Green Check to Save and return to main database screen.

Notes: The ProS assay must be Calibrated One Time per Session. The test calibration
occurs during the analysis cycle. The test cannot be calibrated under the Calibration Menu
but you can view the calibration report after analysis run.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, ProS 50% C (Cal Plasma diluted 1:1 with
Protein S Def Plasma), Protein S Reagent, Protein S Deficient Plasma and Factor
Diluent are automatically assigned when the test is run as a single assay. Refer to the
Materials map screen when calibrating or running the assay for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The ProS test can utilize the following control
materials to verify assay performance:
- Normal Control Plasma
- Low Abnormal Control Plasma
- High Abnormal Control Plasma
- Protein S Control Plasma – packaged in reagent kit

74 Instrumentation Laboratory
On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD range is not known, then initially
leave it set to zero. Once the ranges are known, then you can re-define and click on the
QC Range check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

7. Calibrating the Assay

All reagents, calibrators must be reconstituted according to directions and allowed to sit for 30
minutes prior to calibration.

The ProS assay must be Calibrated One Time per Session. The test calibration occurs during
the analysis cycle. The test cannot be calibrated under the Calibration Menu but you can view
the calibration report after analysis run.

8. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing.

Linearity: 10 – 150 % activity

75 Instrumentation Laboratory
SCT- Screen/Confirm
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test Reference


Range/Cutoff
SetupàTestsàView/Define

Setup the QC for SCT-S/C


QC à Setup/Review

Analyze Patient / QC Samples

76 Instrumentation Laboratory
SCT-Screen/Confirm – ACL Elite/Elite Pro

1. Materials Needed

• Silica Clotting Time Reagent Kit Cat. No. 20004800


• HemosIL Calibrator Cat No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
*Not available in all countries

Silica Clotting Time Reagent Kit Configuration


Kit Contents Stability Preparation
3 x 5mL SCT Screen Reagent 20 Days at 2-8oC – Original vial Add 50 uL of mixed SCT
5 Days at 15 oC on ACL Confirm reagent to one vial of
**Note: Do Not Freeze SCT Screen reagent.
Invert to mix before use.
3 x 5 mL SCT Confirm Reagent 20 Days at 2-8oC – Original vial Invert to mix before use.
5 Days at 15 oC on ACL
**Note: Do Not Freeze
3 x 10 mL SCT Ca/Cl2 20 Days at 2-8 oC – Original vial Invert to mix before use.

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the SCT-S / SCT-C Test. Click on the
Enable/Disable button to enable the test. A check mark will appear in the Enabled test
column for this test.
- Press the Green Check to Save and return to main database screen.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the SCT-S / SCT-C -V test, and press the Detail Icon.
- Scroll down to the row for desired reporting units, and click on the Ranges button.

77 Instrumentation Laboratory
- Enter in the Min and Max values for the normal range.
- The reaction curve min and max may also be set. If the values are unknown, clear the
min and max to zoom the curve display to full scale.
- Press the Green Check to Save and return to main database screen.

4. Setting up Liquid Positions

- The liquid positions for SCT Screen, SCTConfirm and SCT CaCl2 are automatically
assigned when the test is placed in a profile or run as a single assay. Refer to the
Materials map screen when running the assay for placement.

5. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defined The SCT Screen/Confirm test can utilize the
following control materials to verify assay performance:

Materials

• HemosIL Normal Unassayed Control Cat. No. 20003120


• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
*Not available in all countries

On the ACL Elite/Elite Pro this is defined in Setup à Liquids menu. Refer to section 4.1.11 in
the ACL Elite/Elite Pro Operator’s manual for Detailed instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup
button to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target
SD and SD range for the test. If the Mean and SD is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC
Range check button for control result flagging. Refer to the ACL Elite/Elite Pro
Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

6 . Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Freezing of the plasma releases residual platelet phospholipids which can
shorten the SCT screen clotting times. Double centrifuge or filter plasma through a 0.2micron

78 Instrumentation Laboratory
filter to remove platelets before freezing.Frozen samples should be thawed at 37 oC for 15 minutes.
Centrifuge the plasma prior to testing. Samples should be analyzed within 2 hours.

SCT Screen
1. The patient sample result in seconds is divided by the Mean of the SCT Screen normal range.

Screen Ratio = Patient Screen results (in seconds)


Mean of Screen Normal Range (in seconds)

SCT Confirm
1. The patient sample result in seconds is divided by the Mean of the SCT Confirm normal range.

Confirm Ratio = Patient Confirm results (in seconds)


Mean of Confirm Normal Range (in seconds)

2. The ratio result from the SCT Screen is divided by the ratio result from SCT Confirm.

Normalized SCT Ratio = Screen Ratio


Confirm Ratio

Interpretation
1. The final result should be expressed as the Normalized SCT Ratio:

ACL Elite/Elite Pro Ratio > 1.20 indicates Lupus Anticoagulant is present

2. If ratio = 1.20 and SCT Screen and SCT Confirm clotting times are prolonged, then mixing
studies should be performed to investigate factor deficiencies or inhibitors. If the mixing
test is still prolonged, it indicates that some anticoagulant other than LA may be present in
the test plasma.

Each laboratory should establish its own normal cutoff value for the ratio.
Refer to the HemosIL Silica Clotting Time package insert sheet for a procedure to
establish the cut-off value.

79 Instrumentation Laboratory
Thrombin Time
Reagent Preparation

Enable the test within the


analyzer
SetupàTestsà View /Define

Edit the Test


Reference Range
SetupàTestsàView/Define

Setup the QC for TT


QC à Setup/Review

Analyze Patient / QC Samples

80 Instrumentation Laboratory
Thrombin Time (TT) – ACL Elite/Elite Pro

1. Materials Needed

• Thrombin Time Reagent Kit Cat. No. 09758515


• HemosIL Calibrator Cat. No. 20003700
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Low Abnormal Unassayed Control Cat. No. 20003220
• HemosIL Low Abnormal Assayed Control* Cat. No. 20003210
• Cleaning solution Clean A Cat. No. 09831700
*Not available in all countries

Thrombin Time Reagent Kit Configuration


Kit Contents Stability Preparation
4 x 2, 5 or 8mL Bovine Thrombin 15 Days at 2-8oC original vial Add 2.0 / 5.0 or 8.0* mL Diluted
8 Hours at 15 oC onboard ACL Diluent.
Swirl, let sit for 30 min at 15 –
25oC.
Invert. Do Not Shake!
1 x 9mL Diluent 1 month after preparation at 15- Dilute necessary amount 1:5
25 oC using 1 part Diluent + 4 part H2O
*Heparin Therapy: 2.0 mL, Screening Test: 5.0 or 8.0mL reconstitution

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the TT-* Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
* Refers to reconstitution volume 2, 5, or 8mL. Select the appropriate test based upon your
reconstitution volume for the Thrombin Reagent.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the TT-* test, and press the Detail Icon.

81 Instrumentation Laboratory
- Scroll down to the row for units in seconds (s) and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- Press the Green Check to Save and return to main database screen.

4. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, and Thrombin Reagent (TT Thr.) are
automatically assigned when the test is run as a single assay*. Refer to the Materials
map screen when running the assay for placement.
*It is recommended to run the Thrombin Time in the Single test mode and not within a
profile. A Clean-A procedure needs to be performed after the Thrombin Time is
complete prior to running additional test on the analyzer.

5. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defines. The TT* test can utilize the following
control materials to verify assay performance:
- Normal Control Plasma

On the ACL Elite/Elite Pro these liquids are defined in the Setup à Liquids menu. Refer to
section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual for detailed instructions on
defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

6. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

82 Instrumentation Laboratory
83 Instrumentation Laboratory
vonWillebrand Factor
Activity
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test


Reference Range
SetupàTestàView/Define

Setup the QC for VWFACT


QCà Review/Setup

Calibrate the VWFACT test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient/QC samples

84 Instrumentation Laboratory
von Willebrand Factor Activity– ACL Elite/Elite Pro

1. Materials Needed

• vWF Activity Reagent Kit Cat. No. 20004700


• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
• HemosIL Calibrator Cat. No. 20003700
• Factor Diluent Cat. No. 09757600
*Not available in all countries

VWF Reagent Kit Configuration


Kit Contents Stability Preparation
2 x 4.5mL Latex Reagent 1 month at 2-8°C Pour entire contents of 1 vial of
3 days on Elite/Elite Pro Buffer into Latex bottle. Cap,
**Note: Do Not Freeze Swirl for 20 seconds. Allow to
sit at room temperature for 25-30
minutes. Invert to mix prior to
use.

2 x 4.5 mL Buffer

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the VWFACT Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
- Press the Green Check to Save and return to main database screen.

3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the VWFACT test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.

85 Instrumentation Laboratory
- The reaction curve min and max may also be set. If the desired values are unknown,
clear both the min and the max to zoom curve display to full scale.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma.
- Scroll down the Used by column and highlight the VWFACT test
- Click on the Assign Value button, and enter in the value for the Cal Plasma.
This value can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, VWFACT Latex and Factor Diluent are
automatically assigned when the test is calibrated, placed in a profile or run as a single
assay. Refer to the Materials map screen when running or calibrating the assay for
placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined. Verify that your
system has the appropriate QC liquid defined. The VWFACT test can utilize the following
control materials to verify assay performance:
- Special Test Control Plasma Level 1
- Special Test Control Plasma Level 2
- Normal Control

On the ACL Elite/Elite Pro this is defined in the


Setup à Liquids menu. Refer to section 4.1.11 in the ACL Elite/Elite Pro Operator’s manual
for detailed instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define. Recommended controls are Normal and the Special Test controls levels 1 & 2.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.
Refer to the ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC setup.
- Press the Green Check to Save and return to main database screen.

86 Instrumentation Laboratory
8. Calibrating the Assay

Cal Plasma must be reconstituted according to directions and allowed to sit for 30 minutes
prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the VWFACT test from the drop down menu in the Test
to Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be thawed at 37 oC for 15 minutes. Centrifuge the
plasma prior to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 150 % (VWFACT)

87 Instrumentation Laboratory
vonWillebrand Factor
Antigen
Reagent Preparation

Enable the test within the


analyzer
SetupàTestàView/Define

Edit the Test


Reference Range
SetupàTestàView/Define

Setup the QC for VWF:Ag


QCà Review/Setup

Calibrate the VWF:Ag test


CalibrationàCalibrate

Validate Calibration and


Analyze Patient/QC samples

88 Instrumentation Laboratory
von Willebrand Factor Antigen– ACL Elite/Elite Pro

1. Materials Needed

• vWF Activity Reagent Kit Cat. No. 20002300


• Special Test Control Level 1 Cat. No. 20010100
• Special Test Control Level 2 Cat. No. 20010200
• HemosIL Normal Unassayed Control Cat. No. 20003120
• HemosIL Normal Assayed Control* Cat No. 20003110
• HemosIL Calibrator Cat. No. 20003700
• Factor Diluent Cat. No. 09757600
*Not available in all countries

VWF Reagent Kit Configuration


Kit Contents Stability Preparation
2 x 3 mL Latex Reagent 3 month at 2-8°C – original Invert to mix prior to use. Avoid foam
vial formation in reagent when mixing.
1 week at 15°C on ACL
Elite/Elite Pro
**Note: Do Not Freeze

2 x 4 mL Buffer 3 month at 2-8°C – original Invert to mix prior to use. Avoid foam
vial formation in reagent when mixing.
1 week at 15°C on ACL
Elite/Elite Pro
**Note: Do Not Freeze

2. Enabling the Test in the Analyzer

- Setup à Tests à View Define


- Click on the Show Enabled button to display all the tests
- Scroll down the test list and highlight the VWF:Ag Test. Click on the Enable/Disable
button to enable the test. A check mark will appear in the Enabled test column for this
test.
- Press the Green Check to Save and return to main database screen.

89 Instrumentation Laboratory
3. Editing the Test Reference Range/Cutoff

- Setup à Tests à View Define


- Scroll down the list, highlight the VWF:Ag test, and press the Detail Icon.
- Scroll down to the row for units in % and click on the Ranges button.
- Enter in the Min and Max values for the normal range.
- The reaction curve min and max may also be set. If the desired values are unknown,
clear both the min and the max to zoom curve display to full scale.
- Press the Green Check to Save and return to main database screen.

4. Entering in the Calibrator concentration

- Setup à Liquids
- Scroll down the Liquid ID column and highlight Cal Plasma.
- Scroll down the Used by column and highlight the VWF:Ag test
- Click on the Assign Value button, and enter in the value for the Cal Plasma. This value
can be found on the Cal Plasma package insert.
- Press the Green Check to Save and return to main database screen.

5. Setting up Liquid Positions

- The liquid positions for the Cal Plasma, VWF:AgBuf, VWF:AgLx and Factor Diluent
are automatically assigned when the test is calibrated, placed in a profile or run as a
single assay. Refer to the Materials map screen when running or calibrating the assay
for placement.

6. Setting up QC

Prior to setting up QC ranges the QC material first needs to be defined.


Verify that your system has the appropriate QC liquid defined. The VWFACT
test can utilize the following control materials to verify assay performance:
- Special Test Control Plasma Level 1
- Special Test Control Plasma Level 2
- Normal Control

On the ACL ACL Elite/Elite Pro this is defined in the Setup à Liquids menu.
Refer to section 4.1.11 in the ACL ACL Elite/Elite Pro
Operator’s manual for detailed instructions on defining new liquids.

- QC à QC Review and Setup


- Scroll down the Liquid ID list and select the appropriate QC liquid. Press the Setup button
to define. Recommended controls are Normal and the Special Test controls levels 1 & 2.
- Configure the tests from the Enabled tests list. Define the Units, Target Mean, Target SD
and SD range for the test. If the Mean and SD range is not known, then initially leave it
set to zero. Once the ranges are known, then you can re-define and click on the QC Range
check button for control result flagging.

90 Instrumentation Laboratory
Refer to the ACL ACL Elite/Elite Pro Operator’s Manual section 3 for details on QC
setup.
- Press the Green Check to Save and return to main database screen.

8. Calibrating the Assay

Cal Plasma must be reconstituted according to directions and allowed to sit for 30 minutes
prior to calibration.

- Calibration à Calibrate
- From the calibrate screen, select the VWF:Ag test from the drop down menu in the Test to
Calibrate window.
- Confirm the necessary liquids are in place according to the Material Map. The calibration
will require 3 empty 0.5 mL sample cups.
- Press the Start key to begin the calibrate cycle.
- When the calibration is complete the graph and cal curve data will be visible. If the curve
data is acceptable, click on the check to accept the use of the curve.

9. Sample Processing

Citrated plasma centrifuged from nine parts freshly drawn venous blood collected in one part
trisodium citrate. Frozen samples should be quickly thawed at 37oC. Gently mix the plasma prior
to testing. Samples should be analyzed within 2 hours.

Linearity: 10 – 150 % (VWF Antigen)


High Samples that exceed 150 % can be reprocessed using the VWF:AgH test. This assay dilutes
the sample and extends the linearity by a factor of 4 (40 – 600 %).

91 Instrumentation Laboratory
APPENDIX D

ACL Elite/Elite Pro

Printout Examples
Appendix D ACL Elite/Elite Pro Operator’s Manual

Contents

1. Analytical Reference – Cumulative Report.................................... 3


2. Analytical Reference – Plot and Statistics...................................... 4
3. Calibration Printout – PT Assay..................................................... 5
4. Calibration Printout – Factor Assay............................................... 6
5. Calibration Replicate – Curve Details............................................ 7
6. File Error History............................................................................ 8
7. Liquid Setup.................................................................................... 9
8. Logbook Report.............................................................................. 10
9. Maintenance Report........................................................................ 11
10. Parallelism Cumulative Report...................................................... 12
11. Parallelism Sample Report………………………………………. 13
12. Parallelism Detail Report………………………………………… 14
13. Profile Report................................................................................. 15
14. Quality Control – Cumulative Report............................................ 16
15. Quality Control – Plot and Statistics.............................................. 17
16. Quality Control – Daily Printout..................................................... 18
17. Reflex Test Logics......................................................................... 19
18. Sample Report – Single.................................................................. 20
19. Sample Report – Cumulative.......................................................... 21
20. Session Error History Report.......................................................... 22
21. Temperature Report........................................................................ 23
22. Test Detail Report........................................................................... 24

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Appendix D ACL Elite/Elite Pro Operator’s Manual

1. Analytical Reference – Cumulative Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

2. Analytical Reference – Plot and Statistics

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Appendix D ACL Elite/Elite Pro Operator’s Manual

3. Calibration Printout – PT Assay

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Appendix D ACL Elite/Elite Pro Operator’s Manual

4. Calibration Printout – Factor Assay

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Appendix D ACL Elite/Elite Pro Operator’s Manual

5. Calibration Replicate – Curve Details

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Appendix D ACL Elite/Elite Pro Operator’s Manual

6. File Error History

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7. Liquid Setup

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8. Logbook Report

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9. Maintenance Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

10. Parallelism Cumulative Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

11. Parallelism Sample Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

12. Parallelism Detail Report

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13. Profile Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

14. Quality Control Cumulative Report

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Appendix D ACL Elite/Elite Pro Operator’s Manual

15. Quality Control Plot and Statistics

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Appendix D ACL Elite/Elite Pro Operator’s Manual

16. Quality Control – Daily Printout

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Appendix D ACL Elite/Elite Pro Operator’s Manual

17. Reflex Test Logics

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18. Sample Report

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19. Sample Report Cumulative

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20. Session Error History Report

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21. Temperature Report

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22. Test Detail Report

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Intentional Blank Page

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ACL Elite / Elite Pro System (Sistema ACL Elite / Elite Pro
Manual del Operador – P/N 181121-11 – Rev. 0 Diciembre de
2005

Fabricante Representante Autorizado en la UE


Instrumentation Laboratory Company Instrumentation Laboratory SpA
101 Hartwell Avenue – P.O. Box 9113 Viale Monza 338 – 20128, Milán, Italia
Lexington, MA 02421-3125 E.U.A. Teléfono 39-2-25221

EC REP

Instrumentation Laboratory

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Esta publicación y cualquiera y todos los materiales (con inclusión del software) con respecto a los productos ACL Elite /
Elite Pro de IL son de naturaleza de propiedad y se comunican sobre una base estrictamente confidencial, no pueden
reproducirse, registrarse, almacenarse en un sistema de recuperación, transmitirse ni darse a conocer de ninguna
manera ni por ningunos dispositivos, ya sean electrónicos, mecánicos por medio de fotocopia o de otra manera, sin el
consentimiento previo y por escrito de IL. IL considera que la información contenida en el presente es exacta; en
cualquiera de los casos, IL no asume ninguna responsabilidad, ya sea expresa o implícita, por concepto de su uso o con
relación al mismo, o por la violación de los derechos de algún tercero que pudiera surgir por ese concepto, o por
concepto de cualquier declaración u omisión en el mismo.
La información está sujeta a cambio y/o actualización sin aviso.
Sarstedt, Epson y Hewlett Packard son Marcas Registradas.

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Índice
1 Información General
1.0 Introducción 1.1
1.1 Uso del Producto 1.2
1.3 Presentación de los Resultados 1.3
1.4 Descripción y Representación del Instrumento 1.3
1.4.1 Resumen 1.3
1.4.2 Componentes Principales del Hardware 1.4
1.4.3 Charola de Muestras 1.5
1.4.4 Área de Reactivos 1.8
1.4.5 Área de Enjuague/Desechos 1.9
1.4.6 Sistema de Muestreo/Surtido 1.9
1.4.7 Área de Carga y Análisis 1.12
1.4.8 Microprocesador y Electrónica 1.17
1.4.9 Pantalla de Cristal Líquido (LCD) 1.18
1.4.10 Teclado 1.18
1.4.11 Conectores de Interfaz0 1.19
1.4.12 Sistema de Enfriamiento Interno 1.20
1.4.13 Lector de Código de Barras a Bordo 1.20
1.4.14 Escáner de Código de Barras Externo (Optativo) 1.21
1.4.15 Impresora Externa (Optativa) 1.22
1.4.16 Unidad de disco flexible 1.23
1.5 Elementos Adicionales 1.24
1.5.1 Estado de Espera (Standby) 1.24
1.5.2 Final del Ciclo 1.24
1.5.3 Pérdida de Energía 1.24
1.5.4 Ajuste y Programas de Utilidad 1.25
1.5.5 Detección de Fallas 1.25
1.5.6 Indicación Limitaciones de Procedimiento de Video – 1.25
2
Colores y Símbolos)
1.6 Limitaciones de Procedimiento 1.25
1.7 Certificaciones 1.26
1.8 Disposición del Instrumento 1.28
1.9 Tabla de Símbolos 1.29
2 Instalación
2.0 Introducción 2.1
2.1 Requerimientos para la Instalación 2.1
2.1.1 Condiciones Ambientales 2.1
2.1.2 Requerimientos de Espacio 2.2
2.1.3 Requerimientos Eléctricos 2.2
2.2 Entrega y Desempacado del Instrumento 2.5
2.3 Montaje de las Partes del Instrumento 2.6
2.4 Encendido del Sistema 2.10
2.5 Cable de Interconexión de ACL – Computadora Principal 2.13
3 Operaciones Analíticas
3.0 Introducción 3.1
3.1 Componentes y Uso de la Interfaz del Operador 3.1
3.1.1 Pantalla Sensible al Tacto 3.1
3.1.2 Teclado Numérico 3.2
3.1.3 Teclado de PC Estándar 3.3
3.1.4 Lector de Código de Barras Externo 3.4
3.1.5 Puerto 2 de Ratón 3.4
3.1.6 Menús 3.4
3.1.7 Ventanas y Cuadros 3.4
3.1.8 Elementos Clave de la Pantalla 3.4
3.1.9 Una Ventana Especial para Alarmas y Errores 3.9
3.1.10 Protector de Pantalla 3.9
3.1.11 El Árbol de Software de ACL Elite / Elite Pro 3.9
3.2 Análisis de las Muestras 3.11
3.2.1 Procedimientos de Análisis de las Muestras - Resumen 3.11
3.2.2 Modos de Análisis de las Muestras 3.14
3.2.3 Mapa de Materiales 3.23
3.2.4 Análisis: Lista de Carga 3.25
3.2.5 Análisis: Reporte de la Sesión 3.30
3.2.6 Condiciones de Pausa de la Sesión 3.33
3.2.7 Análisis: Pausa/Funciones STAT 3.34
3.2.8 Lista de resultados 3.37
3.2.8.1 Icono de extraer 3.39
3.2.8.2 Icono de Detalle de las Muestras 3.40
3.2.8.3 Icono de Nueva Muestra (Tubos en carpeta) 3.43
3.2.8.4 Icono de Suprimir (Bote de Basura) 3.44
3.2.8.5 Impresión de los Resultados 3.45
3.2.8.6 Enviar los Resultados a la Computadora Principal 3.46
3.3 Control de Calidad 3.48
3.3.1 Análisis de los Materiales de Control de Calidad con 3.48
el uso de una Lista de Carga
3.3.2 Ajuste del Control de Calidad 3.49
3.3.3 Revisión de los Resultados del Control de Calidad 3.52
3.3.4 Control de Calidad – Trazo y Estadísticas 3.53
3.3.5 Control de Calidad – Resultados Acumulativos 3.55
3.3.6 Control de Calidad – Comunicación con la Computadora 3.59
Principal
3.3.7 Control de Calidad – Extracción de Resultados 3.60
3.4 Calibración 3.62
3.4.1 Procedimiento de Calibración General - Resumen 3.63
3.4.2 Guardar una Calibración – Resumen 3.64
3
3.4.3 Calibraciones Dedicadas – Detalles 3.64
3.4.4 Calibración – Revisar Calibración 3.65
3.4.5 Calibración de Ensayos de Factor 3.71
3.4.6 Calibración de Ensayos de Factor Pruebas de 3.78
Paralelismo
3.4.7 Resultados del Paralelismo de los Ensayos de Factor 3.79
3.5 Referencia Analítica 3.81
3.5.1 Referencia Analítica: Ajuste 3.81
3.5.2 Referencia Analítica: Trazo y Estadísticas 3.83
3.5.3 Referencia Analítica: Resultados Acumulativos 3.84
3.5.4 Referencia Analítica: Comunicación con la Computadora 3.86
Principal
3.5.5 Referencia Analítica: Extracción de Datos 3.87
4
4 Ajuste y Utilidad
4.0 Introducción 4.1
4.1 Ajuste 4.1
4.1.1 Submenú de Ajuste 4.1
4.1.2 Ajuste – Pruebas – Ver/Definir 4.2
4.1.3 Ajuste – Pruebas - Clasificar 4.4
4.1.4 Ajuste – Pruebas – Tabla de Interferencias 4.6
4.1.5 Ajuste – Pruebas – Pruebas por Omisión 4.8
4.1.6 Ajuste – Pruebas – Pruebas Reflejas 4.9
4.1.7 Ajuste – Perfil de Múltiples Pruebas 4.13
4.1.8 Ajuste – Múltiples Pruebas – Grupos de Pruebas 4.17
4.1.9 Ajuste – Múltiples Pruebas – Perfiles de los Grupos 4.22
de Pruebas
4.1.10 Ajuste – Múltiples Pruebas – Clasificar Múltiples 4.26
Pruebas
4.1.11 Ajuste – Múltiples Pruebas por Omisión 4.27
4.1.12 Ajuste - Líquidos 4.27
4.1.13 Ajuste – Interfaces – Computadora Principal 4.36
4.1.14 Ajuste – Interfaces - Impresora 4.38
4.1.15 Ajuste – Interfaces – Código de Barras Interno 4.40
4.1.16 Ajuste – Interfaces – Código de Barras Externo 4.42
4.1.17 Ajuste – Interfaces - Teclado 4.43
4.1.18 Ajuste – Interfaces - Red 4.43
4.1.19 Ajuste – Interfaces - Módem 4.44
4.1.20 Ajuste – Configuración del Sistema 4.44
4.1.21 Ajuste - Seguridad 4.46
4.1.22 Ajuste – Alarmas Audibles 4.51
4.1.23 Ajuste – Fecha/Hora 4.52
4.1.24 Ajuste – Unidades (Temperatura) 4.53
4.2 Ajuste – Pruebas - Definir 4.54
4.2.1 Copiar Prueba 4.56
4.2.2 Ajuste – Detalles de las Pruebas 4.57
4.2.3 Análisis: Ajustar Carga 4.62
4.2.4 Calibración: Ajustar Carga 4.72
4.2.5 Ajuste de Adquisición 4.82
4.2.6 Ajuste de Cálculo 4.84
4.3 Utilidad 4.113
4.3.1 Submenú de Utilidad 4.113
4.3.2 Utilidad – Actualizar Biblioteca de IL 4.113
4.3.3 Utilidad: Respaldo/Restaurar 4.114
4.3.4 Utilidad - Archivar 4.115
4.3.5 Utilidad – Software – Identificación de Software 4.117
4.3.6 Utilidad – Software – Actualizar/Subir Software 4.117
4.3.7 Utilidad – Guardar Mapa de Rotores 4.119
4.3.8 Utilidad – Guardar Seguimiento 4.120
4.3.9 Utilidad – Prueba/Material – Respaldar/Subir 4.121
5 Diagnóstico y Mantenimiento
5.0 Introducción 5.1
5.1 El Submenú de Diagnóstico 5.1
5.1.1 Cebado 5.2
5.1.2 Limpieza 5.4
5.1.3 Mantenimiento 5.7
5
5.1.4 Control de Temperatura 5.8
5.1.5 Posición de las Agujas 5.10
5.1.6 Historia de Errores de la Sesión 5.11
5.1.7 Historia de Errores de Archivos 5.12
5.1.8 Libro de Registro 5.14
5.1.9 Servicio (atenuado) 5.15
5.2 Procedimientos de Mantenimiento 5.16
5.2.1 Introducción 5.16
5.2.2 Mantenimiento Preventivo Diario 5.16
5.2.3 Mantenimiento Preventivo Semanal 5.19
5.2.4 Mantenimiento Preventivo Quincenal 5.20
5.2.5 Mantenimiento Preventivo Mensual 5.21
5.2.6 Mantenimiento según se Necesite 5.22
5.2.7 Procedimiento de Descontaminación 5.28
5.3 Tabla de Mantenimiento 5.30
6 Localización de Fallas
6.0 Introducción 6.1
6.1 Fallas, Alarmas y Advertencias 6.1
6.1.1 Anomalías del Sistema 6.2
6.1.2 Anomalías REM (Módulo de Intercambio de Rotores) 6.7
6.1.3 Anomalías de Temperatura 6.9
6.1.4 Anomalías Mecánicas 6.12
6.1.5 Anomalías de la Estación de Adquisición 6.14
6.1.6 Anomalías de Líquidos 6.15
6.1.7 Anomalías Ópticas 6.18
6.1.8 Anomalías Operativas 6.18
6.1.9 Anomalías de Análisis Sintáctico y Carga 6.19
6.1.10 Anomalías de la Base de Datos 6.20
6.2 Falla en la Transmisión de Datos 6.20
6.3 Claves de Errores de la Reducción de Datos 6.20
6.3.1 Claves de Errores de la Sesión 6.21
6.3.2 Claves de Errores de la Curva de Reacción 6.22
6.3.3 Claves de Errores de Calibración 6.25
6.3.4 Claves de Errores de Referencia Analítica 6.29
6.3.5 Claves de Errores de Control de Calidad 6.33
6.3.6 Claves de Errores de Pruebas Dobles 6.34
6.3.7 Claves de Errores de Relación e INR 6.35
6.3.8 Errores de DMS 6.36
6.3.9 Otros Errores Diversos 6.37
6.4 Errores de Coagulación (Reducción de Datos) 6.37
6.5 Errores de Identificación de Muestras 6.38
6.6 Diagrama de Reducción de Datos para PT, APTT y TT 6.39
7 Especificaciones de Ensayos e Instrumento
7.0 Introducción 7.1
7.1 Parámetros Medidos 7.3
7.2 Cálculo de Resultados 7.5
7.2.1 Pruebas Coagulométricas 7.7
7.2.2 Pruebas Cromogénicas 7.14
7.3 Configuración y Especificaciones de 7.18
Muestras/Reactivos
7.3.1 Requerimientos y Posiciones de las Muestras 7.18
7.3.2 Posición de las Muestras en el Rotor 7.20
7.3.3 Volúmenes de las Pruebas Coagulométricas 7.22
7.3.4 Volúmenes de las Pruebas Cromogénicas 7.24
7.3.5 Volúmenes de Pruebas Especiales 7.25
7.4 Características del Procesamiento de Datos, 7.26
Parámetros
6
y Especificaciones Analíticas
7
7.4.1 Límites de Indicaciones 7.26
7.4.2 Formato de Resultados VDU e Impresora 7.29
7.4.3 Manejo de los Mensajes de Resultados 7.29
7.4.4 Pendiente de la Curva de Calibración (m) 7.32
7.4.5 Intercepción de la Curva de Calibración (q) 7.32
7.4.6 Rangos para los Valores del Plasma de Calibración 7.33
7.4.7 Tiempos de Reacción 7.33
7.4.8 Algoritmos de Pruebas 7.36
7.5 Características del Desempeño de los Ensayos 7.37
7.5.1 Estudios de Comparación de Datos, Linealidad y 7.37
Desempeño de Precisión de los Ensayos
7.5.2 Estabilidad de la Calibración de los Ensayos 7.41
7.6 Limitaciones Analíticas 7.42
7.6.1 Traspaso 7.42
7.6.2 Cefalina: Autoacondicionamiento de Agujas 7.43
7.6.3 Muestras Lipémicas 7.43
7.7 Especificaciones de los Contenedores 7.43
7.7.1 Tubos Primarios 7.43
7.7.2 Copas y Contenedores de Reactivos 7.44
7.8 Especificaciones del Instrumento 7.45
7.8.1 Especificaciones del Hardware y Operativas 7.45
7.8.2 Dimensiones 7.46
7.8.3 Especificaciones de las Bases de Datos 7.46
7.9 Especificaciones Ambientales 7.48
7.10 Especificaciones Eléctricas 7.48
7.11 Riesgos 7.49
7.11.1 Advertencia General 7.49
7.11.2 Riesgo de Descarga 7.49
7.11.3 Riesgos Eléctricos 7.49
7.11.4 Riesgos Biológicos 7.50
7.11.5 Riesgos Mecánicos 7.50
Adición: Estudios de Comparación de Métodos 7.51
8 Recolección y Almacenamiento de Muestras
8.0 Introducción 8.1
8.1 Recolección de Muestras 8.1
8.2 Manejo del Plasma 8.2
8.2.1 Separación del Plasma 8.2
8.2.2 Transporte del Plasma 8.2
8.2.3 Almacenamiento del Plasma 8.2
8.3 Plasma de Calibración 8.2
8.3.1 Descripción 8.2
8.3.2 Preparación 8.3
8.3.3 Asignación de Valor 8.3
9 Partes y Consumibles
9.0 Introducción 9.1
9.1 Estuche de Inicio0 9.1
9.2 Información para Ordenar Consumibles 9.4
10 Garantía
10.0 Condiciones Generales de Garantía 10.1
10.1 Denegación con Respecto a Producto que no Sea de 10.2
Marca IL
11 Localidades Mundiales de IL
Apéndice A Protocolo de Comunicación con la Computadora
Principal
Apéndice B Especificación de las Etiquetas de Código de
Barras
Apéndice C Procedimientos de Pruebas Especiales
8
Apéndice D Ejemplos de Impresión de ACL Elite/Elite Pro

1.1
Información General
1.0 Introducción
El Manual del Operador contiene la información necesaria para
operar, mantener y localizar las fallas con respecto al ACL
Elite y Elite Pro de Instrumentation Laboratory. El personal
responsable de la operación y el mantenimiento del
instrumento debe leer y entender el material incluido aquí,
antes de usar el sistema. Este Manual debe guardarse cerca
del instrumento o en un sitio adecuado para consulta según se
requiera.
Esta Sección del Manual contiene información general acerca
de los sistemas ACL Elite/Elite Pro, con inclusión del uso y
los parámetros medidos, la descripción de los módulos del
hardware, así como su función y operación, la metodología,
las características adicionales y las limitaciones del
procedimiento. La descripción y el uso de la interfaz del
Operador del ACL Elite/Elite Pro se aborda en Secciones por
separado de este Manual
Sistema ACL Elite Pro
(Ilustración)
1.2
1.1 Uso del Producto
El sistema IL ACL Elite/Elite Pro es un analizador de alta
productividad, completamente automatizado, diseñado
específicamente para uso clínico en el laboratorio de
hemostasis, para pruebas de coagulación y/o fibrinólisis. El
sistema proporciona resultados tanto para mediciones directas
de hemostasis como para parámetros calculados.
1.2 Parámetros Medidos
El sistema ACL Elite/Elite Pro se utiliza para efectuar las
pruebas siguientes:
Pruebas Coagulométricas
• PT-FIB (Tiempo de Protrombina y concentración de
Fibrinógeno basado en PT)
• APTT (Tiempo de Tromboplastina Parcial Activada)
• TT (Tiempo de Trombina)
Pruebas de Absorbencia
• Antitrombina
• Heparina
• Proteína C
• Inhibidor de Plasmina
• Plasminógeno
• Fibrinógeno C (método de Clauss)
9
Pruebas Inmunológicas
• Dímero D
• Factor de von Willebrand – Actividad y Antígeno
• Proteína S Libre
Pruebas Especiales
• ProClot (Proteína C de coagulación)
• Proteína S
• Factor V Leiden
• Examen y Confirmación LAC
• Complejo Pro-IL*
• Hepatocomplejo*
NOTA
Un (*) indica que la prueba no está disponible en los Estados
Unidos.
Prueba Única o Múltiples Pruebas
El usuario puede programar una única prueba o pruebas
múltiples en las muestras de los pacientes para efectuarse
sobre una base de acceso aleatorio. Consulte la Sección 4
para información adicional sobre este tema.
1.3
Grupos de Pruebas
Algunas pruebas pueden correrse juntas como un grupo y, así,
ahorrar tiempo cuando el número de muestras que van a
analizarse es relativamente pequeño. Se incluyen algunos
ejemplos a continuación:
PT-FIB/APTT
PT-FIB/APTT
Fib-C/AT/Dímero D
Pruebas Dobles (Pruebas por Duplicado)
El ACL Elite/Elite Pro ofrece al usuario la capacidad de
ajustar pruebas dobles. El Capítulo 4.0 contiene información
que permite ajustar pruebas dobles en el sistema.
1.3 Presentación de los Resultados
El sistema ACL ofrece las siguientes opciones para mostrar e
imprimir los resultados de las pruebas.
• s (segundos)
• R (Relación)
• NR (Relación Normalizada)
• INR (Relación Normalizada Internacional)
• % (Porcentaje de actividad)
• U/mL (unidades/mL)
• mg/dL (por ejemplo, para Fibrinógeno)
• mg/dL
• g/L (por ejemplo, para Fibrinógeno)
10
• ng/mL (por ejemplo, para Dímero D)
• microg/L
• microg/L (por ejemplo, para Dímero D)
• micromol/L
• IU/Ml (Unidad Internacional)
• Unidad configurable por el usuario
1.4 Descripción y Operación del Instrumento
1.4.1 Resumen
El ACL pertenece a una familia de analizadores
microcentrífugos, completamente automáticos, controlados por
computadora. El sistema ACL Elite/ Elite Pro IL incorpora a
una unidad de Pantalla de Cristal Líquido (LCD) que muestra
la condición del instrumento, permite que el usuario
seleccione los procedimientos deseados y, por medio del uso
de menús y opciones, guía al operador a través de estos
procedimientos. La información y las instrucciones se
introducen en el sistema por medio de un dispositivo de
Pantalla Sensible al Tacto o por medio de un teclado de PC
estándar o ratón.
Cuando se inician las pruebas de las muestras, las muestras y
los reactivos se pipetean en secuencia a un rotor de
poliestireno de 20 cuvetas (proceso de carga). Un proceso de
centrifugación mezcla a continuación la muestra y los
reactivos. El mezclado se lleva a cabo mediante una...
1.4
...combinación de acciones de aceleración y frenado rápidos,
que son efectivas para mezclar los líquidos perfectamente. Se
efectúan las mediciones de la reacción (adquisición de datos)
por medio del fotómetro, mientras el rotor está girando.
El ACL mide los parámetros a 37°C ± 1°C (98.6°F ± 1.8°F), a
una temperatura ambiente de 15°C a 32°C (59°F a 89°F). Sin
embargo, cuando el ACL se encuentra en un ambiente de
temperatura controlada, en el que la temperatura ambiente se
mantiene constante, se efectúan las mediciones dentro de un
rango de temperatura más angosto: 37°C ± 0.25°C.
Los resultados se muestran en en la LCD y se imprimen
optativamente por medio de la impresora externa y/o se envían
a una computadora principal. El ACL efectúa la calibración
automática, ofrece una serie de programas de utilidad para el
operador y maneja un programa de control de calidad completo.
1.4.2 Componentes principales del hardware
El analizador ACL Elite/Elite Pro incluye a varios
componentes de hardware que interactúan unos con otros para
llevar a cabo el proceso analítico. Esta sección contiene
descripciones de esos componentes y de sus funciones, así
11
como las operaciones que tienen lugar durante el proceso
analítico.
La figura que aparece a continuación resalta a los
componentes principales del ACL Elite/Elite Pro, vistos desde
la parte frontal del sistema.
Sistema – Componentes (ACL Elite no tiene Transportador del
Rotor ni Brazo del Rotor).
(Ilustración)
1.5
1. Emulsión de Lavado R
2. Diluyentes
3. Charola de Muestras
4. Área de Reactivos
5. Brazo de Muestreo
6. Unidad de Disco Flexible
7. LCD
8. Área de Apilamiento del Rotor
9. Cubierta del Sujetador del Rotor
10. Transportador/Brazo del Rotor
11. Área de Desechos del Rotor
12. Teclado
13. Área de Adaptadores
14. Salida de Desecho de Líquido
* No Disponible en el ACL Elite
1.6
Se abordarán los siguientes conceptos en las Secciones a
continuación:
• Charola de Muestras (Sección 1.4.3)
• Área de Reactivos (Sección 1.4.4)
• Área de Enjuagado/Desechos (Sección 1.4.6)
-emulsión de referencia/lavado
-bloque de pistón y electroválvulas
-Conjunto del brazo de muestreo
-Sensores
• Área de Carga y Análisis (Sección 1.4.8)
-Rotores (cuvetas de reacción)
-Alojamiento de rotores y transportador de rotores*
-Sujetador de rotor y carga del rotor
-Sistema de medición óptica (fotométrica y nefelométrica)
-Área de desechos del rotor
• Microprocesador y Electrónica (Sección 1.4.8)
• Pantalla de Cristal Líquido (LCD)(Sección 1.4.9)
• Teclado (Sección 1.4.10)
• Conectores de Interfaz (Sección 1.4.11)
• Sistema de Enfriamiento Interno (Sección 1.4.12)
• Lector de Código de Barras a Bordo (Sección 1.4.13)
12
• Escáner de Código de Barras Externo (Sección 1.4.14)
• Impresora externa (Sección 1.4.15)
• Unidad de disco flexible (Sección 1.4.16)
*El sistema Transportador del Rotor no está disponible en
el ACL Elite.
1.4.3 Charola de Muestras
El sistema automuestreador del ACL incluye a una charola de
muestras giratoria, que contiene:
-40 posiciones de 14.2 mm para copas y tubos primarios y
-10 posiciones de 23 mm de diámetro para sujetar materiales
accesorios, tales como calibradores, diluyentes, frasquitos
de reactivos, etc.
Los sensores ópticos situados alrededor de la charola
verifican que la charola esté colocada correctamente y
detectan también la presencia de las copas, tubos y
frasquitos.
Pueden usarse tres charolas de muestras diferentes (con el
sistema ACL) dependiendo de la configuración del instrumento.
Cada una es apropiada para un tamaño diferente de tubos
primarios: 3 mL. 5 mL y S11.5; todas ellas pueden usarse para
copas de 0.5, 2 ó 4 mL.
Corta (3 mL) Tubo primario (13x75 mm)
Alta (5 mL) Tubo primario ](13x75 mm y/o 13x100 mm)
Alta (S 11.5) tubo primario Sarsted (11.5x66 mm) y/o (11.5x92
mm)
Las dimensiones arriba mencionadas son todas valores
nominales.
1.7
(Ilustración)
Charola de Muestras
(Ilustración)
Ubicación de la Charola de Muestras en el ACL
Oprima el Botón para Retirar la Charola
1.8
• Posiciones adicionales de reactivos
Las diez posiciones internas de la charola de muestras –A1 a
A10 – se utilizan para colocar materiales tales como
calibradores, diluyentes o reactivos en una opción de
contenedores, tales como frasquitos de 23 mm (10 mL de
volumen de llenado), frasquitos de 18 mm (4 mL de volumen de
llenado) o copas. Se necesitan adaptadores para los
frasquitos de 4 mL y las copas, tal como se ve en la
ilustración a continuación.
Normalmente, la posición A1 se reserva para una copa que
contiene plasma de calibración) y la posición A2 se reserva
para una copa que contiene Diluyente de Factor IL para uso en
el procedimiento de calibración.
13
(Ilustración)
Adaptadores para las posiciones internas en la Charola de
Muestras
Adaptador para Frasquitos
Adaptador para copas
1.9
1.4.4 Área de Reactivos
El área de reactivos del AC lite consta de 8 reservorios
rotulados R1 a R8, concebidos para sujetar contenedores de
reactivos. El ACL Elite Pro tiene 4 posiciones enfriadas
adicionales sin agitación, rotuladas R9 a R12. Un área a lo
largo de los orificios para los frasquitos es concebida para
sujetar los tapones de los frasquitos mientras los frasquitos
están en uso.
Las posiciones R1 a R4 (todos los modelos) y R9 a R12 (ACL
Elite Pro solamente) se mantienen entre 10 – 16°C mediante un
regulador de efecto de Peltier. Las posiciones R1 a R4 están
equipadas con un mecanismo de agitación.
Las posiciones R5 a R8 se utilizan para reactivos a la
temperatura ambiente, estas posiciones no tienen un mecanismo
de agitación.
Los reactivos en las posiciones R1 a R6 y R9 a R12 se aspiran
con la aguja interna (para Reactivos), en tanto que los
reactivos colocados en las posiciones R7 y R8 se aspiran con
la aguja externa (para Muestras)
(Ilustración)
Área de Reactivos – ACL Elite
Todas las posiciones de reactivos pueden contener frasquitos
de 28 mm (16 mL de volumen de llenado). Los frasquitos de
volumen más pequeño requieren el uso de adaptadores
codificados con colores.
(Ilustración)
Adaptadores de Frasquitos
Gris: para frasquitos de 10 mL que requieren agitador magnético
Rosa: para frasquitos de 10 mL que no requieren agitador magnético
Verde: para frasquitos de 4 mL que no requieren agitador magnético
1.10
1.4.5 Área de Enjuague/Desechos
El sistema de enjuague/desechos del ACL consiste en un
reservorio de copa removible, colocado entre las posiciones
R4 y R5 de los reactivos, un tubo de plástico conectado al
reservorio de copa que drena los desechos de la copa, y un
contenedor de desechos en el exterior del analizador (lado
izquierdo) recolecta los desechos.
La copa, que está siempre llena con Emulsión de Lavado R, se
utiliza como cuenca de lavado para las agujas surtidoras
entre ciclos; el desecho líquido se drena a continuación y se
14
recolecta en el contenedor de desechos en el exterior del
analizador para la disposición apropiada.
(Ilustración)
Sistema de Enjuague/Desechos

Enjuague del Reservorio de Desechos bajo las Agujas Contenedor de Desechos Externo
(lado izquierdo, frente de la unidad)
1.4.6 Sistema de Muestreo/Surtido
El sistema de muestreo/surtido del ACL Elite/Elite Pro
incluye a los componentes siguientes:
Botella de Emulsión de Lavado-Referencia
Es una botella de plástico que contiene 1000 mL de emulsión
de silicio, que se emplea como solución de lavado y sirve
como referencia óptica para el canal nefelométrico. Un
sensor ubicado en el interior de la botella alerta al usuario
cuando el nivel de líquido cae por debajo de valores
aceptables. El tapón de la botella se quita levantándolo de
la botella.

1.11
Bloque de Pistón y Electroválvulas
Fijado contra la pared posterior del analizador, se encuentra
un bloque de acrílico con dos cilindros, cada uno de los
cuales tiene un pistón de acero inoxidable. Dos
electroválvulas están conectadas a los pistones. Las
electroválvulas est{an controladas electrónicamente y
conectan los pistones con la botella de Emulsión de Lavado-
Referencia, así como a las dos agujas montadas en el brazo de
muestreo/surtido.
Conjunto de Brazo de Muestreo/Surtido
Dos agujas de acero inoxidable, externa (Muestra) e interna
(Reactivo), están montadas en el extremo distal de un brazo,
que se activado radialmente por un motor a pasos. Otro motor
a pasos mueve el brazo en el plano vertical por medio de un
tornillo sin fin. La combinación de estos dos movimientos
permite las operaciones siguientes:
- Aspiración de la muestra y/o reactivo de sus lugares
respectivos.
- Surtido de la muestra y reactivo a los compartimientos
interno y externo de las cuvetas de reacción dentro del
rotor.
- Lavado de las agujas en la estación de desechos/enjuague.
(Ilustración)
Sistema de Muestreo-Surtido
15
Sensores
Dos sensores de nivel de líquido, conectados al bloque de
agujas, se utilizan para detectar la presencia de muestras y
reactivos en las agujas.
Por medio de los sensores de nivel del líquido, el sistema
monitorea la presencia de muestras y materiales líquidos
(calibradores, plasma, diluyentes, etc.) en...
1.12
...la charola de muestras y los reactivos en los frasquitos
de reactivos originales situados en el área de reactivos.
Tres sensores de líquido están integrados en los ciclos
analíticos del ACL, de tal manera que su operación no afecte
al rendimiento del sistema. Para todos los ciclos analíticos,
la verificación por parte de los sensores se efectúa “en
línea” durante la fase de carga. El brazo de muestreo se
detiene cuando la aguja se encuentra exactamente debajo de la
superficie del líquido para permitir la aspiración apropiada
de la cantidad programada de líquido.
Los sensores de líquido se activan al comenzar cada ciclo
analítico. La secuencia de las operaciones de los sensores
durante un ciclo es como sigue:
- autoverificación
- prueba del líquido
- lavado
- autoverificación final de los sensores
- si fuera aplicable, reporta las fallas de los sensores
para mostrarlas en la LCD.
Cuando se advierte a los Operadores acerca de fallas de los
sensores de muestras/reactivos, los resultados de una muestra
para la que el sistema detectó volumen insuficiente,
aparecerán con una advertencia. Por ejemplo, en caso de que
la falla se haya debido a muestra insuficiente en una copa,
el mensaje de advertencia mostrará “nivel bajo”. En caso de
que todos los contenedores de muestras de la charola de
muestras estuvieran vacíos, se abortará el ciclo después de
la autoverificación final. No aparecen otras advertencias en
el video o la impresora.
(Ilustración)
Brazo de Muestreo con sensor
La línea de las muestras está en la parte superior
Interna (Reactivo) Externa (Muestra)
1.13
Cualquier advertencia de falla de sensor, debida a la
autoverificación o a reactivo insuficiente:
- desaparecerá al principio de la fase de carga
- aparecerá durante la incubación/adquisición en caso de
error de la autoverificación o reactivo insuficiente
16
- permanecerá hasta la siguiente fase de carga en el ciclo
siguiente.
Aunque la prueba de los sensores termina tan pronto como se
detecta un error durante la autoverificación inicial, el
ciclo analítico continúa. En este caso, se proporcionan los
resultados de la prueba y aparece una advertencia en la línea
de condición, que indica la falla de los sensores. No se
proporcionarán ningunas indicaciones acerca de la ausencia de
muestras y/o reactivos.
El operador puede ver la condición de alarma oprimiendo el
icono de Advertencia. Se imprimirá un mensaje equivalente con
los resultados.
Nota: No se aspira ninguna cantidad adicional de líquido
(muestra o reactivo) para la verificación del sensor.
1.4.7 Área de Carga y Análisis
El área del analizador en donde se cargan las cuvetas de
reacción y tiene lugar el análisis, está situada debajo del
sujetador de la cubierta del sujetador del rotor en el centro
del instrumento, en el lado derecho del área de reactivos.
Esta área incluye a los sistemas de almacenamiento de las
cuvetas de reacción (rotores) y a los mecanismos que
intervienen en el transporte de estos rotores, la placa en la
que está situado el rotor durante la carga y el análisis
(sujetador del rotor), los componentes del hardware
responsables de asegurar el mezclado apropiado de los
reactivos y las muestras en las cuvetas y y el sistema óptico
empleado para hacer las mediciones analíticas. La cubierta
del sujetador del rotor puede abrirse oprimiendo el icono de
la cubierta del rotor.
(Ilustración)
Rotor Pocillo Interno
Pocillo Externo
Precaución: Evite tocar el área del rotor en donde ocurre la lectura óptica. La anterior incluye a la parte superior, el lado
y la parte inferior de la parte exterior sobre el rotor.

1.14
Rotor (cuvetas de reacción)
Las cuvetas de reacción desechables, hechas con precisión de
poliestireno transparente a la UV, se disponen radialmente en
grupos de 20. La unidad de 20 cuvetas se denomina rotor. Las
lecturas ópticas se efectúan en la parte exterior del rotor.
Cada cuveta en forma de cuña contiene dos compartimientos,
uno interno cerca del centro para contener la muestra y/o el
reactivo, y uno externo que contiene reactivos solamente. Una
represa parcial entre los compartimientos mantiene al
contenido separado durante el proceso de carga; cuando
comienza la acción centrífuga, la muestra/reactivo del
compartimiento interno fluye sobre la represa para mezclarse
17
con el contenido del compartimiento externo. La reacción y el
análisis tienen lugar dentro el compartimiento grande
externo, mientras el rotor está girando.
Apilamiento de Rotores, Transportador de Rotor y Brazo del
Rotor
Apilamiento de rotores – Antes de su uso, los rotores se
almacenan en una pila que contiene hasta 12 rotores. El
compartimiento de apilamiento de los rotores, al que puede
tenerse acceso desde la parte superior del analizador en el
lado derecho, puede llenarse en cualquier momento (carga
continua de rotores), ya sea manualmente (un rotor a la vez)
o con el uso de la herramienta de llenado (hasta 10 rotores a
la vez). El área de apilamiento de rotores está controlada
termostáticamente a fin de mantener los rotores con un rango
de temperatura entre 36°C y 39°C; la pila de rotores está
aislada para ayudar a la regulación térmica. El instrumento
informa al Operador cuando la Pila de Rotores está vacía en
el ACL Elite Pro.
(Ilustración)
Uso de la Herramienta de Llenado de Rotores
Oprima el botón del centro para cargar y descargar rotores.

1.15
(Ilustración)
Alimentación de la Pila de Rotores
Transportador de Rotores* – Debajo de la pila de rotores, un
mecanismo de deslizamiento de transporte de rotores desplaza
al rotor inferior hacia afuera para que quede disponible para
el mecanismo del brazo del rotor.
Brazo del Rotor* - El brazo robótico toma al rotor y lo
introduce en el sujetador del rotor. Ésta es un área en la
que permanecerá el rotor durante la cara y el proceso de
análisis. Una vez que se completa el análisis, en caso de que
el rotor se utilice completamente (o que lo solicite el
usuario), el brazo del rotor desecha al rotor al contenedor
de desecho de rotores.
(Ilustración)
Transportador y Brazo del Rotor – (No Aplicable en el ACL Elite)*
En el ACL Elite, los rotores deben cargarse manualmente del
área de almacenamiento al compartimiento de análisis.
Oprima el icono de “Abrir Tapa” para subir/bajar la
cubierta del compartimiento de análisis. Oprima el botón en
el centro del cubo del compartimiento de análisis para
asentar y retirar el rotor. El analizador alertará al
operador cuando se necesite un cambio de rotor.
1.16

Sujetador de Rotor y Carga de Rotor


18
El sujetador de rotor es un disco de aluminio que sujeta al
rotor en su sitio durante la carga y el análisis. El
sujetador del rotor está controlado termostáticamente a una
temperatura de 38.5 ± 0.5°C para asegurar 37°C en el
interior de la cuveta.
(Ilustración)
Área del Sujetador del Rotor
Oprima este botón para colocar y retirar manualmente los rotores.
Carga del rotor: como se indica arriba, la carga de la
muestra y de los reactivos en las cuvetas de reacción implica
la acción del brazo y de las agujas de muestreo/surtido.

Sistema de Medición Óptica


El área de Carga y Análisis aloja también al sistema óptico
para análisis en dos canales: nefelométrico y de
absorbencia.
Canal nefelométrico: la fuente de luz de este canal es un
diodo emisor de luz (LED); la luz (λ = 660 nm) se dirige a
las cuvetas de reacción en el rotor mediante un sistema de
fibra óptica. La luz difusa se lee en un ángulo de 90° con
respecto al haz incidente, con el uso de un detector de
estado sólido situado debajo del sujetador del rotor.
Canal de absorbencia: la fuente de luz es una lámpara de
halógeno, desde la cual se dirige la radiación a las cuvetas
de reacción en el rotor, mediante fibra óptica de cuarzo y un
sistema de enfoque. La selección de la longitud de onda para
análisis se efectúa mediante un filtro de interferencia de
banda angosta, centrado en λ = 405 nm.
El detector óptico está montado en la cubierta del área de
carga/análisis; por lo tanto, las lecturas se efectúan en un
ángulo de 180° del haz de luz.
El ancho de la trayectoria óptica para el canal de
absorbencia es de 0.5 cm (altura de la cuveta). Los valores
de absorbencia que proporciona el analizador se normalizan a
1 cm. Estos valores son generalmente del doble de aquellos
obtenidos en otros modelos de ACL,...
1.17
...para los que los valores de absorbencia no se normalizan y
son, de esta manera, exactamente los obtenidos para la
trayectoria de 0.5 cm de la cuveta.
La lámpara de halógeno puede reemplazarse mediante acceso
al área a través de una cubierta removible en el interior
del área de desecho del rotor en el centro del instrumento
por medio de un ingeniero de servicio de IL.
(Ilustración)
Sistemas de Detección Nefelométrico y de Absorbencia
19
Canal de coagulación Canal de Absorbencia
Sensor
Filtro de 405 nm
Rotor
Lentes

Fibra óptica de cuarzo

Lámpara de Halógeno

Área de Desecho de Rotor


Los rotores usados se dejan caer automáticamente en un
contenedor de desecho en el sistema ACL Elite Pro. En el
sistema ACL Elite, los rotores pueden moverse manualmente
al depósito de desechos o desecharse inmediatamente a un
contenedor designado para riesgos biológicos de acuerdo con
el protocolo del laboratorio. Se tiene acceso a este
contenedor desde una puerta en el área frontal derecha del
analizador para retiro y disposición de los rotores usados,
como se ve en la figura a continuación. El instrumento
informa al usuario cuando el Desecho de Rotores está lleno.
(Símbolo)
Advertencia: Las cuvetas dentro del rotor tienen como
finalidad el uso de una sola vez. IL no recomienda ni apoya
la nueva utilización de las cuvetas lavadas y previamente
usadas en un rotor.
1.18
(Ilustración)
En el área de desechos, un interruptor (sensor) verifica la
presencia del contenedor de desechos.
1.4.8 Microprocesador y Electrónica
La unidad del analizador ACL está construida alrededor de
tres microprocesadores de computadora. Estos
microprocesadores controlan a todas las acciones del
analizador: movimientos mecánicos, aspiración y surtido de
muestras y fluidos, la adquisición y procesamiento de datos
y la interfaz del operador con dispositivos de entrada
(teclado) y salida (video/impresora).
La electrónica consiste en tableros de circuito impresos
que se mantienen juntos mediante un bastidor montado detrás
del tablero frontal del analizador. Tres de estos tableros
están asignados a las secciones de microprocesadores y
lógica, en tanto que los otros tres se utilizan para los
módulos de interfaz y los diversos controles de activación.
Estos circuitos y los subconjuntos del instrumento están
20
soportados por una fuente de energía de conmutación,
conectada directamente a la energía principal.
1.19
1.4.9 Pantalla de Cristal Líquido (LCD)
Este módulo consiste en una Pantalla de Cristal Líquido, de
matriz activa de 12 pulgadas (LCD), que está equipada con
una función de Pantalla Sensible al Tacto, que permite que
la mayoría de las operaciones se lleve a cabo con el uso de
la LCD.
La LCD guía al operador durante el proceso analítico y
muestra los datos del calibrador y los resultados del
paciente. Se utiliza también para mostrar las curvas de
calibración y efectuar programas de utilidad, que son
fácilmente accesibles por medio del dispositivo de entrada.
El sistema de pantalla LCD reproduce 256 colores y muestra
caracteres numéricos y alfanuméricos. La interacción con el
operador está también orientada hacia el usuario mediante
la disponibilidad de gráficas e iconos. La pantalla está
dividida en tres áreas:
- La sección superior muestra a los submenús
- La sección central muestra menús, resultados, trazos de
gráficas y lineamientos de instrucciones
- La sección superior muestra iconos de instrucciones.
1.4.10 Teclado
El ACL Elite/Elite Pro tiene un teclado de computadora
estándar con teclas mecánicas que permiten que el usuario
tenga acceso a diversos modos de operación del instrumento.
Aunque el instrumento está equipado con la distribución de
teclado en inglés (Estados Unidos y el Reino Unido) y la
soporta, el propio software del ACL soporta a los idiomas
siguientes: alemán, francés, español, japonés (Kanji) e
italiano.
(Ilustración)
Teclado
1.20
1.4.11 Conectores de Interfaz
Interfaz RS-232 para Computadora Principal (puerto 1)
El ACL Elite/Elite Pro contiene una interfaz RS-232 (DTE
Estándar) para la salida de datos a una computadora central
(Principal) o una computadora personal. La comunicación con
una computadora principal es por medio del protocolo ASTM.
21
Interfaz RS-232 para un ratón serial (puerto 2)
Puertos USB (4 receptores)
Los puertos USB pueden utilizarse para un ratón, impresora o
el lector de código de barras de reactivos externo.
Módem (puerto 4) no soportado en esta liberación de software.
Salida de Impresora Externa (puerto 5)
El ACL Elite/Elite Pro tiene una salida para una impresora
externa optativa. Hay dos protocolos de emulación disponibles
para las impresoras: ESC/P2 (impresoras similares a la Epson)
y HP-PCL (para Impresoras Láser similares a las HP).
Teclado de PC Estándar (puerto 6)
(Ilustración)
Tablero Posterior y Fusible
1. RS232C 1 (Computadora Principal – Optativa)
2. RS232C 2 (Ratón)
3. USB (4 puertos) Ratón, Impresora, Código de Barras
Externo
4. MODEM (NS)
5. Impresora Paralela (Optativa)
6. Teclado
NS = No soportado en esta liberación de software
1.21
1.4.12 Sistema de Enfriamiento Interno
El enfriamiento del sistema está asegurado por la presencia
de ventiladores montados en el lado derecho interno del
analizador. Un filtro de aire impide que el polvo entre en
el sistema (ver la sección de Mantenimiento).
Una alarma de dos niveles advierte al usuario cuando sube
la temperatura interna del instrumento y muestra una
advertencia. El segundo nivel apaga al instrumento.
1.4.13 Lector de Código de Barras a Bordo
El lector de código de barras a bordo, un elemento estándar
del ACL Elite/Elite Pro, está ubicado en el área de
muestreo, según se indica en la figura a continuación. Para
información adicional acerca del uso del lector de código
de barras a bordo, consulte la Sección 3, la Sección 7 y el
apéndice B de este Manual.
Las claves legibles numéricas y alfanuméricas son:
- Codabar
- Clave 39
22
- Clave 128
- Interpuesta 2 de 5
Cuando se utilizan tubos de muestras con código de barras, es
importante ponerlos en la charola de muestras de manera de
que las etiquetas queden frente al exterior de la charola de
muestras. Lo anterior permitirá la lectura correcta de las
etiquetas por el lector de código de barras a bordo.
(Ilustración)
Lector de Código de Barras a Bordo
1.22
1.4.14 Escáner de Código de Barras Externo (optativo)
El escáner de código de barras externo es un elemento
estándar del ACL Elite. Este escáner de código de barras
puede leer la información alfanumérica en los frasquitos de
reactivos HemosIL cuando se muestra el mapa de materiales. La
etiqueta del frasquito incluye a la información siguiente
utilizada por el ACL Elite/Elite Pro.
- Últimos 4 dígitos del número del lote
- Fecha de caducidad del número del lote
- Identificación del material
El escáner está conectado a uno de los puertos USB situados
en la parte posterior del analizador. Conecte el escáner al
analizador apagado y reinicie el sistema. El escáner se
activará.
El escáner se activa automáticamente cuando se muestra el
mapa de materiales.
(Ilustración)
Escáner de Código de Barras Externo
1.23
1.4.15 Impresora Externa (optativa)
Una impresora externa de 80 columnas puede conectarse en
interfaz con el ACL Elite/Elite Pro.
Pueden usarse dos protocolos de emulación: ESC P2 o HP-PCL.
El ESC P2 es un protocolo típico similar al Epson, en tanto
que el HP-PCL es un protocolo típico similar al Hewlett
Packard para impresoras de chorro de tinta y Láser.
La impresora puede usar un conector USB o Paralelo. Cuando se
usa la conexión USB, la impresora debe conectarse y
encenderse antes de iniciar el sistema. Cuando se apaga la
impresora mientras el instrumento está encendido, debe
reiniciarse el analizador a fin de que ocurra la impresión.
23
(Ilustración)
Impresora Externa
1.24
1.14.16 Unidad de Disco Flexible
Una unidad de disco flexible está montada en el área superior
derecha en el ACL Elite/Elite Pro.
Este dispositivo se utiliza para algunos de los programas de
utilidad (consultar la sección 4).
(Ilustración)
El disco flexible es accesible desde la cubierta empujando
ambos lados de la misma para abrirla.
Deben utilizarse discos preformateados IBM de Alta Densidad,
de Doble Lado, de 3.5”.

1.25
1.5 Características Adicionales
1.5.1 Estado de Espera (Standby)
Cuando el ACL Elite/ACL Elite Pro se deja ENCENDIDO por un
período mayor de 30 minutos sin ninguna acción por parte del
operador, el sistema se desplaza a la condición de espera
(Standby). La pantalla de LCD se “Apaga”. Al oprimir la
Pantalla Sensible al Tacto se reactiva a la pantalla y
permite que el sistema reanude la operación normal.
Cuando el sistema entra en la condición de espera, se guarda
la base de datos, se desactivan todos los motores para
reducir el consumo de energía y se apaga la fuente de LEDs.
Mientras el instrumento se encuentra en Espera, se efectúa un
ciclo de cebado automático cada 30 minutos.
1.5.2 Final del Ciclo
Al terminar cada ciclo analítico, una señal de bip avisa al
operador que se ha completado el ciclo.
1.5.3 Pérdida de Energía
El ACL contiene una memoria no volátil para conservar la base
de datos en el caso de una interrupción de la energía. El
instrumento efectúa una operación automática para guardar la
base de datos cada vez que se entra en la condición de espera
o cuando sale del programa principal para apagar. No salir
del sistema antes de apagarlo puede dar como resultado la
pérdida de algunos resultados que no se hayan guardado en la
base de datos.
24
El instrumento tiene un reloj interno que efectúa el
seguimiento de la fecha y la hora.
Cuando regresa la energía después de una interrupción, el
instrumento efectúa verificaciones automáticas y muestra la
pantalla de entrada al sistema. Al entrar en la pantalla
principal, hay dos situaciones posibles:
1. La temperatura del sujetador del rotor se encontraba
dentro del rango aceptable durante la verificación. El
sistema está listo.
2. La temperatura del sujetador del rotor se encontraba
fuera del rango. En el menú Principal, el icono de
Advertencia, en la parte inferior de la pantalla, se
activa e indica que una o más temperaturas están fuera
del rango.
(Símbolo)
Nota: Al seleccionar el icono de “ADVERTENCIA”, puede
mostrarse un mensaje en caso de que las temperaturas del
sistema de enfriamiento de los reactivos, el sujetador del
rotor, el transportador del rotor y/o la pila de rotores se
encuentren fuera del rango.
1.26
1.5.4 Ajuste y Programas de Utilidad
El instrumento incorpora a varios programas de utilidad quie
permiten cambiar o ajustar ciertas funciones de acuerdo con
las necesidades del usuario. Estos programas ayudan también a
la localización de fallas.
Para información adicional, consulte la Sección 4 y la
Sección 6 de este Manual.
1.5.5 Detección de Fallas
El sistema monitorea automáticamente las fallas para asegurar
la exactitud de los datos de las muestras y el desempeño
apropiado del sistema. El monitoreo de las fallas incluye a
la indicación de alarmas y advertencias.
Para información adicional, consulte la Sección 6 de este
Manual.
1.5.6 Indicación de Video – Colores y Símbolos
Ciertas situaciones, relacionadas con los resultados y los
parámetros de la calibración, se indican como sigue:
- Negro = Resultado dentro del rango Normal.
- Violeta = fuera del rango Normal.
25
- Rojo = fuera del rango de la Prueba
- *** = resultado fuera del rango de la Escala, alto para el ensayo
- --- = resultado fuera del rango de la Escala, bajo para el ensayo
-? = No hay ningún resultado disponible para esta prueba ordenada
-* = Hay más de un resultado disponible para esta prueba
Para información adicional, consulte la Sección 3.2.2 y la
Sección 7 de este Manual.
Los límites de los rangos normales, de prueba y de escala
pueden obtenerse detallando las definiciones de las pruebas
individuales en el sistema. El usuario debe introducir los
rangos normales.
1.6 Limitaciones de Procedimiento
El rango de operación del ACL Elite/ACL Elite Pro es de 15 a
32ºC (59 a 89ºF) y hasta 85% de humedad relativa (sin
condensación). El sistema se ha sometido a prueba de acuerdo
con la EN61010-1 para asegurar que no ocurra ningún riesgo
de seguridad en el rango de temperatura de 5-40ºC (41 a
104ºF) y las características de desempeño funcional se
reanudan cuando el instrumento vuelve a entrar en el rango
de 15 a 32ºC (59 a 89ºF).
1.27
1.7 Certificación
Certificación CE
La etiqueta CE en la parte posterior del instrumento indica
que el ACL Elite/Elite Pro está conforme con las Directivas
Europeas, según se expresa en la Declaración de Conformidad
de IL.
Directiva de la UE:
IVD – 98/79/EC (27/10/1998), Anexos I y III.
Normas aplicables:
• EN 61326-1:1998/A2 2001 (Clase A).
• EN 61010-2-04 Requisitos de seguridad para equipo
eléctrico para la medición, control y uso de laboratorio.
Parte 1: Requisitos Generales.
• EN 61010-2-101. Parte 2: Requisitos en particular para el
equipo de laboratorio de diagnóstico in vitro.
• EN 61010-2-081. Parte 2: Requisitos en particular para
equipo de laboratorio automático y semiautomático para
análisis y otros fines.
26
Certificación CSA
La etiqueta CSA en la parte posterior del instrumento indica
que la Asociación Canadiense de Normas (CSA) ha certificado
al ACL Elite/ACL Elite Pro de acuerdo con las normas
aplicables.
Normas aplicables:
• CANCSA C22.2 No. 1010.1-92.
• UL Norma No. 61010-1, 2ª Edición.
LOPD (Ley Orgánica de Protección de Datos)
Directiva 95/46/CE del Parlamento Europeo y la Directiva del
Consejo del 24 de octubre de 1995.
1.28
Reglamento europeo sobre la protección de datos, con respecto
a:
Luxemburgo Irlanda Grecia
Reino Unido Bélgica Portugal
Austria Alemania Países Bajos
Dinamarca Finlandia España
Directivas y reglamentos del Parlamento Europeo y del Consejo
sobre la protección de datos.
Constitución española de 1978.
Ley Orgánica del 15 de diciembre de 1999 sobre la Protección
de Datos Personales (LOPD).
Decreto Real 994/1999 sobre Medidas de Seguridad. Decreto
Real 1332/1994.
Reglamento del Procesamiento Computarizado de Datos
Personales.
Instrucciones de la Agencia Española de Protección de Datos.
Otra Certificación
El ACL Elite/Elite Pro cumple con la CEI/IEC 61010-1, 2001,
Mod. Segunda Edición para lo siguiente:
• Temperatura Superficial Externa
• Resistencia a la Llama
• Resistencia a Fluidos
• Flujo de Aire y Temperatura Internos
• Ruido Audible
27
• Etiquetado del Producto
El empaque para embarque del ACL Elite/Elite Pro, para los
Estados Unidos o para el extranjero, cumple con el
Procedimiento de Pruebas de Empaque para Tránsito Seguro
Internacional ISTA 1B (junio de 1999) y la ASTM 999.
1.29
1.8 Disposición del Instrumento
Directiva 2002/96/EC de la Unión Europea sobre Equipo
Eléctrico y Desechos Eléctricos (WEEE).
Instrumentation Laboratory está comprometido a cumplir o
exceder las condiciones de la Directiva WEEE y ser un buen
socio ambiental. En cumplimiento con la Directiva, comenzando
con el producto que se embarque después del 13 de agosto de
2005, todos los instrumentos se etiquetarán con el símbolo de
depósito “wheelie”.
Sírvase llamar al distribuidor local de Instrumentation
Laboratory para información con respecto a la disposición de
cualesquiera instrumentos cuya vida llegue a su fin.
1.30
1.9 Tabla de Símbolos
La tabla siguiente muestra los diversos símbolos que pueden
estar relacionados con el sistema ACL Elite/Elite Pro.

(Símbolo) (Símbolo) (Símbolo) (Símbolo) (Símbolo)


Marca CE Limitación de Temperatura Uso para Fabricante Clave de Lote

(Símbolo) (Símbolo) (Símbolo) (Símbolo) (Símbolo)


Riesgo Biológico ATENCIÓN: PRECAUCIÓN: NOTA: ATENCIÓN:
Ver Instrucciones para el Riesgo de descarga Información Importante Consultar Documentos
Uso eléctrica para el Usuario

(Símbolo) (Símbolo) (Símbolo) (Símbolo) (Símbolo)


Número de Catálogo Número de Serie Dispositivo de Diagnóstico Representante Autorizado Contiene suficiente para
In Vitro <n> pruebas

(Símbolo) (Símbolo) (Símbolo) (Símbolo) (Símbolo)


Terminal Conductora de Tierra Apagado (suministro) Encendido (suministro) Disposición por Final de la
Tierra de Protección Vida (WEEE)
28

2.1
Instalación
2.0 Introducción
Esta sección contiene toda la información necesaria para
instalar y ajustar el sistema ACL Elite/Elite Pro.
(Símbolo)
Advertencia: El sistema ACL Elite/Elite Pro debe ser
instalado solamente por personal de IL o personas autorizadas
por IL.
Antes de intentar la instalación del sistema ACL Elite/Elite
Pro en el laboratorio, inspeccione el sitio con el personal
del laboratorio para identificar la ubicación deseada para el
sistema y asegurarse de que el ambiente cumpla con los
requisitos para su instalación con éxito.
2.1 Requerimientos para la Instalación
Las secciones siguientes detallan los requerimientos
específicos para la instalación del sistema ACL Elite/Elite
Pro.
2.1.1 Condiciones Ambientales
El instrumento funcionará correctamente en una temperatura
ambiente de 15-32ºC (59ºF a 89ºF), con una humedad relativa
de hasta 85% sin condensación.
De acuerdo con los reglamentos IEC, no ocurrirán ningunas
fallas del instrumento en la presencia de temperaturas
ambientales tan bajas como de 5ºC o tan altas como de 40ºC.
El instrumento debe ubicarse en un área libre de polvo,
vapores, vibraciones y variaciones excesivas de temperatura.
2.2
2.1.2 Requerimientos de Espacio
Las dimensiones externas del analizador son:
Altura en el nivel de pantalla 60 cm 23.6 pulgadas
Altura de la superficie de análisis 27 cm 10.6 pulgadas
Ancho (con inclusión de la LCD) 100 cm 39.4 pulgadas
Profundidad 60 cm 23.6 pulgadas
Peso 63 kg 139 libras
29
El calor generado por el instrumento durante la operación
normal escapa desde la parte inferior, en el lado frontal
derecho y el lado izquierdo de la unidad.
Debe permitirse espacio suficiente alrededor del instrumento
para permitir la circulación del aire para enfriamiento. El
instrumento debe colocarse de manera de que pueda conectarse
fácilmente un tubo de desechos a su lado izquierdo.
Cuando el operador desee trabajar en una posición sentada,
frente al sistema, debe proveerse espacio para las piernas
bajo la parte frontal del instrumento.
2.1.3 Requerimientos Eléctricos
Se ha diseñado el instrumento para operar correctamente con
variaciones de ± 10% del voltaje nominal de la línea y con
frecuencias de la línea entre 50-60 Hz.
El instrumento tiene una fuente de energía que puede operar
de 100 a 240 V y efectúa automáticamente la conmutación al
voltaje de línea requerido.
(Símbolo)
Advertencia: Verifique que el voltaje nominal de la línea en
el laboratorio sea compatible con la etiqueta en la parte
posterior del instrumento, como se muestra en la tabla a
continuación. La instalación eléctrica de la sala debe
cumplir con los requisitos locales, estatales o nacionales
(con inclusión de un circuito de suministro de energía con
conexión independiente a tierra).
Valor como se muestra en la etiqueta Valores del voltaje de línea
para el funcionamiento normal
100-240 V 100,110,115,120,125 VCA ±10%
220,230,240 VCA ± 10%
Consumo de Energía
Compruebe que la línea sea capaz de suministrar 350 VA.
2.3
(Símbolo)
Advertencia: El consumo de energía promedio es de 350 VA
aproximadamente, pero las cargas pico o los picos
transitorios pueden exceder de este valor cuando se enciende
el instrumento.
Frecuencia de la Línea
El instrumento funcionará con cualquier frecuencia entre 50-
60 Hz.
30
El cable de energía que se proporciona con el sistema está
específicamente diseñado para uso con el ACL Elite/Elite Pro.
No debe substituirse por ningún otro cable. El cable se
enchufa en el receptáculo (socket) como se muestra en la
figura a continuación. Los fusibles están contenidos en el
compartimiento a la derecha del receptáculo (socket). El
módulo de entrada de energía y el interruptor de
ENCENDIDO/APAGADO están incluidos.
(Figura)
Receptáculo (Socket) de Energía y Fusible
2.4
Conectores
El instrumento está provisto de varios conectores situados en
el lado posterior.
(Figura)
Conectores
1. RS232C 1 (Computadora Principal – Optativo)
2. RS232C 2 (Ratón Serial)
3. Puertos USB (4): Ratón, Impresora o lector de Código de
Barras Externo
4. Módem (NS)
5. Impresora Paralela (Optativo)
6. Teclado
NS = No soportado en esta liberación de software.
2.5
2.2 Entrega y Desempacado del Instrumento
Un representante certificado de IL debe desempacar las cajas
que contienen al ACL y sus accesorios, inspeccionarlos
visualmente para verificar que no ha habido ningún daño
durante el embarque y manejo. IL no es responsable de los
daños que resulten de que cualquier representante no
certificado de IL abra las cajas.
En caso de daño, notifique al transportista y a IL
inmediatamente.
Retire la caja que contiene a los rotores y el estuche de
inicio. Mediante el uso de la lista del estuche de inicio
incluida en la caja, confirme que todos los componentes de la
lista de embarque estén presentes.
31
Retire el instrumento y colóquelo sobre la superficie de
trabajo.
Quite la cinta adhesiva, que se utiliza para el transporte,
de las diversas partes (cubiertas, cubierta de ventilador,
etc.).
Precaución: Dos personas deben levantar el instrumento con el
uso del espacio por debajo de la unidad, en la parte frontal
y la parte posterior, como se muestra en la figura a
continuación.
(Figura)
Puntos para transportar el instrumento
2.6
2.3 Montaje de las Partes del Instrumento
Tubo para desechos
Conecte el tubo para desechos al accesorio en el lado
inferior de mano izquierda del instrumento. Corte el tubo con
la longitud adecuado para que ajuste en el contenedor de
desechos que debe estar situado debajo del orificio de salida
de los desechos del instrumento, como se muestra en las
figuras a continuación.
Precaución: La sección horizontal del tubo debe mantenerse
tan corta como sea posible y el extremo libre no debe
sumergirse en el contenedor de desechos líquidos.
(Símbolo)
Advertencia
Los desechos líquidos provenientes del instrumento deben
considerarse contaminados y debe disponerse de ellos de
acuerdo con los procedimientos para manejo de desechos del
laboratorio y en cumplimiento con los reglamentos locales
(ver también CLSI GP25-A, Vol. 13 No. 22: Manejo de Desechos
de Laboratorios Clínicos, Dic. 1993).
(Figura)
Conexión del tubo para desechos y posición del contenedor de desechos.
2.7
Accesorios para Enjuague, Muestras y Reactivos
• Verifique que el reservorio de enjuague-desechos esté
colocado en la posición apropiada.
• Ajuste la charola de muestras apropiada en su soporte
correspondiente.
• Ajuste los adaptadores de reactivos en sus posiciones
apropiadas (en caso necesario), como se muestra en la
figura a continuación. Tres adaptadores de reactivos, con
claves de colores, están disponibles para las posiciones
de reactivos R1 a R8 (ACL Elite) y R1 a R12 (ACL Elite
Pro).
32
Gris para frasquitos de 10 mL que requieren agitador magnético (R1 a R4 solamente)
Rosa para frasquitos de 10 mL que no requieren agitador magnético
Verde para frasquitos de 4 mL que no requieren agitador magnético
Se utilizan adaptadores de frasquitos azules para las
posiciones adicionales en la charola de muestras.
• Coloque los agitadores magnéticos dentro de los
frasquitos de reactivos en las posiciones de reactivos r1
a R4, en caso necesario.
(Figura)
Adaptadores de Reactivos para las posiciones R1-R8 (ACL Elite) y R1-R12 (ACL Elite Pro)
2.8
(Figura)
Adaptadores de Reactivos para las posiciones A1-A10 de la Charola de Muestras
Adaptador para Copas Adaptador para Frasquitos
Emulsión de Lavado-Referencia
Coloque una botella de 1 litro de Emulsión de Lavado-
Referencia en la posición apropiada en la parte posterior del
bloque de diluyente. Introduzca el tubo de aspiración.
Asegúrese de que el conector del tubo de aspiración esté
debidamente conectado al dispositivo sensor de nivel.
(Figura)
Colocación de la botella de emulsión de lavado-referencia
Conjunto de electroválvulas-agujas
Verifique que los dos tubos provenientes del conjunto de
diluyente/electroválvulas al bloque de agujas estén
conectados de manera apretada.
2.9
(Símbolo)
NOTA: El tubo proveniente de la electroválvula de mano
izquierda se ajusta en el conector de aguja inferior y los
tubos de mano derecha se ajustan en el conector de aguja
superior.
(Figura)
Conjunto de electroválvulas-agujas
Colocación de la pantalla LCD – pantalla sensible al tacto
Conecte la pantalla LCD al accesorio apropiado en el lado
derecho del instrumento, como se muestra en la figura a
continuación.
(Figura)
Posición de la pantalla LCD
El monitor puede ajustarse para un ángulo de visión
izquierdo/derecho y hacia arriba/hacia abajo.
2.10
2.4 Encendido del Sistema
Antes de encender el instrumento, verifique que el ajuste del
voltaje de línea del laboratorio concuerde con la etiqueta
del instrumento. Conecte el instrumento a la fuente de
33
energía y enciéndalo con el uso del interruptor de energía en
el tablero posterior.
Verifique que el mensaje de Advertencia “TEMPERATURA DE
INCUBACIÓN FUERA DEL RANGO” aparezca en la pantalla mediante
acceso al icono de ADVERTENCIA. Verifique que los agitadores
magnéticos en los frasquitos de reactivos R1 y R4 estén
girando (en caso necesario).
Fecha/Hora
Seleccione Ajustar en la barra del menú de pantalla Principal
y haga clic en la opción de Fecha/Hora. Escoja el formato de
la fecha. Ajuste la fecha y la hora. Oprima
Confirmar/Cancelar para aceptar o hacer caso omiso de los
cambios (consulte la Sección 4-Ajuste de la Fecha/Hora).
(Símbolo)
NOTA: Se muestra el mensaje “TEMPERATURA DE INCUBACIÓN FUERA
DEL RANGO” en la lista de Advertencia durante 15 minutos
aproximadamente, hasta que el sujetador del rotor haya
alcanzado la temperatura de operación.
Conjunto del Brazo de Agujas
Consulte la Sección 5 para información acerca del
procedimiento de ubicación de las agujas.
Cebado
Seleccione Diagnóstico en la barra del menú de pantalla
principal y haga clic en la opción de Cebado.
Se muestra la pantalla de Cebado durante el ciclo de cebado.
2.11
(Figura)
Pantalla de Cebado
Durante el cebado, verifique que el número de burbujas en las
cámaras de diluyente se reduzca a un mínimo. En caso
necesario, pellizque a los tubos de salida de la cámara con
los dedos, mientras desciende el pistón y libérelas antes de
que el pistón llegue hasta el mero centro inferior. Repita
el ciclo de cebado en caso necesario.
Verifique que no haya bloqueos ni fugas en la trayectoria del
fluido y que el líquido fluya suavemente de la botella a los
diluyentes y de los diluyentes a las agujas.
Verifique que la descarga de líquido de la copa de enjuague a
la salida del instrumento y luego al contenedor de desechos
no se vea obstaculizada.
(Símbolo)
Advertencia: En caso de que aparezca el mensaje “FALLA DEL
SENSOR” en el área de Advertencias, debe repetirse el ciclo
de cebado.
Verificación del Sistema de Enfriamiento de Aire
34
Localice el sujetador del filtro de ventilación en el lado
derecho del instrumento. Verifique que el filtro esté limpio
y que los dos ventiladores estén funcionando debidamente.
2.12
Verificación de la Temperatura
Espere hasta que haya desaparecido la advertencia de
TEMPERATURA DE INCUBACIÓN FUERA DEL RANGO y que se muestre el
menú Principal. Haga clic en el botón de Diagnóstico en la
barra del menú y seleccione la opción de Control de
Temperatura, que abrirá a la pantalla de Control de
Temperatura. Para los detalles, consulte la Sección 5.
(Figura)
Pantalla de Control de Temperatura
La temperatura debe estar dentro de los siguientes rangos
para cada área:
• Sujetador de Rotor 38 a 39ºC
• Peltier* 10 a 16ºC
• Transportador de Rotor 34 a 40ºC (N/A ACL Elite)
• Pila de Rotores 34 a 40ºC
*ACL Elite Pro mostrará dos Peltiers para R1-R4 y R9-R12.
La indicación de temperatura se renueva constantemente y
muestra un efecto de centelleo en la pantalla.
2-13
Lector de Código de Barras a Bordo
Hay un elemento estándar para el ACL Elite/Elite Pro. Ajuste
el Lector de Código de Barras a Bordo de acuerdo con el
procedimiento que se describe en la Sección 4 de este Manual.
Para mayor información acerca del Lector de Código de Barras
a Bordo, consulte el Apéndice B.
Responsabilidad del Fabricante
El fabricante es responsable de los defectos que tengan un
impacto sobre la seguridad, la confiabilidad y el desempeño
del equipo, solamente cuando:
- las operaciones de ensamblaje, extensiones, reajustes,
modificaciones o reparaciones son llevados a cabo por el
personal autorizado del fabricante; y
- la instalación eléctrica cumpla con los requisitos
nacionales; y
- el equipo se utilice de acuerdo con estas instrucciones
de operación.
2.5 Cable de Interconexión del ACL – Computadora
Principal
La tabla siguiente proporciona información con respecto al
cableado del cable de interconexión entre el ACL y una PC
(principal).

Lado ACL Lado PC


35
Tipo de Interfaz: DTE Tipo de Interfaz: DTE
Conector Delta Hembra de 9 Pins Conector Delta Hembra de 9 Pins
PIN DESCRIPCIÓN PIN DESCRIPCIÓN
1 N.C 1 N.C
2 TXD 2 TXD
3 RXD 3 RXD
4 DTR 4 DTR
5 Señal GND 5 Señal GND
6 DSR 6 DSR
7 RTS 7 RTS
8 CTS 8 CTS
9 N.C. 9 N.C.

3.1
3 Operaciones Analíticas
3.0 Introducción
Esta Sección describe los diferentes procedimientos
relacionados con los análisis de las muestras, la calibración
y el Control de Calidad (Q.C. por sus siglas en idioma
inglés) en el Sistema ACL Elite/Elite Pro. Como estos
procedimientos requieren una interacción del operador con el
ACL, esta Sección comienza con cierta información general
acerca de la Interfaz con el Operador del Sistema (OI) para
consulta fácil, según surja la necesidad.
3.1 Componentes y Uso de la Interfaz del Operador
Las subsecciones siguientes tienen como finalidad
familiarizar al operador con los elementos de la Interfaz del
Operador (OI) que se utilizan durante el proceso de solicitar
y efectuar las operaciones analíticas, tales como los
dispositivos de entrada de datos, los elementos del menú, los
botones y los iconos. Se incluye también el árbol del
software del ACL Elite/Elite Pro
3.1.1 Pantalla Sensible al Tacto
La interacción básica con el ACL se efectúa por medio de
menús que permiten acceso a los conjuntos de funciones
relacionadas (análisis, calibración, control de calidad,
ajuste, diagnóstico, etc.) y por medio del uso de cuadros de
diálogo o mensaje para introducir o recuperar información.
El dispositivo de entrada de información principal es la
pantalla sensible al tacto. Para iniciar una acción de
“introducir” o “editar”, el operador toca el área que va a
editarse. Cuando la información que va a introducirse sea
estrictamente numérica, la edición se efectúa directamente en
el teclado o teclado numérico desplegable (configuración del
sistema optativa). Cuando la información requiere caracteres
alfanuméricos, se efectúa la introducción por medio del
teclado externo.
La acción de edición puede cerrarse oprimiendo los botones de
“Confirmar”  o de “Cancelar” .
36
Una vez que se complete la confirmación, el sistema efectúa
una verificación automática sobre el valor introducido; en
caso de que se detecte una introducción errónea, se notifica
al usuario por medio de cuadros de diálogo y se reactiva la
acción de edición. La pantalla sensible al tacto soporta
funciones de repetición automática a fin de hacer que las
listas sean más fáciles de desplazarse (por ejemplo, listas
de muestras, listas de pruebas, orden creciente/decreciente).
La Pantalla de Base de Datos Principal se divide en tres
áreas principales:
1. Área de estado: Parte superior de la pantalla, que
contiene:
Estado del instrumento Fecha y Hora
Usuario actual Revisión de software
Logotipo de IL
3.2
2. Área de trabajo: Área central de la pantalla, que
muestra ventanas que contienen datos o mensajes.
3. Área de la barra de herramientas: Parte inferior de la
pantalla, que contiene una serie de botones para acceso
inmediato a funciones en particular y acceso fácil a
comandos específicos. El estado de los botones depende
del estado del instrumento, pero es independiente del
tipo de información mostrada en el área de trabajo.
(Símbolo)
NOTA: En la pantalla sensible al tacto, cualquier objeto
desactivado (menú, cuadro a marcar, icono, botón) se opaca y
no puede seleccionarse.

3.1.2 Teclado Numérico


El teclado numérico permite que el operador edite datos
numéricos sin usar el teclado de PC estándar. El teclado
numérico puede configurarse para mostrar automáticamente
cuando el usuario comienza una acción de edición (consulte la
Sección 4.1.17). El teclado numérico permite que el operador
visualice la secuencia editada, mientras la edición está en
proceso. El teclado numérico desaparece automáticamente
cuando se seleccionan los botones de “Confirmar”  o de
“Cancelar”  o se cierra la acción de edición
implícitamente.
El teclado numérico muestra el nombre del campo que se está
editando como una leyenda de ventana y la información sobre
los valores del rango aceptados; soporta también el formato
de fecha.
Cuando se abre el teclado numérico, los valores que se
muestran en los campos son los valores por omisión o los
37
valores introducidos anteriormente. Utilice los botones de
flechas para seleccionar el campo que va a editarse.
3.3
3.1.3 Teclado de PC Estándar
La función principal del teclado de PC es introducir y editar
datos en los campos alfanuméricos. La entrada del teclado es
sensible al caso.
Para comenzar la acción de edición, seleccione el campo que
va a editarse. Se efectúa lo anterior moviendo el cursor del
objeto actual (puede ser el objeto por omisión cuando la
ventana se acaba de abrir) al objeto escogido oprimiendo
[TAB] o [Shift]+[TAB].
Para cerrar la acción de edición del cuadro de texto actual,
oprima [Enter] o seleccione otro objeto activo, o mueva el
cursor oprimiendo las teclas de [TAB] o [Shift]+[TAB]. En
todos los casos, el cierre de la acción de edición ocasiona
que el sistema active las verificaciones sobre los datos
introducidos y se notifica al usuario acerca de cualquier
condición de error por medio del cuadro de diálogo. Cuando
se ha cerrado la acción de edición (tocando un área diferente
de la pantalla), el valor introducido cambia por el existente
previamente.
La acción de edición del cuadro de texto actual puede también
cerrarse oprimiendo la tecla de [ESC], sin activar ningún
cambio; en este caso, el valor regresa al existente
previamente.
Los menús principal y secundarios pueden seleccionarse
mediante el uso del teclado. Los menús se abren oprimiendo
[ALT] + el Caracter subrayado; las selecciones dentro de los
menús se efectúan con el uso del caracter subrayado
específico. Al oprimir la tecla de [INTRODUCIR], se permite
el acceso a los menús secundarios.
Las teclas de funciones del teclado (F1-F10) pueden
utilizarse también para activar las funciones en la hilera
inferior de iconos. Utilice [Ctrl] + F4 para salir del
teclado.
3.4
3.1.4 Lector de Código de Barras Externo (optativo en el ACL
Elite)
Los puertos USB permiten la conexión de un lector de código
de barras externo, que puede sujetarse con la mano. Este
dispositivo puede usarse para identificar reactivos e indicar
su colocación a bordo del sistema. Consulte la sección
1.4.16.
3.1.5 Puerto 2 de Ratón
Puede utilizarse un ratón serial como dispositivo señalador
en lugar de tocar la pantalla. Los puertos USB proporcionan
38
también la capacidad para conectar un ratón USB con el
analizador.
3.1.6 Menús
Puede abrirse un menú seleccionando el área apropiada de la
pantalla (toque o haga clic con el ratón) o utilizando el
teclado: [ALT] + letra subrayada.
La selección de menús que van a abrirse puede efectuarse en
todas las direcciones: hacia arriba y hacia abajo, o a la
derecha y a la izquierda.
Los conceptos mostrados, que tienen un menú secundario, se
identifican con un marcador (Símbolo).
Al seleccionar un elemento del menú y tocar un área externa,
u oprimir [ESC] en el teclado estándar, se cierra un menú.
(Símbolo)
NOTA: En cualquier menú, un elemento inactivo se opaca. La
selección de un elemento inactivo no produce una respuesta;
por lo tanto, este método no puede emplearse para salir del
menú.
3.1.7 Ventanas y Cuadros
Dentro de las pantallas del ACL, los datos, la información o
los mensajes para el usuario están agrupados o contenidos en
unidades definidas de tres tipos diferentes:
• Ventana estándar: generalmente un área más grande que
contiene conjuntos de datos relacionados, que pueden ser
editados por el usuario.
• Cuadro de diálogo: un área pequeña que se utiliza para
indicar al usuario que escoja una de varias opciones (es
decir, OK, Abortar, Volver a Intentar, Hacer Caso Omiso,
Cancelar, Sí, No).
• Cuadro de mensaje: un área utilizada solamente para
proporcionar información-
Se incluyen con frecuencia ICONOS en un cuadro de
mensaje. La tabla a continuación incluye a todos los
iconos posibles con sus significados correspondientes.
3.5
Icono Significado
(Icono) ERROR. Llama la atención para fallas de alta
prioridad y mensajes de falla.
(Icono) ADVERTENCIA. Envía diferentes tipos de
mensajes, es decir, para advertir al usuario
acerca de una operación “no permitida
/errónea”, o problemas/errores detectados por
el instrumento durante una operación o
después de la misma.
(Icono) PREGUNTA. Solicita confirmación por el
usuario antes de comenzar una operación o
antes de cancelar una acción.
39
(Icono) INFORMACIÓN. Ofrece información general. En
algunos cuadros, pero no siempre, después del
mensaje aparece una solicitud de confirmación

3.1.8 Elementos Clave de la Pantalla


Se incluyen a continuación las descripciones de los elementos
más significativos que se encuentran en las pantallas del
ACL.
• Estado del Instrumento
Situado en la parte superior de la pantalla, dentro del área
de Estado, este elemento identifica el estado actual del
instrumento como uno de los siguientes:
INIT (INIC) (CARGA/ARRANQUE): indica que el instrumento está
efectuando las operaciones de arranque (inicialización).
READY (LISTO): indica que no se han detectado errores, no hay
ningunas operaciones analíticas en proceso y el instrumento
está listo para comenzar.
OPERATING (EN OPERACIÓN): indica que una función analítica
está en proceso (es decir, calibración o análisis de
muestra), o se está efectuando una función de diagnóstico.
HOLD (RETENER): identifica una condición de “pausa” del
sistema durante una sesión analítica (es decir, solicitud
STAT, ningunos rotores, etc.).
FAILURE (FALLA): indica que el sistema detectó un mal
funcionamiento mecánico (dispositivos, control de
temperatura, etc.).
STAND-BY (EN ESPERA): el estado al que el instrumento se
desplaza automáticamente después de 30 minutos de
inactividad. La pantalla LCD se apaga (protector de
pantalla); lo anterior prolonga la vida de la LCD. Un LED
anaranjado indica que el instrumento está ENCENDIDO. Tocar la
pantalla o cualquier tecla del teclado, hará que el
instrumento salga de standby.
(Símbolo)
NOTA: cuando el instrumento se encuentra en operación de
espera, se efectúa un ciclo de cebado cada 30 minutos. El
consumo de la Emulsión de Lavado-Referencia es de 0.9 mL
aproximadamente (3 carreras por diluyente de pistón
individual – total de 6 carreras, cada carrera individual de
0.15 mL).
3.6
SERVICE (SERVICIO): el estado que asume cuando las funciones
de Servicio están en uso.
• Cuadros de Marcado, Botones e Iconos
Los botones permiten que el usuario seleccione opciones, haga
que se efectúen acciones y vaya de un lado del software a
otro. Los botones están ubicados en áreas diferentes,
40
dependiendo de la pantalla. Los botones se identifican con un
texto que explica la acción por sí solo. Los iconos, que
ilustran a la acción, se definen a continuación.
Los cuadros de marcado permiten que el usuario “marque” un
elemento.
Cuando un cuadro de marcado o botón es excluyente de otro
cuadro de marcado o botón, hay un marco que encuadra a los
dos, junto con una información “gráfica”.
• ICONOS
Los iconos pueden encontrarse en el Área de Trabajo media de
la pantalla o se alinean en el Área de la Barra de
Herramientas en la parte inferior de la pantalla.
Se incluyen a continuación dos listas que agrupan a los
iconos estándar que se utilizan en todo el ACL Elite/Elite
Pro, junto con sus comandos asociados. La primera incluye a
los Iconos de Ventana que se encuentran en el Área de Trabajo
de la pantalla, y la segunda incluye a los Iconos de la Barra
de Herramientas que se encuentran en el Área de la Barra de
Herramientas de la pantalla.
NOTAS:
1. El mismo icono puede tener un significado ligeramente
diferente, dependiendo de la pantalla en donde se encuentra.
2. Uno o más de éstos pueden estar inactivados en una
pantalla específica, lo que se indica mediante una
representación opaca. Se hace caso omiso de su selección.
3. Los botones “activos” de la barra de herramientas,
correspondientes a cada pantalla específica y a sus acciones,
se describen al final de cada sección apropiada de este
Manual.
41
3.7
Tabla – Iconos de Ventana
Iconos de ventana Comando/Acción
(Icono) Confirmar (Atenuado cuando no se
permite la acción de Editar)
(Icono) Cancelar
(Icono) Imprimir
(Icono) Transmitir (Computadora Principal)
(Icono) Suprimir
(Icono) Añadir un concepto a la lista
(Icono) Eliminar un concepto de la lista
(Icono) Transferir un concepto de una lista a
otra
(Icono) Detalles
(Icono) Información en diferentes idiomas
(Icono) Nueva Muestra
(Icono) Extracción de Datos de la Muestra
(Icono) Nota
(Icono) Nombre del Paciente
(Icono) Detalles del Paciente
(Icono) Guardar la información en disco
flexible

3.8
Tabla – Iconos de la Barra de Herramientas
Iconos de la Barra de Comandos/Acciones Estado del Instrumento
Herramientas (Icono activo)
(Icono) STAT/Pausa Operando
Pone en pausa el sistema para Retener
introducción de la muestra o
stat.
(Icono) Estado del Instrumento Operando
Estado de la operación en Listo
proceso. Muestra el mapa de Retener
materiales en Listo
(Icono) Cerrar/Abrir cubierta Listo
Retener
(Icono) PARO Listo
Se requiere confirmación Operando
Retener
(Icono) Mapa del Reactivo Operando
Cambian los colores
dependiendo del estado del
mapa del reactivos.
(Icono) Control de Calidad Listo Retener
Oprima para ver los datos de Operando
42
Control de Calidad más Falla
recientes. El rojo indica una
falla en el Control de Calidad

Iconos de la Barra de Comandos/Acciones Estado del Instrumento


Herramientas (Icono activo)
(Icono) Vista de la Base de Datos Listo
Regresa a la vista de la base Operando
de datos o pantalla “Principal” Retener
(Icono) Condición de la Computadora Listo Retener
Principal Operando
Comunicación con la Falla
computadora principal en
proceso
(Icono) Advertencia Listo Retener
Este icono indica la existencia Operando
de Advertencias. Oprima para Falla
abrir la “Lista de Advertencias”
(Icono) Salida Listo
Permite que el operador Salga Falla
de la pantalla.
Se requiere confirmación
(Icono) Inicio o Reanudación de la Listo Retener
Corrida

3.9
3.1.9 Una Ventana Especial para Alarmas y Errores
En caso de que se presente una situación anormal y ocasione
una interrupción durante el avance de una operación, se
informa al operador por medio de un mensaje de alarma en un
cuadro de mensaje específico. El cuadro de mensaje se
muestra al frente de todas las demás ventanas presentes en el
área de trabajo. Después de que el operador confirma el
mensaje, puede verse la información acerca de la alarma en
esta ventana de advertencia.
Las condiciones de error que no afectan a la sesión analítica
en proceso, pueden revisarse mediante acceso a “Historia de
Errores de la Sesión”. El operador puede ver una lista de
todas las advertencias y mensajes de error, clasificados por
tiempo, que corresponden a la última sesión analítica o a la
que está en proceso. La Historia de Errores de la Sesión se
guarda al concluir cada sesión analítica, de manera que
pueden verificarse los errores entre las sesiones analíticas.
La ventana de “Historia de Errores del Archivo” contiene una
lista, clasificada por tiempo, de las últimas 100 alarmas o
condiciones de error. Las ventanas de “Historia de Errores
de la Sesión” y de la “Historia de Errores de Archivo” se
43
actualizan dinámicamente cuando se abren y deben cerrarse
cuando se comienza una nueva operación.
3.1.10 Protector de Pantalla
La condición en blanco de la pantalla se activa después de 30
minutos de inactividad del sistema, con la condición de que
el sistema ACL se encuentre en el estado de LISTO. El
operador no puede modificar este tiempo. Cualquier acción
efectuada en la pantalla sensible al tacto, por medio del
teclado o el lector de código de barras, reactivará al
sistema.
3.1.11 El Árbol de Software de ACL Elite / Elite
Pro
La página siguiente muestra la estructura de la interfaz del
Operador del ACL Elite/Elite Pro – o Árbol de Software del
sistema – que incluye al menú principal y los submenús de
primero y segundo niveles.
3.10
Árbol del Software de ACL Elite/Elite Pro
Menú Submenú de Primer Nivel Submenú de Segundo Nivel
ANÁLISIS Sesión de Múltiples Pruebas
Sesión de Una Sola Prueba
Lista de Carga
Historia de la Sesión

CONTROL DE CALIDAD Revisión de Control de


Calidad

CALIBRACIÓN Calibrar
Revisar Calibraciones
Referencia Analítica

DIAGNÓSTICO Cebado
Limpieza
Mantenimiento
Control de Temperatura
Posición de las Agujas
Historia de Errores de la
Sesión
Historia de Errores del Archivo
Registro
Servicios (atenuado)

AJUSTE Pruebas Ver/Definir


Clasificar Pruebas
Grupo de Pruebas
Tabla de Interferencias
44
Pruebas por Omisión
Pruebas Reflejas

Múltiples Pruebas Perfiles


Grupos de Pruebas
Perfiles de los Grupos de
Pruebas
Clasificar Múltiples Pruebas

Menú Submenú de Primer Nivel Submenú de Segundo Nivel


Múltiples Pruebas por Omisión
Líquidos
Interfases Computadora Principal
Impresora
Código de Barras Interno
Código de Barras Externo
Teclado
Red (opaca)
Módem (atenuado)
Configuración del Sistema
Seguridad
Alarmas Audibles
Fecha/Hora
Unidades

3.11
Menú Submenú de Primer Nivel Submenú de Segundo Nivel
UTILIDAD Actualización de Biblioteca IL
Respaldar/Restaurar
Archivar
Software Identificación del SW
Actualización del SW (#)
Guardar Último Mapa de
Rotores
Guardar Trazo
Prueba/Material Respaldo
Subir
Depurar (atenuado)
Probar (atenuado
(#) La actualización de SW se divide en SW Amo, SW esclavo y
SW REM.
45
3.2 Análisis de las Muestras
La Sección 3.2.1 y las siguientes contienen descripciones
detalladas de las pantallas, las opciones y los pasos
implicados en el proceso de análisis de las muestras en el
ACL Elite/Elite Pro.
El ACL proporciona 2 modos para correr las muestras. Prueba
Única y Múltiples Pruebas. Dentro de cada uno de éstos, se
considera que una “sesión” representa el total de todas las
“corridas” de las pruebas individuales. Por ejemplo, cuando
se utiliza el perfil de PT-APTT y hay 20 muestras por
procesar. Cada muestra contiene a ambas pruebas. Por lo
tanto, la “Sesión” estaría compuesta por 4 “Corridas” de
prueba, 2 corridas para PT y 2 corridas para APTT, dado que
el número máximo de muestras por corrida es de 19 para las
pruebas de PT y APTT.
El ACL permite una variedad de opciones para introducir la
información acerca de la identificación de la muestra en el
sistema, antes del análisis, dependiendo de los
procedimientos del laboratorio y el ajuste del sistema. Para
aquellos usuarios que ya están familiarizados con la Interfaz
del Operador con el ACL, la Sección 3.2.1 incluye protocolos
de análisis de muestras resumidos a seguir, dependiendo del
modo de introducción de la identificación de la muestra.
3.2.1 Procedimientos de Análisis de las Muestras – Resumen
Introducción Manual de la Identidad de la Muestra – Lista de
carga originada antes del Análisis.
1. Seleccione Análisis
2. Seleccione la Lista de Carga
3. Seleccione la Lista de Carga deseada (vacía); haga clic
en el icono de detalles.
4. Haga clic en el botón de Introducir/Editar la
Identificación de la Muestra.
5. Teclee la Identificación de la Muestra; utilice ? para
desplazarse a la siguiente posición o Confirmar cuando se
hayan introducido todas las identificaciones de las
muestras.
6. En caso de que se deseen Pruebas por Omisión para la
lista, no programe muestras para pruebas individuales.
Haga clic en el botón de “Ajustar Prueba por Omisión”.
7. Haga clic en el botón de Programar Prueba.
8. Programe Pruebas/Múltiples Pruebas para la muestra
haciendo clic en la selección de prueba deseada en la
matriz de Pruebas. La selección se mostrará en la lista
de pruebas Programadas. Pueden hacerse correcciones
haciendo clic en la selección de pruebas nuevamente para
dejar de seleccionar en caso de que las pruebas/perfiles
deseados fueran iguales que para la muestra anterior;
46
haga clic en el botón de Prog. Prev. Oprima ? para pasar
a la siguiente posición de la lista de carga o Confirmar
cuando se complete.
3.12
9. Haga clic en el botón de Confirmar: La Fecha y la Hora
están asociadas al Número de la Lista de Carga y el
sistema efectúa la conmutación a la pantalla de Lista de
Carga.
10. Haga clic en el botón de Confirmar: El sistema efectúa la
conmutación a la pantalla Principal. Las muestras
introducidas se indican en la base de datos.
11. Seleccione Análisis; escoja a continuación Múltiples
Pruebas o Prueba Única.
12. Haga clic en el cuadro de No. de Lista de Carga e
introduzca el número de la lista de carga.
13. En caso de que no se hayan ordenado previamente las
pruebas para la muestra (paso 6) o que no se deseen las
pruebas por omisión, haga clic en el botón de Programar
Muestra. Seleccione la prueba que se va a correr y
oprima el ? para pasar a la siguiente muestra de la Lista
de Carga o Confirmar cuando se complete.
14. Verifique que la selección de la prueba actual sea la
elegida; confirme el mapa de materiales y haga clic en el
icono de Corrida.
15. Durante el Análisis, se muestra la pantalla de Reporte de
la Sesión. Se indica la secuencia de las pruebas. En
esta pantalla, el Mapa de Materiales y la Historia de
Errores están disponibles.
Introducción Manual de la Identificación de la Muestra
1. Seleccione Análisis.
2. Seleccione la Sesión de Múltiples Pruebas o la Prueba
Individual.
3. Con el cursor en la primera posición de la charola de la
Lista de Carga, haga clic en el botón de Programar
Muestra. Puede añadirse el Control de Calidad haciendo
clic en el botón de Añadir Control de Calidad.
4. En la pantalla de Introducción de la Muestra, introduzca
la Identificación de la Muestra y seleccione las Pruebas
que Van a Correrse.
5. Haga clic en el icono de la “Nueva Muestra” para entrar
en la siguiente posición e introduzca la Identificación
de la Siguiente Muestra.
6. En caso de que las pruebas que van a correrse sean
iguales a las anteriores, haga clic en el botón de Prog.
Prev.; en caso de que sean diferentes, seleccione una
Nueva Prueba.
47
7. Repita los pasos 6 y 7 hasta que se introduzcan todas las
muestras y pruebas.
8. Haga clic en el botón de Confirmar para aceptar los
cambios; el sistema efectúa la conmutación a la pantalla
Previa al Análisis para la Prueba Única (en caso de que
se haya seleccionado una prueba única) o a la pantalla
Previa al Análisis de las Múltiples Pruebas (en caso de
que se hayan seleccionado múltiples pruebas).
9. Las posiciones de la charola se mostrarán con azul oscuro
con la letra P (Pendientes).
10. Oprima el botón de Guardar Lista de Carga y entre en un
número de la lista de carga.
11. Una vez que las muestras se encuentren en la charola de
muestras, confirme los materiales y haga clic en Correr.
Introducción Manual de la Identificación de la Muestra –
Lista de Carga originada en el menú de la Base de Datos.
1. Haga clic en el icono de Nueva Muestra.
2. Introduzca la Identificación de la Muestra.
3. Seleccione la Prueba que va a programarse.
4. Repita los pasos 1, 2 y 3 hasta que se introduzcan todas
las muestras.
5. Después de programar la última muestra, haga clic en el
botón de Confirmar. El sistema efectúa la conmutación de
regreso a la pantalla Principal. Las muestras
introducidas se indican y marcan con una P (Pendientes)
en el área de “Solicitud de Prueba”; las pruebas
solicitadas se marcan con ?
6. Seleccione Análisis.
7. Seleccione Lista de Carga.
8. Haga clic en el botón de Hacer Lista de Carga.
9. Introduzca el Número de la Lista de Carga para comenzar
(1-20); por omisión es 1 y el Número de muestras por
Lista de Carga (1-40); por omisión es 40.
10. Haga clic en el botón de Pendientes (selección de “Todas”
o “Pruebas”). Puede entonces seleccionarse un cierto
rango de “Fecha y Hora”, junto con un rango de
“Identificación de la Muestra”.
11. Un método alterno es hacer clic en Marcar Muestras y
seleccionar las Identificaciones de las Muestras de la
Base de Datos de las Muestras.
3.13
12. Haga clic en el botón de Confirmar. El sistema efectúa
la conmutación de regreso a la pantalla de Lista de Carga
que muestra a la Fecha y Hora cuando se guarda la lista
de carga.
13. Haga clic en el botón de Confirmar. El sistema efectúa
la conmutación de regreso a la pantalla Principal.
48
14. Seleccione Análisis.
15. Seleccione Sesión de Múltiples Pruebas o Prueba Única.
16. Haga clic en el cuadro de No. de la Lista de Carga e
introduzca un número válido de la Lista de Carga.
17. Una vez que las muestras estén en la charola de muestras,
confirme los materiales y oprima Correr.
Introducción de la Identificación de la Muestra mediante
códigos de barra – ninguna conexión a una computadora
principal
1. Seleccione Análisis.
2. Seleccione Sesión de Múltiples Pruebas o Prueba Única.
3. Coloque las muestras en la charola de muestras.
4. Seleccione Leer Códigos de Barra y el instrumento
originará la lista de carga con el uso del lector de
código de barras.
5. Haga clic en Programar Muestra y seleccione la Muestra
que va a correrse.
6. Haga clic en el botón de “” para pasar a la
identificación de la muestra de la siguiente posición.
7. En caso de que las pruebas que van a correrse sean
iguales a las de antes, haga clic en el botón de Prog.
Prev.; en caso de que sean diferentes, seleccione una
nueva Prueba. Repita el paso 6 o cuando se complete,
haga clic en el botón de Confirmar.
8. Confirme el Mapa de Materiales y oprima el icono de
Correr.
9. Durante el Análisis se muestra la pantalla de Reporte de
la Sesión. Se indica la secuencia de las pruebas. El
Mapa de Materiales y la Historia de Errores están
disponibles en esta pantalla.
Introducción de la Identificación de la Muestra mediante
código de barras – conexión a una computadora principal (modo
de pregunta a computadora principal)
1. Seleccione Análisis; seleccione las Múltiples Pruebas o
la Prueba Única que se desee.
2. Confirme el mapa de reactivos y haga clic en el icono de
Correr (el instrumento efectuará la Pregunta a la
Computadora Principal y procederá al análisis).
3. Durante el Análisis, se muestra la pantalla de Reporte de
la Sesión. Se indica la secuencia de las pruebas. El
Mapa de Materiales y la Historia de Errores están
disponibles en esta pantalla.
Introducción de la Identificación de la Muestra por códigos
de barra – conexión a una computadora principal (modo de
Pregunta a Computadora Principal) – Múltiples Pruebas por
Omisión
49
1. Coloque las muestras con códigos de barras en una charola
de muestras. En la pantalla de base de datos principal,
haga clic en el icono de Correr (el instrumento efectuará
la Pregunta a la Computadora Principal y procederá al
análisis).
Nota: Es importante asegurarse de que las posiciones de
los Reactivos a bordo del analizador estén ajustadas con
los reactivos correctos colocados para esta opción. No
hacerlo así, puede dar por resultado que las pruebas
corran con un reactivo inapropiado. Consulte la pantalla
de Ajuste del Perfil para ver el mapa de materiales para
el perfil por omisión.
3.14
El ACL Elite/Elite Pro puede procesar hasta 40 muestras en
una sola sesión (con inclusión de pruebas Reflejas)
programadas con un número de pruebas, mientras se hacen
óptimas las posiciones de las cuvetas dentro de los rotores.
A medida de que se completan las posiciones en la charola de
muestras, pueden sustituirse por nuevas muestras en estas
posiciones. Se logra lo anterior con el uso del Icono de
Stat/Pausa. Los reactivos y las muestras (de las copas o
contenedores originales) se aspiran automáticamente y son
surtidos por el brazo de agujas. Los rotores se cargan y
descargan automáticamente, lo que permite un sistema completo
para alejarse del ACL Elite Pro. El ACL Elite indicará al
usuario cuándo se requiere un nuevo rotor para análisis.
3.2.2 Modos de Análisis de las Muestras
El proceso de análisis de las muestras comienza en la
pantalla Principal al seleccionar Análisis en la barra del
menú. Las 2 opciones que se proporcionan en la pantalla de
Análisis para procesar las muestras son MÚLTIPLES PRUEBAS y
PRUEBA ÚNICA. Además, el icono de “Correr” en la base de
datos principal dará comienzo a una corrida con el uso del
ajuste de Múltiples Pruebas por omisión.
• Múltiples Pruebas: Esta opción permite procesar múltiples
pruebas de una manera de acceso aleatorio en las muestras
en la charola. Los grupos de pruebas son definidos por
el usuario y se configuran de acuerdo con el menú de
Ajuste. Los grupos de múltiples pruebas pueden estar
compuestos por una o más pruebas únicas (perfil) o uno o
más grupos de pruebas (perfil de grupo de pruebas).
• Prueba Única: Esta opción configurará al sistema para
procesar únicamente la prueba única seleccionada para
análisis. Cuando las muestras de la charola tienen
múltiples pruebas programadas para ellas, se analizará
solamente la prueba seleccionada y las pruebas no
procesadas permanecerán pendientes para una muestra.
50
Pantalla DE ANÁLISIS DE UNA PRUEBA ÚNICA
(Ilustración)
3.15
Pantalla DE ANÁLISIS DE MÚLTIPLES PRUEBAS
(Ilustración)
(Símbolo)
Notas:
• El menú descendente de Pruebas Múltiples Actuales
incluirá a la lista de los perfiles, los grupos de
pruebas y los perfiles de los grupos de pruebas
disponibles en el orden seleccionado por la función de
clasificación de múltiples pruebas.
Estas 2 pantallas de análisis contienen múltiples ventanas y
botones asociados:
1. El área superior izquierda: la ventana de Múltiples
Pruebas o Prueba Única Actuales muestra la selección que se
correrá en la sesión analítica actual. La selección puede
cambiarse oprimiendo el botón de () a la derecha de la
ventana y navegando a través de la lista mostrada; debe
confirmarse la decisión oprimiendo el mismo botón. El
objetivo principal de esta pantalla es activar el mapa de
Materiales, dado que la programación del mapa depende de la
selección Actual mostrada.
Los () que se muestran antes de los nombres de los grupos
de pruebas tienen el significado siguiente:

 Grupo de Prueba Única


 Sesión de Múltiples Pruebas compuestas por
 pruebas únicas

  Sesión de Múltiples Pruebas compuestas por


  Grupos de Pruebas

Puede hacerse clic en el botón para Dejar de Seleccionar


Pruebas (disponible en la Pantalla de Análisis de Múltiples
Pruebas solamente) para abrir la ventana de Detalles de las
Múltiples Pruebas. Esta...
3.16
...pantalla permite que el operador deje de seleccionar la
corrida de una (o más) de las pruebas, con todas las
muestras, las Múltiples Pruebas incluidas.
Al hacer clic en el botón de la Lista de Materiales en la
parte inferior izquierda de la pantalla, se abre la lista de
materiales requerida para el análisis.
Al hacer clic en el botón de Mapa de Materiales, se abre la
ventana Previa al Análisis: Estado de los Materiales, como se
51
muestra a continuación (para los detalles consulte la Sección
3.2.3).
(Ilustración)
2. Área de en medio: Las dos ventanas en la parte media de
la pantalla Previa al Análisis Seleccionada (consulte la
pantalla en las páginas 3.14 y 3.15) contienen la información
acerca de la programación de las muestras. El círculo en la
parte izquierda, dividido en 4 cuadrantes, se utiliza para
seleccionar una región en la charola de muestras. El
cuadrante seleccionado actual se muestra en amarillo y se
hace resaltar. La ventana a la derecha muestra el estado de
las 10 muestras dentro del cuadrante seleccionado. El color
del círculo proporciona información acerca del estado de la
muestra. Además del color, el círculo puede contener una
letra o símbolo que proporciona detalles adicionales acerca
del tipo de muestra. La tabla siguiente contiene detalles
acerca de los colores y las letras de tipo de muestra.
3.17
Color Estado Letra/Símbolo Estado
Gris Vacío
Disponible
+ Stat

Azul Claro Ningunas pruebas Programadas


Programadas P A Bordo

Azul Oscuro Programadas, pero Completo


no se correrán en C
esta sesión
Lavanda La muestra tiene No Programado
una prueba que N
coincide con la
corrida actual
Verde Completado en una Control de Calidad
sesión anterior o QC
actual
Anaranjado Pendiente, pero se  Copa vacía en
procesará en la posición
sesión

Amarillo Advertencia o Error (Reloj de Arena)


de Identificación de Procesamiento de
la Muestra
X muestra

Muestra no
52
 identificada

Los círculos estarán coloreados y contendrán también un


círculo. Los ejemplos incluyen:
(Ilustración)
1-2: Stats Programado
3-4: Rutina Programada
5: Muestra Completada
6: Pruebas No Programadas
7: Muestra No Identificada
8: Muestra de Control de Calidad
9: Posición Vacía
10: Copas 0.5 en Posición
3.18
Al hacer clic en un círculo de posición, se mostrará la
información acerca de la muestra.
(Ilustración)
#: Posición en la charola de muestras
+: Prioridad de la Muestra – Stat indicado por !
S: Estado de las Pruebas (P, C o N)
• P – Pendientes: A una o más pruebas les falta un
resultado.
• C – Completas: Se han analizado todas las pruebas
programadas para la muestra.
• N – Ninguna Prueba: A la Identificación de la Muestra no
se le ha ordenado ninguna prueba.
F: Indicadores asociados a esa muestra.
Las muestras que se detectan como cortas se indican con color
amarillo con L. No se efectuarán ningunas pruebas
adicionales en esta posición de la muestra durante esta
sesión. Cuando se reabastece la muestra, debe moverse la
muestra a una posición diferente en la charola si se desea el
procesamiento en la sesión actual.
La ventana pequeña en la parte superior izquierda, Mapa de la
Charola de Muestras, permite mostrar el botón de Leer Código
de Barras. La ventana de No. de la Lista de Carga permite
que el operador origine una nueva lista de carga o que
seleccione una guardada. Para crear una nueva, introduzca el
número de Lista de Carga (1-20) que no esté actualmente
definido para las muestras. Consulte la sección 3.2.4 para
los detalles de la lista de carga. Para modificar una lista
de carga, oprima el botón de Guardar Lista de Carga para
guardar los cambios.
El operador escoge la manera de programar las muestras de
acuerdo con el modo de introducción deseado de la
identificación de la muestra (consultar la sección 3.2.1):
53
- Introducción Manual en el menú de “Análisis”
- Introducción Manual en el menú de “Lista de Carga”
- Introducción Manual en el menú de “Base de Datos”
- Uso de muestras con código de barras, ninguna conexión
con la Computadora Principal.
- Uso de muestras con código de barras, con conexión, modo
de Pregunta a Computadora Principal.
• Al hacer clic en el botón de Leer Códigos de Barra, se
activa la rotación de la charola de muestras. Durante la
rotación, el lector de código de barras y el lector de la
posición de la copa/tubo de las muestras identifican a
una copa/tubo colocados en la charola, junto con la
identificación de las muestras mediante la lectura de los
códigos de barra. Cuando hay muestras con código de
barras presentes y los códigos de barras son legibles,
sus Identificaciones de Muestras correspondientes se
indican en la ventana grande. Cuando se identifica que
una copa o tubo está en su lugar y el sistema no puede
leer la etiqueta del código de barras, se presenta al
operador una advertencia de “Error en la Identificación
de la Muestra”. En caso de que ocurra lo anterior,
verifique la posición del tubo para asegurarse de que la
etiqueta de código de barras esté orientada de manera
apropiada y, a continuación,...
3.19
...haga clic en el botón de Leer Código de Barras
nuevamente. Indicadores de la lectura del Código de
Barras: (No_R) – Identificación de Muestra faltante,
(Dpl) – Identificación de Muestra duplicada, (No_C) –
Identificación de Muestra trunca, (Inv) – Identificación
de Muestra inválida. Una etiqueta de identificación que
no puede ser leída por el lector, puede introducirse
manualmente seleccionando la posición de la Lista de
Carga y oprimiendo el botón de Editar Identificación de
la Muestra. Consulte la sección 6.5 para información
acerca de la localización de fallas del código de barras.
• El botón de Lista de Carga mostrará el estado de las 20
Listas de Carga.
• El botón de Guardar Lista de Carga guarda los cambios en
la lista actual.
• Al hacer clic en el botón de Añadir Control de Calidad en
la parte inferior de la pantalla, se abrirá la pantalla
de Control de Calidad. Efectúe el despliegue descendente
de la lista y seleccione el líquido de Control de Calidad
deseado que se procesará en la posición actual de la
copa. Oprima confirmar (v) para aceptar.
(Ilustración)
54
• Al hacer clic en el botón de Editar Identificación de la
Muestra, aparece una ventana que permite que el operador
teclee la identificación de la muestra. Pueden
introducirse hasta 16 dígitos alfanuméricos por medio del
teclado estándar o hasta 16 dígitos numéricos con el uso
del teclado numérico de la pantalla. Utilice ? para
introducir identificaciones adicionales en posiciones
subsiguientes en la charola de muestras.
• Una vez que se hayan tecleado 10 números, al hacer clic
el botón de Confirmar se aceptan todas las
identificaciones y se regresa a la Pantalla Previa al
Análisis Seleccionada. Para regresar a la Pantalla Previa
al Análisis sin aceptar los cambios, haga clic en el
botón de Cancelar. El sistema no permite que se cargue la
misma Identificación de Muestra dos veces. En caso de que
se intentara lo anterior, aparece una advertencia:
Identificación de Muestra Duplicada.
• Al hacer clic en el botón de Despejar Identificación se
suprime la Identificación de la Muestra seleccionada y
deja el espacio en blanco para introducir otra
Identificación de Muestra. No se solicita ninguna
confirmación.
• Al hacer clic en el botón de Programar Muestra, se abre
la ventana que permite programar una nueva muestra.
3.20
1. Programar Muestra para una NUEVA MUESTRA.
(Ilustración)
Dentro de esta pantalla, el operador teclea la Identificación
de la Muestra (campo requerido) e introduce la información
Demográfica del Paciente (optativo) en la parte superior de
la pantalla. En caso de que la muestra sea una muestra Stat,
debe marcarse el icono Stat. La Prueba o las Múltiples
Pruebas (que se muestran cuando se encuentra en el modo de
análisis de Múltiples Pruebas) para correr la muestra, se
ordenan haciendo clic en la selección deseada. En caso de que
se cometa un error, el icono de tijeras puede utilizarse para
suprimir la prueba o las Múltiples Pruebas para esta muestra,
o puede dejarse de marcar un cuadro de selección. Utilice el
icono de Nueva Prueba (tubos en la carpeta) para guardar esta
solicitud y presentar una nueva pantalla (en blanco) de
introducción de la orden para la siguiente muestra. En caso
de que la muestra actual tenga la misma prueba o perfil que
la anterior, puede utilizarse el Botón de Prog. Prev. Esta
secuencia se repite para todas las nuevas muestras.
Después de programar la última muestra, haga clic en el botón
de Confirmar (v). El sistema efectúa la conmutación de
55
regreso a la pantalla Previa al Análisis de la Prueba
Única/Múltiples Pruebas.
Las muestras introducidas se indican y marcan con una P
(Pendientes).
3.21
2. Detalles correspondientes a la MUESTRA con pruebas
Anteriores
(Ilustración)
Datos demográficos del paciente: la parte superior de esta
ventana muestra la información demográfica del paciente. Los
campos mostrados que pueden editarse incluyen a la
Identificación del Paciente, el Nombre del Paciente, el
Nombre o Número del Departamento (Depto.), la Fecha de
Nacimiento y el Sexo. Nota: El campo de identificación de la
muestra no puede cambiarse una vez que se confirma (v).
Los campos de la Lista de Carga y la Posición muestran la
Lista de Carga y la posición actuales dentro de la lista
correspondiente a la muestra que se indica.
Detalles del Paciente: al hacer clic en este icono se tiene
acceso a campos adicionales, tales como las Notas del
Operador, el nombre del Médico y la Fecha de Introducción
(ver la pantalla a continuación)
(Ilustración)
3.22
Cuando la muestra es una muestra Stat, debe marcarse el icono
Stat.
Estado: el “estado” asociado a cada muestra se indica en la
Pantalla de Datos de las Muestras:
• Trans. T = Transmitida y L = Local (No Transmitida)
• Estado de la Muestra (Ninguna prueba ordenada (N);
Pendiente para una prueba por lo menos (P); Completada
(C).
Las pruebas programadas para la muestra se indicarán en la
parte central de la pantalla. Las pruebas pendientes se
indicarán con un (?). Se indicarán los resultados para las
pruebas completadas. Oprima el icono de Detalles para ver la
información detallada acerca de la prueba (es decir, la curva
de coagulación). Para suprimir una prueba que esté pendiente
o que haya sido completada con respecto a una muestra, mueva
el cursor a la prueba y oprima el icono de Papelera
(Suprimir).
Las Pruebas adicionales o repetidas que vayan a correrse con
la muestra se ordenan haciendo clic en el botón de Programar
Prueba. Utilice el icono de Nueva Muestra (tubos en la
carpeta) para guardar esta solicitud y presentar una nueva
pantalla (en blanco) de introducción de la orden para la
56
siguiente muestra. Esta pantalla sería la mostrada en la
opción 1 anterior.
Para desplazarse a la siguiente identificación de la muestra
en la lista, utilice (??) para desplazarse hacia abajo o
hacia arriba en la lista. Las muestras pueden imprimirse
utilizando el icono de Impresora.
Después de programar la última muestra, haga clic en el botón
de Confirmar (v). El sistema efectúa la conmutación de
regreso a la pantalla Previa al Análisis de Prueba
Única/Múltiples Pruebas o grupo de Pruebas.
Las muestras introducidas se indican y marcan con una P
(Pendientes).
3.23
3.2.3 Mapa de los Materiales
Al oprimir el Botón de Mapa de Materiales se mostrarán los
Líquidos necesarios para efectuar las pruebas
correspondientes a esta sesión.
(Ilustración)
El mapa de Materiales muestra en formato gráfico las
posiciones de los líquidos en el analizador. El Mapa que se
muestra arriba se aplica al ACL Elite Pro. El ACL Elite no
tiene posiciones (R9-R12) que se muestren.
Esta pantalla muestra el estado de los reactivos actualmente
a bordo del sistema, junto con otra información. El color de
los círculos de las posiciones puede ser:
Verde: El volumen de líquido en la posición es
superior al límite de advertencia.
Anaranjado: El volumen de líquido en la posición es
inferior al límite de advertencia, o a bordo o
la estabilidad del número del lote ha caducado.
Rojo: El analizador detectó una escasez de reactivo
en esta posición.
(Símbolo)
Nota: Cuando se inicia una corrida, no se verifica el mapa de
materiales para determinar el estado del volumen. El
analizador procederá con las pruebas independientemente del
color de la posición del reactivo. Los colores solamente
alertan al usuario.
El operador puede evaluar la situación de las diez posiciones
de la Charola de Muestras y las posiciones de la Charola de
Reactivos. Al hacer clic en una de las posiciones de colores
de líquido, se mostrarán los detalles acerca de ese líquido.
Esta información incluye:
• Identificación del Líquido: El Nombre del líquido
asignado a esa posición.
• Número del Lote: Número del lote actual introducido para
el líquido en esta posición.
57
• Nivel del Líquido: El volumen restante de líquido en esta
posición. Este nivel se conserva desde la última sesión
para la que se empleó este líquido. El sistema efectúa el
seguimiento del nivel mediante la cuenta regresiva del
volumen durante las pruebas.
3.24
El operador debe introducir el volumen de “arranque”
inicial. Se efectúa generalmente lo anterior cuando se
coloca una nueva botella a bordo o por el código de
barras optativo.
• Fecha de Caducidad: La fecha de caducidad del número del
lote. Cuando se utiliza esté líquido después de la fecha
de caducidad, se alertará al operador con una advertencia
en la lista de Historia de Errores de la Sesión. La fecha
de Caducidad se define previamente en la pantalla de
Líquidos.
• Estabilidad a Bordo: El tiempo restante para este líquido
a bordo del analizador. El sistema efectúa el seguimiento
del tiempo que la botella se encuentra a bordo del
analizador. El operador debe poner el reloj en
funcionamiento con el uso del botón de “Poner Reloj en
Funcionamiento” cuando se coloca una nueva botella en el
analizador. El “Poner Reloj en Funcionamiento para Todos”
pondrá en funcionamiento el reloj para todos los líquidos
que se muestran en el mapa de materiales actual. Cuando
se retira la botella del analizador, puede hacerse una
pausa en la cuenta regresiva del reloj oprimiendo el
botón de “Pausa del Reloj”. Cuando se regresa la botella
al analizador, puede reanudarse el funcionamiento del
reloj oprimiendo el botón de “Pausa del Reloj”. En caso
de que se utilice este líquido más allá del tiempo de
estabilidad a bordo, se alertará al operador con la
advertencia Caducó la estabilidad del material a bordo en
la posición XX” en la lista de Historia de Errores de la
Sesión. El tiempo de Estabilidad a Bordo se define
previamente en la pantalla de Líquidos. La caducidad de
la estabilidad se mostrará en anaranjado en el Mapa de
Materiales.
(Símbolo)
Nota: El uso del seguimiento del Nivel de Líquido, la Fecha
de Caducidad y la Estabilidad a Bordo es optativo. El
operador puede efectuar el seguimiento de estos conceptos
fuera de línea y no tiene que utilizar los elementos a bordo.
Pueden llevarse a cabo tres operaciones en los ajustes del
Nivel de Líquido:
• Ajusta Volumen permitirá la actualización del volumen de
la posición de reactivo respectiva a un valor de acuerdo
58
con especificaciones particulares (con el uso del teclado
o el teclado numérico en la pantalla).
• Reajustar uno solo actualizará el volumen de la posición
de reactivo seleccionada a su valor por omisión
(previamente definido en la pantalla de Líquidos).
• Reajustar todos actualizará a todos los volúmenes de
todas las posiciones de reactivos que se muestran en el
mapa actual a los valores por omisión (previamente
definidos en la pantalla de Líquidos).
Cuando se activa la pantalla, el sistema verifica también y
muestra información acerca del estado de la estación de
rotor, el estado de los desechos, el número de cuvetas
disponibles en el rotor y el volumen actual de la Emulsión de
Lavado-Referencia. Para comenzar la sesión con un rotor no
usado, el operador debe marcar el cuadro de Comenzar con un
Nuevo Rotor.
Oprima Confirmar (v) para Aceptar los cambios y regresar a la
pantalla Previa al Análisis. Al oprimir Cancelar (x), se
descartarán cualesquiera cambios efectuados. Oprima el icono
de Correr y comenzará la corrida.
Detalles de los Líquidos: Este botón mostrará la pantalla de
ajuste de los líquidos para la posición de líquido actual
seleccionada. Consulte la sección 4.1.3 para mayores
detalles.
El Lector de Código de Barras Externo optativo puede
utilizarse para identificar la colocación de reactivos y
validar el número del lote y la fecha de caducidad. Cuando se
muestre el mapa de materiales, lea la etiqueta del frasquito
con el uso del lector. Se verifica la información del número
del lote y la caducidad y centelleará la posición para
colocar...
3.25
...el reactivo a bordo del analizador. Coloque el frasquito
en la ubicación designada. Cuando el número del lote o las
fechas de caducidad sean inválidos, el sistema mostrará un
cuadro de advertencia en la pantalla. Puede configurarse el
lector de código de barras externo para reajustar
automáticamente el volumen por omisión y la estabilidad a
bordo para el frasquito cuando se lee una etiqueta.
Cuando se marca “Pausa del Reloj” para un frasquito de
reactivo, la “Pausa del Reloj” dejará de estar marcada cuando
se lee el frasquito con el lector de código de barras
externo. Cuando se lee a continuación el frasquito una
segunda vez en este punto, el volumen y el reloj se
reajustarán en caso de que se hayan activado estas opciones
bajo el ajuste del lector de código de barras externo.
59
Consulte la sección 4.1.16 para información acerca de la
activación del lector de código de barras externo.
3.2.4 Análisis: Lista de Carga
Puede tenerse acceso a la pantalla de Lista de Carga a
continuación seleccionando Análisis en la barra de menú de la
pantalla Principal y luego la opción de Lista de Carga en el
menú de Análisis.
(Ilustración)
Esta pantalla proporciona acceso al operador a la información
de las listas de carga almacenadas, al estar en blanco o
definidas. Cada una de las listas de carga almacenadas (20
máximo) se identifica con un número, estado y fecha/hora.
Hay varias opciones disponibles:
• Despejar una Sola despeja a la Lista de Carga individual
resaltada actual. La limpieza de una Lista de Carga no
tiene ningún impacto sobre las muestras en las bases de
datos. Las muestras que estaban en la lista de carga
pueden todavía verse e imprimirse después de que se
despeja una Lista de Carga.
3.26
• Despejar todas despeja a todas las Líneas de Carga
definidas.
• Hacer Lista de Carga abre a la pantalla de creación de
listas de carga.
• Al hacer clic en el botón de Despejar una Sola en la
pantalla de Listas de Carga, se muestra una pantalla de
confirmación: ¿Quiere realmente despejar la lista de
carga seleccionada? OK despeja a la sola lista de carga
seleccionada, Cancelar cancelará la operación.
• Al hacer clic en el botón de Despejar Todas en la parte
inferior derecha de la pantallas, se muestra una ventana
de confirmación: ¿Quiere realmente despejar todas las
listas de carga seleccionadas? OK despeja a todas las
listas de carga seleccionadas, Cancelar cancelará la
operación.
• Al hacer clic en el botón de Hacer Lista de Carga, se
abre la pantalla de Hacer Lista de Carga (ver los
detalles a continuación)
(Ilustración)
La lista de carga puede crearse de 4 maneras:
1. Intervalo de Tiempo (Fecha/Hora en que se introdujo la
muestra en la base de datos).
2. Rango de identificación de la muestra.
3. Marcado o selección de las muestras individuales.
60
4. Creación de una Lista Automática con el uso de UN Prefijo
o Sufijo de Identificación de la Muestra, previamente
definido.
Una vez que se escoge uno de los cuatro criterios para la
lista, se seleccionan cuáles pruebas se incluirán en la
lista. Al hacer clic en el botón de Pendiente (todas), se
buscará la base de datos para todas las pruebas pendientes
correspondientes al grupo de muestras escogidas. Al hacer
clic en el botón de Pendiente (selección de pruebas),
permitirá desplazarse hacia abajo en la lista de pruebas
mostradas y seleccionar las pruebas deseadas oprimiendo
Seleccionar. En caso de que se cometa un error, puede
eliminarse una prueba haciendo clic en el botón de Dejar de
Seleccionar. Se eliminará entonces la anotación en la columna
de Seleccionar.
Proceso de Creación de la Lista de Carga
El primer concepto a definir en la parte superior de la
pantalla es el Número de la Lista de Carga para Comenzar.
Debe introducirse un valor entre 1-20 en este campo. A la
derecha...
3.27
...de este campo se encuentra la ubicación de la introducción
para el Número de Muestras por lista de carga. Introduzca un
valor entre 1-40.
A continuación, puede seleccionarse una de las 4 maneras
antes indicadas para uso en la creación de la lista de carga.
1. Intervalo de Tiempo – Al hacer clic en Todo Intervalo de
Tiempo, se creará la lista de carga sin considerar la
hora en que se introducen las muestras en la base de
datos. Cuando se hace clic en Desde/Hasta, debe
introducirse una Fecha/Hora de Inicio y una Fecha/Hora de
Terminación.
2. Rango de Identificación de las Muestras – Al hacer clic
en Todas las Muestras, se seleccionarán todas las
muestras sin considerar la Identificación de la Muestra
que le corresponde. Cuando se hace clic en Desde/Hasta,
debe introducirse una Identificación de Muestra Inicial y
una Identificación de Muestra Final para incluirse en la
lista de carga.
3. Cuando se hace clic en el botón de Marcar Muestras,
aparecerá la pantalla siguiente:
(Ilustración)
Esta pantalla mostrará todas las muestras, junto con su
estado actual en la base de datos. Puede efectuarse el
desplazamiento descendente en la lista y oprimir Seleccionar
para marcar la muestra individual actual. En caso de que se
someta un error, oprima Dejar de Seleccionar una Sola para
61
eliminar la anotación en la columna de marcado. Al oprimir
Dejar de Seleccionar Todas, se eliminará la anotación en la
columna de marcado para todas las muestras. Cuando haya
terminado, oprima Confirmar (v) o Cancelar (X) para regresar
a la pantalla anterior.
4. Haga clic en el botón de Lista Automática para mostrar la
pantalla de creación de lista de carga automática. Esta
pantalla permitirá crear una o más listas de carga.
Pueden crearse las identificaciones de las muestras para
la lista de carga mediante el uso de un prefijo o sufijo.
3.28
(Ilustración)
En esta pantalla, debe introducirse el número de lista de
carga que se quiere preparar. Pueden crearse hasta 20 listas
de carga; cada lista de carga contendrá hasta 40 muestras. En
el campo de Secuencia Fija, introduzca una secuencia de
caracteres para anexarse a cada identificación de muestra.
Cuando quiera usar la secuencia fija como prefijo, haga clic
en el botón de Usar como prefijo. En caso de que no se haga
clic en este campo, la secuencia fija se anexará entonces
como sufijo a la identificación.
El campo de secuencia Variable determinará el número máximo
de identificaciones de muestras que se crearán. Cuando se
selecciona una secuencia variable de 2, el número máximo de
muestras será de 99; cuando se selecciona 3, el número máximo
será de 999. El campo de números iniciales variará en
longitud dependiendo de la introducción del campo de la
secuencia variable. El número que se introduce en el campo de
Números Iniciales se utilizará para la primera muestra. Las
identificaciones de muestras restantes se indexarán en uno
después de este valor.
Cuando haya terminado, oprima Confirmar (v) o Cancelar (X)
para regresar a la pantalla anterior.
(Símbolo)
Nota: En esta pantalla, se determina el número de lista de
carga que se preparará. En la pantalla anterior, se introdujo
el número de lista de carga para comenzar, junto con el
número de identificaciones de muestras que contendrá cada
lista de carga.
3.29
(Ilustración)
Una vez que se crea la Lista de Carga/Lista de Carga
Automática, se programan a continuación las pruebas para las
identificaciones de las muestras de la lista. Seleccione la
Lista de Carga y oprima el icono de Detalles a continuación.
(Ilustración)
62
Las identificaciones de las muestras en esta lista de carga
se mostrarán en la columna de mano izquierda. Pueden
cambiarse las identificaciones de las muestras de la lista
seleccionando una muestra en particular y oprimiendo Editar
Identificación de la Muestra. En caso de que se necesite
suprimir muestras de la lista, pueden utilizarse los botones
de Suprimir Identificación de la Muestra o Suprimir las
Identificaciones de Todas las Muestras.
Para programar o cambiar las pruebas solicitadas, seleccione
una identificación de muestra en particular o la primera de
la lista.
3.30
Haga clic en el botón de Prog. Prev. a Todas para programar
la solicitud de las pruebas previas para TODAS las muestras
de la lista de carga. Cuando se oprime el botón de Prog.
Prev., las pruebas previas se ordenarán simplemente para la
muestra resaltada actual solamente.
Haga clic en el botón de Ajustar pruebas por omisión para
programar las pruebas por Omisión para todas las muestras de
la lista de carga.
Haga resaltar una muestra y haga clic en el botón de Detalles
para ver la muestra actual. Lo anterior mostrará los datos
demográficos, junto con las pruebas ordenadas y cualesquiera
resultados completados correspondientes a la muestra.
Para imprimir una lista de carga, haga clic en el icono de la
Impresora.
• Al Confirmar o Cancelar, se sale de la pantalla; el
sistema regresa a la pantalla anterior.
• Los BOTONES ACTIVOS en la parte inferior de la pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.2.5 Análisis: Reporte de la Sesión
Se muestra automáticamente esta pantalla durante una corrida.
(Ilustración)
Esta pantalla muestra información acerca del estado de las
pruebas y de las muestras para las corridas analíticas
efectuadas en el sistema.
La línea superior muestra a la prueba actual que se está
analizando y la fase actual correspondiente a la prueba (es
decir, carga, espera, adquisición...).
63
3.31
La parte media de la pantalla muestra los 4 cuadrantes de
anillo de las muestras a la izquierda y las 10 copas de
muestras incluidas dentro del cuadrante. Consulte la sección
3.2.2 para los detalles acerca de las claves de colores y los
símbolos empleados para las posiciones de las muestras.
Los detalles (resultados) de una muestra pueden indicarse al
seleccionar el cuadrante de anillo de la muestra a la
izquierda y mediante la selección de la posición de la copa
deseada y al hacer clic en el botón de Detalles. Cuando se
completa una muestra, se mostrarán los resultados.
El botón del Mapa de Materiales mostrará al mapa del reactivo
actual correspondiente a la sesión. Consulte la sección 3.2.3
para los detalles acerca del Mapa de Materiales.
El botón de Estado de la Sesión mostrará la pantalla de
reporte de la Sesión de Análisis para todas las muestras de
la sesión actual.
(Ilustración)
El cuadro de Estado de Ejecución de la Prueba indica
información acerca de las pruebas de la sesión. Indica las
pruebas que pueden analizarse en esta sesión, junto con el
número de muestras programadas, el número de pruebas reflejas
que se procesarán y el número de pruebas completadas. Los
grupos de pruebas se consideran ser pruebas individuales y se
indican de esa manera en el cuadro.
El cuadro de Estado de las Muestras para la Sesión indica las
muestras que se procesarán en esta sesión. Este cuadro está
dividido en 5 columnas:
• # de Columna: posición en la charola de muestras
• +: un ! en esta columna indica que la muestra está
designada como una muestra stat.
• Estado: Indica el estado actual de esta muestra. El
estado puede indicarse mediante los símbolos siguientes
- Símbolo de reloj de arena: Muestra en proceso.
- Símbolo de reloj: Muestra en estado de espera.
- Marca de Paloma (v): Se ha terminado de procesar la
muestra.
3.32
• Escasa: Esta columna mostrará un indicador de “baja”
cuando se ha detectado que una muestra es escasa. Una
muestra que se ha hallado que es escasa detendrá a toda
prueba ulterior en esa muestra.
• La columna de identificación de la muestra indica las
identificaciones de las muestras de la lista de carga.

El botón del Mapa de Materiales mostrará al mapa de reactivos


actual correspondiente a la sesión.
64
(Símbolo)
Nota: La hilera inferior de iconos de la pantalla principal
contiene a uno de una botella de reactivos. El color de la
botella indica el estado de los reactivos en el mapa. Cuando
todos los reactivos tienen niveles por arriba del volumen de
advertencia, el icono se mostrará con color verde. Mientras
las pruebas están en proceso, cuando el nivel del reactivo
sea bajo, el icono de la botella se pondrá de color
anaranjado. Cuando se agota un reactivo durante el análisis,
el icono de la botella se pone de color rojo. Al oprimir el
icono de la botella, se mostrará el mapa de reactivos actual.
Cuando escasea un reactivo durante el análisis, el sistema
continuará procesando todas las demás pruebas. Cuando se
completan las pruebas, el sistema mostrará un cuadro de
mensaje con lo siguiente:
Uno o más reactivos son insuficientes para completar todas
las muestras. ¿Quiere reabastecer?
Oprima Sí para reabastecer y reinicie a continuación.
Oprima No para cerrar la sesión.
Cuando se selecciona la opción de Sí, el operador debe
reabastecer los reactivos que sean escasos y oprimir el icono
de correr para reiniciar la corrida.
Cuando se selecciona “No”, el sistema finalizará la sesión
analítica actual. La corrida puede reiniciarse posteriormente
seleccionando Análisis  Historia de la Sesión.
El botón de Reiniciar esta Sesión dará comienzo al análisis
nuevamente para procesar aquellas muestras con un estado de
“Pendientes”. Lo anterior puede ser útil cuando un reactivo
escasea durante el análisis.
El Botón de Historia de la Sesión se opacará normalmente
durante el análisis. En caso de que ocurra una condición de
error durante el análisis, se iluminará el botón. El operador
debe tomar nota del estado del botón. Cuando se ilumina el
botón, el operador debe oprimir el botón para mostrar la
Lista de la Historia de la Sesión.
3.33
(Ilustración)
La lista mostrará la Fecha y la Hora, junto con el Error que
ocurrió.
La opción de Imprimir hará que se imprima el Reporte de la
Historia de Errores de la Sesión y aparecerá a continuación
una ventana de confirmación ¿Quiere realmente imprimir? La
respuesta de Sí permite que el operador imprima el Reporte de
la Historia de Errores de la Sesión, No cancelará la
operación.
Oprima el botón de Confirmar (v) para regresar a la pantalla
anterior.
65
Una vez que se haya completado la sesión, puede regresarse a
la pantalla de Historia de la Sesión seleccionando Análisis
en la barra de menú de la pantalla Principal e Historia de la
Sesión en el menú de Análisis. Lo anterior abre a la pantalla
de Análisis: Reporte de la Sesión.
• Los BOTONES ACTIVOS en la parte inferior de la pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.2.6 Condiciones de Pausa de la Sesión
Las condiciones siguientes pondrán al ACL Elite/Elite Pro en
un estado de pausa durante el análisis. Cuando ocurre lo
anterior, la condición observada debe corregirse. La corrida
puede reanudarse a continuación oprimiendo el icono de
correr.
CONTENEDOR DE DESECHOS DE ROTOR LLENO (Elite Pro Solamente)
Cuando el contenedor de desechos de rotor esté lleno, el
instrumento producirá un bip y efectuará automáticamente una
pausa.
3.34
Para proceder, el operador tiene que vaciar el contenedor de
desechos de rotor y oprimir el icono de “correr”.
PILA DE ROTORES VACÍA (Elite Pro Solamente)
Cuando la pila de rotores está vacía, el instrumento
producirá un bip y efectuará automáticamente una pausa.
Para proceder, el operador tiene que reabastecer la pila de
rotores y oprimir el icono de “correr”.
ESCASEZ DE REACTIVOS
Una escasez de reactivos detectada durante el análisis pondrá
al sistema en la condición de Detener al final de la sesión.
En este momento, el operador tiene la opción de reabastecer
los reactivos y reanudar la sesión.
3.2.7 Pausa del Análisis/Funciones STAT
Durante una corrida, el estado de la sesión se presenta
mostrando el número de pruebas ejecutadas y cuál fase de la
prueba está en proceso.
(Ilustración)
Es posible hacer una pausa en el sistema durante una sesión
analítica mediante el uso del icono de “Ambulancia”
Stat/Pausa en el lado inferior izquierdo de la pantalla.
66
Cuando se activa este icono, se presentará un mensaje que
dice: ¿Quiere realmente detener la sesión?”
Al oprimir “NO”, la sesión procederá.
Al oprimir “SÏ”, habrá una pausa en la sesión en el momento
apropiado de la sesión actual. Se notificará cuando sea
seguro proseguir.
Las muestras Stat no pueden ejecutarse durante la Transmisión
Automática a la Computadora Principal.
Durante el estado de Detener, puede efectuarse lo siguiente
en el sistema:
3.35
• Añadir Muestras, tanto STAT como Rutinarias.
• Cambiar la Prioridad de una Muestra de Rutinaria a Stat.
• Añadir Pruebas a una muestra en la charola de muestras.
• Añadir muestras de Control de Calidad a la sesión.
• Tener acceso al Mapa de Materiales para Reabastecer
reactivos.
• Sustituir Muestras en la charola de muestras. Las
muestras completadas, indicadas mediante un círculo verde
de la posición de la copa (se hace notar también por una
“C” en la columna “S”) pueden retirarse y reemplazarse
con una nueva muestra.
(Ilustración)
La pantalla de “Añadir Muestras/Stats” indica el estado de
las muestras en la charola.
El Estado de las muestras se indica con el uso de colores y
letras/símbolos para las posiciones de las copas (consulte la
sección 3.2.2 para los detalles acerca de los colores y los
símbolos). La charola de muestras está dividida en 4
cuadrantes de 10 posiciones de muestras cada uno. Para
cambiar por un cuadrante diferente, haga simplemente clic en
el segmento deseado en el círculo a la izquierda.
Muestras Stat – Código de Barras
Leer los Códigos de Barras: Este botón activará al lector del
código de barras de las muestras y leerá las identificaciones
de las muestras en la charola. Mostrará a continuación las
identificaciones de las muestras. No se efectúa ninguna
pregunta a la computadora principal durante esta acción. Las
identificaciones de las muestras sin código de barras
(excepto las copas de Control de Calidad) se suprimirán de la
lista para las muestras que no estén actualmente activas en
el rotor que se está analizando. Cuando no se cuenta con
interfaz bidireccional, después de leer el código de barras,
haga clic en la posición deseada de la muestra para mostrar
la pantalla de programación de muestras. Introduzca la
información demográfica optativa. Para designar la muestra
67
como stat, haga clic en el icono de Stat. Seleccione las
pruebas haciendo clic en el cuadro de prueba deseado. Para
retirar una prueba de las pruebas programadas,...

3.36
...haga clic en el nombre de la prueba una segunda vez.
Utilice la flecha hacia abajo para proceder a la siguiente
posición de la muestra. Cuando complete, oprima el botón de
Confirmar.
Reiniciar con BCR: Este botón puede seleccionarse cuando se
utilizan muestras con código de barras y pregunta a
computadora principal. Haga clic en este botón y oprima a
continuación el icono de reanudar. El sistema leerá las
identificaciones de las muestras y preguntará a la
computadora principal con respecto a las pruebas a procesar.
No se recomienda utilizar esta opción cuando hay presente una
combinación de muestras con código de barras y sin código de
barras en la charola de muestras.
Muestras stat sin código de barras
Programación de Muestras sin Código de Barras: Haga clic en
la posición de muestra deseada para mostrar la pantalla de
programación de muestras.
(Ilustración)
Para programar las muestras, introduzca la Identificación de
la Muestra junto con cualquier otra información demográfica
optativa. Para designar la muestra como stat, haga clic en el
icono de Stat. Seleccione las pruebas haciendo clic en el
cuadro de prueba deseado. Para retirar una prueba de la lista
de las pruebas programadas, haga clic en el nombre de la
prueba una segunda vez. En caso de que haya pruebas
adicionales para programar, haga clic en el icono de Nueva
Muestra. Cuando haya terminado de programar las muestras,
haga clic en el botón de Confirmar. Oprima el icono de Correr
para comenzar el análisis.
Introducir/Editar la Identificación de la Muestra: Este botón
permite introducir manualmente una identificación o editar
alguna mostrada. Las posiciones que no pueden editarse
opacarán al botón.
Despejar Identificación: Este botón despejará una
identificación de una posición en la charola de pruebas. La
posición puede utilizarse a continuación para programar una
nueva muestra en la charola. Este botón se opacará cuando la
charola de muestras no tenga posiciones en las que la muestra
esté completada. Las muestras completadas se designarán como
un círculo verde de la posición de la copa, con la letra C.
Las muestras con pruebas pendientes por completarse se
68
designarán como un círculo anaranjado de la posición de la
copa, con la letra P.
Las posiciones en las que no puede despejarse la
identificación opacarán al botón.
3.37
Programar Muestra: Abre la pantalla de orden de las pruebas.
Consulte la información en la sección 3.2.2 para los detalles
acerca de esta función.
Añadir Líquidos de Control de Calidad: Muestra la lista de
líquidos de Control de Calidad. Seleccione el líquido deseado
y haga clic en el botón de Confirmar para aceptar. El líquido
de Control de Calidad se añadirá entonces a las muestras en
la charola de muestras. Nota: No haga clic en Reiniciar con
el botón de BCR cuando se añada el Control de Calidad a una
lista. Oprima el icono de Correr solamente para iniciar la
corrida.
Una vez que se hayan programado las Nuevas Pruebas/Stat y
añadido a la charola de pruebas, se reinicia la corrida con
el uso del icono de Correr.
(Símbolo)
Notas:
• Cuando se oprime el icono de stat/pausa, el sistema
mostrará un mensaje que indica cuando es seguro
añadir/retirar muestras de la charola. Espere a que
aparezca este mensaje. Es una indicación de que el brazo
de muestreo no se moverá hacia la charola de muestras.
• Cuando se añada una prueba que no esté contenida en las
Múltiples Pruebas o la Prueba Única que se están
corriendo actualmente, la prueba se programará solamente.
• Las pruebas por omisión se añadirán a una muestra cuando
se inicie la siguiente prueba de la corrida. Antes de
esto, se mostrará el círculo con color azul claro, con el
estado de N. Después de que se inicie la siguiente prueba
de la corrida, se añadirán las pruebas por omisión a las
muestras y el círculo se hará morado cuando ocurra el
procesamiento.
• En caso de que una prueba esté contenida en las Múltiples
Pruebas o la Prueba Única que se están corriendo
actualmente, la prueba interrumpirá a la sesión actual o
se ejecutará en una sesión después de la actual. La
sesión actual se interrumpirá cuando no se hayan
pipeteado las muestras. En caso de que ocurra la
interrupción de stat durante una sesión en la que el
reactivo se esté pipeteando solamente, el sistema
abortará la corrida para procesar la stat. En caso de que
no quiera abortar la corrida actual, espere hasta que la
69
unidad comience a pipetear la muestra antes de solicitar
la interrupción por stat.
• Los BOTONES ACTIVOS en la parte inferior de la pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
- Confirmar hace que se salga de la pantalla; el sistema
regresa a la pantalla anterior.
3.2.8 Lista de resultados
La pantalla principal del ACL Elite/Elite Pro es la base de
datos o lista de resultados. La base de datos de muestras
puede contener hasta 1000 identificaciones de muestras. Se
maneja la base de datos de una manera de lo que primero entra
primero sale (fifo por sus siglas en idioma inglés) para las
muestras completadas. Cuando la...
3.38
... base de datos llega a las 1000 muestras, las muestras más
antiguas con un estado de “Completadas” se suprimirán
permanentemente. Cada identificación de muestra puede hacer
referencia a 30 pruebas. Las pruebas procesadas por duplicado
ocupan un mínimo de 3 posiciones de pruebas (primer
resultado, segundo resultado y media).
(Ilustración)
La “Vista de la Base de Datos en la parte superior de la
pantalla indica si se están viendo “Todas las Muestras” o un
“Subconjunto” de las muestras. Un subconjunto de las muestras
en la base de datos se obtiene mediante Extracción de los
resultados. Cuando se ve un subconjunto de los resultados y
se desea ver todos, debe extraerse de nuevo y seleccionar la
opción de “Todas las Muestras”.
Los valores numéricos en la parte derecha de la pantalla (es
decir, 147/540) indican cuántas muestras se indican
actualmente en la base de datos. Cuando se extrae, el primer
valor indica cuántas muestras se extrajeron y el segundo
valor indica el número total de muestras en la base de datos
entera. Cuando se ven “Todas las Muestras”, los dos valores
serán idénticos.
La lista de resultados tiene varias columnas:
- + indica si se corrió la muestra con un atributo de
prioridad (STAT)
70
- La Columna S indica el estado de la identificación de la
muestra.
• N significa que no hay ningunas pruebas programadas con
esa identificación de muestra.
• P significa que a una o más pruebas les falta un
resultado.
• C significa que se han corrido todas las pruebas con la
muestra y que se considera completa.
- La Columna E indica que hay errores presentes por lo
menos en una prueba para la identificación de la muestra
(consulte la sección 6.3 para mayores detalles).
- Columna de Identificación de la Prueba (máximo 16
caracteres). Cada una de las 1000 muestras en la base de
datos debe tener una Identificación de Muestra única. No
se permiten identificaciones por duplicado.
3.39
En caso de que se necesite volver a utilizar una
identificación de una muestra, debe suprimirse primero la
original. Haga resaltar la identificación y haga clic en
el icono de la “papelera” para suprimir.
- Columna del Nombre del Paciente (máximo 25 caracteres).
Esta columna puede ocultarse con el uso de la “Tarjeta de
Identidad”. Esto permitirá que se muestren más pruebas a
lo ancho de la pantalla de la base de datos.
- Las columnas de Pruebas y Unidades se definen (de acuerdo
con especificaciones particulares) en el submenú de
clasificación de pruebas en el Ajuste de Pruebas.
Consulte la Sección de Ajuste de Pruebas (capítulo 4).
Cuando una prueba tiene un ? en una columna, entonces el
resultado de la prueba está pendiente. Al completarse la
prueba, se reemplazará el ? con el resultado. Cuando el
resultado se indica junto con un símbolo de “Copo de
Nieve”, hay entonces más de un resultado disponible para
esa prueba en particular. Las pruebas con errores se
harán notar en lugar de un resultado en la pantalla. Haga
resaltar la muestra y oprima el icono de “detalles” para
ver todos los resultados.
Un resultado presentado con un color “negro” significa que se
encuentra dentro del rango normal.
Un resultado presentado con un color “violeta” significa que
está fuera del rango normal.
Un resultado presentado con un color “rojo” significa que
está fuera del rango de la prueba.
Un resultado presentado como “***” significa que está fuera
de la escala de manera alta.
Un resultado presentado como “---” significa que está fuera
de la escala de manera baja.
71
La línea de estado del instrumento indica también que el
Usuario actual entró en el sistema y la revisión actual del
software en el analizador.
Hay varias funciones disponibles en la lista de resultados de
las pruebas
(Símbolo) Extraer Resultados (Símbolo) Icono de Detalles de Muestras
(Símbolo) Nueva Muestra (Símbolo) Suprimir Muestras
(Símbolo) Imprimir Muestras (Símbolo) Transmitir a Computadora Principal
3.2.8.1 Icono de Extraer
• Con el uso del Icono de Extraer (Mano en Cajón de
Archivo), es posible filtrar la base de datos para las
muestras deseadas con base en varios criterios. Ver la
pantalla a continuación.
- Identificación de una Sola Muestra
- Identificación de la Muestra – Desde...Hasta (Utilice
el Mismo número de Caracteres cuando defina el rango de
Desde/Hasta que se tiene normalmente para la
Identificación de la Muestra).
- Identificación del Paciente
- Nombre del Paciente
- Número de la Lista de Carga
3.40
- Todas las muestras
- Introducir Fecha Desde...Hasta...
- Departamento
Es posible combinar los criterios de Identificación de la
Muestra anteriores con las selecciones del cuadro de marcado
de los criterios de los resultados en la parte inferior de la
pantalla.
- Completado/Pendiente
- Stat/No Stat
- Transmitido/No Transmitido
- Con Indicador/Sin Indicador
(Ilustración)
(Símbolo)
Nota: Cuando se hace la extracción a un subconjunto de la
base de datos, debe volverse a extraer usando el cuadro de
marcado de “Todas las Muestras” para regresar a la base de
datos a fin de indicar todas las muestras. Las nuevas
muestras introducidas en la base de datos, mientras se
encuentra uno en un subconjunto, no pueden mostrarse en la
base de datos.
3.2.8.2 Icono de Detalles de las Muestras
• Con el uso de la función de Detalles (lupa), puede
mostrarse la información adicional acerca de la Muestra y
de las Pruebas. Esta información incluiría a los datos
Demográficos, los Resultados, los Errores y las curvas de
Reacción.
72
3.41
(Ilustración)
En la pantalla de Datos de las Muestras, el icono de detalles
del paciente indica información demográfica adicional.
(Ilustración)
En la pantalla de Datos de las Muestras, es posible ver la
curva de reacción. Haga resaltar la prueba deseada y oprima
el icono de detalles para ver la curva.
3.42
(Ilustración)
Las advertencias asociadas a los resultados de las pruebas se
muestran en la lista de advertencias. Revíselas y lleve a
cabo la acción apropiada en caso necesario, antes de reportar
los resultados.
El icono de “Disco Flexible” permite guardar las “lecturas de
los datos normalizados” correspondientes a la curva. Los
datos pueden verse utilizando otro programa de software (es
decir, Microsoft Excel). La curva, según se presenta, puede
imprimirse con el uso del icono de imprimir. Las advertencias
asociadas a los resultados se muestran en la lista de
advertencias.
La Curva de Coagulación/Reacción muestra los puntos de los
datos normalizados registrados durante la fase de
adquisición. El eje de las “Y” muestra el cambio de la
reacción total dividido en 5 puntos. El cambio de la reacción
se redondea a 2 puntos decimales; por lo tanto, las muestras
con una pequeña cantidad de cambio pueden mostrar puntos por
duplicado dentro de los 5 que se muestran. Las curvas para
los ensayos de coagulación se presentarán normalmente con un
patrón de “S”. La curva está generalmente compuesta por 4
secciones: Línea Base, Aceleración, Desaceleración y Punto
Final.

(Gráfica)
Lecturas Ópticas Punto Final

Desaceleración
Delta
Aceleración
Línea Base
Tiempo de Adquisición
3.43
Las lecturas de la Línea Base comienzan después de
cualesquiera ajustes de demora de la adquisición en la
definición de la prueba. Durante la línea base, la muestra y
los reactivos se mezclan y continúa esto hasta que ha
comenzado a formarse el coágulo. En la fase de aceleración,
el coágulo continúa formándose y da por resultado un aumento
73
en las lecturas ópticas. La fase de desaceleración es el
momento en que la formación del coágulo comienza a hacerse
más lenta. Para un ensayo basado en la coagulación, una vez
que el fibrinógeno se ha convertido en fibrina, se ha llegado
al punto final y la lectura se estabiliza.
El sistema utiliza diversos algoritmos para seleccionar el
tiempo de coagulación real. Algunos ejemplos de éstos
incluyen:
- A la Primera Derivada: momento en que se observa la
velocidad máxima de formación del coágulo.-
- A la Segunda Derivada: momento en que se observa el
cambio máximo en la velocidad (aceleración máxima) de la
formación del coágulo.
- Al Umbral: momento en que se alcanza un valor de densidad
óptica previamente fijado.
- Al Umbral – 2ª Derivada: En caso de que no se cumpla con
la lectura del umbral, el sistema utilizará el valor de
la 2ª Derivada.
Cuando se ven las curvas de coagulación, los conceptos de los
que debe tomarse nota incluyen:
- A la forma de la curva (Las primeras curvas pueden
indicar que no hay ninguna coagulación).
- A líneas base largas que indican un tiempo de coagulación
prolongado.
- Al rango del eje de las “Y”. Un rango estrecho puede
indicar que no hay ninguna coagulación o un valor de
fibrinógeno bajo. Compare las “Y” de las muestras
cuestionables con las de una muestra normal. Un rango
amplio en el eje de las “Y” puede indicar un valor de
fibrinógeno alto.
- A un aumento continuo en la fase de Aceleración sin
ningún punto final, lo que indica que la muestra no se
coaguló dentro del tiempo de adquisición.
- A una caída en el punto final, lo que puede indicar una
formación de coágulo inestable.
3.2.8.3 Icono de Nueva Muestra (Tubos en carpeta)
• Con el uso del icono de Nueva Muestra, es posible añadir
una nueva muestra a la base de datos y programar
manualmente pruebas para la misma. Consulte la página
3.20 para los detalles.
3.44
(Ilustración)
3.2.8.4 Icono de Suprimir (Papelera)
• Con el uso del icono de Suprimir es posible suprimir los
resultados con el uso de los criterios siguientes:
- Identificación de una Sola Muestra
74
- Identificación de la Muestra Desde...Hasta (Utilice
el Mismo número de Caracteres cuando defina el rango
de Desde/Hasta que tenga normalmente para la
Identificación de la Muestra).
- Identificación de la Muestra
- Nombre del Paciente
- Número de la Lista de Carga
- Todas las muestras
- Fecha de Introducción De...A...
- Departamento
Es posible combinar los criterios anteriores para la
Identificación de la Muestra con las selecciones del cuadro
de marcado de los criterios de prueba en la parte inferior de
la pantalla.
- Completada/Pendiente
- Stat/No Stat
- Transmitida/No Transmitida
- Con Indicador/Sin Indicador
3.45
(Ilustración)
3.2.8.5 Impresión de los resultados
Con el uso del icono de Imprimir, es posible Imprimir los
resultados (pueden generarse dos tipos de reportes: Reportes
Acumulativos y de Muestras) con el uso de los criterios
siguientes:
- Identificación de una Sola Muestra
- Identificación de Muestras de...a... (Utilice el mismo
número de Caracteres cuando defina el rango De/A que
pueda tener la Identificación de la Muestra normalmente)
- Identificación del Paciente
- Número de la Lista de Carga
- Todas las muestras
- Nombre del Paciente
- Fecha de Introducción de...a...
- Departamento
Es posible combinar los criterios de Identificación de la
Muestra anteriores con las selecciones de cuadro de marcado
en la parte inferior de la pantalla.
- Completada/Pendiente
- Stat/No Stat
- Transmitida/No Transmitida
- Con Indicador/Sin Indicador
3.46
(Ilustración)
3.2.8.6 Envío de los resultados a la Computadora Principal
75
Con el uso del icono de Principal (Host), es posible bajar
las solicitudes de pruebas o transmitir los resultados con el
uso de los criterios siguientes:
- Identificación de una Sola Muestra
- Identificación de Muestras Desde...Hasta...(Utilice el
Mismo número de Caracteres cuando defina el rango
Desde/Hasta que pueda tener la Identificación de la
Muestra normalmente)
- Identificación del Paciente
- Número de la Lista de Carga
- Todas las muestras
- Nombre del Paciente
- Fecha de Introducción De...A...
- Departamento
Es posible combinar los criterios de Identificación de la
Muestra anteriores con las selecciones del cuadro de marcado
en la parte inferior de la pantalla.
- Completada/Pendiente
- Stat/No Stat
- Transmitida/No Transmitida
- Con Indicador/Sin Indicador
3.47
(Ilustración)
(Símbolo)
Nota: Cuando se desactivan los sensores de líquido y/o Lavado
R, el sistema no transmitirá automáticamente los resultados a
la computadora principal. Al final de cada corrida, aparecerá
un mensaje de advertencia que dará instrucciones al operador
para que verifique los niveles de material y de muestra a fin
de asegurar que haya volumen residual suficiente en los
contenedores. Una vez que se efectúa la verificación, los
resultados pueden transmitirse manualmente a la computadora
principal. Cuando se vuelven a activar los sensores, se
reanudará la transmisión automáticamente.
3.48
3.3 Control de Calidad
Esta Sección contiene toda la información necesaria para
efectuar el análisis de los materiales de control de calidad
y cumplir con los requisitos del programa de control de
calidad de cada laboratorio en el Sistema ACL Elite/Elite
Pro. La primera subsección presenta un resumen del
procedimiento para aquellos usuarios ya familiarizados con el
sistema ACL Elite/Elite Pro. Los detalles específicos acerca
de las pantallas, las opciones, etc., se describen
posteriormente en los procedimientos paso por paso.
• Los Materiales del Control de Calidad deben definirse
previamente en la pantalla de Ajuste de Líquidos;
76
consulte la información pertinente en la Sección 4 –
Ajuste.
• Los valores que constituyen el objetivo de los Materiales
de Control de Calidad deben definirse previamente en la
pantalla de Ajuste de Control de Calidad; consulte la
información pertinente en la Sección 4 – Ajuste.
• Los Materiales de Control de Calidad pueden correrse con
las muestras de los pacientes durante las pruebas
rutinarias o solos como una corrida por separado; en el
primer caso, consulte la sección 3.2.1 de “Análisis”; en
el segundo caso, siga los pasos a continuación.
3.3.1 Análisis de los Materiales de Control de Calidad con
el uso de una lista de carga.
Este procedimiento describirá la manera de correr el Control
de Calidad en una lista de carga, sin muestras de los
pacientes.
La lista de carga puede guardarse y recuperarse cada vez que
se necesite correr el Control de Calidad. Pueden configurarse
varias listas de carga diferentes en el sistema. Cada lista
de carga podría contener materiales de Control de Calidad
diferentes.
• Seleccione Análisis
• Seleccione Múltiples Pruebas o Prueba Única
• Haga clic en el cuadro del No. de Lista de Carga.
Introduzca un número de lista de carga (1-20). Cuando no
sepa cuáles listas de carga están disponibles, haga clic
en el botón de “Listas de Carga” para mostrar el estado
de las 20 listas de carga.
• Ubique el cursor sobre la posición de copa deseada en la
charola de muestras. Haga clic en el botón de Añadir
Líquido de Control de Calidad.
• Escoja el control y haga clic en el botón de Confirmar
(v).
• Repita las dos últimas acciones hasta que se hayan
introducido todos los materiales.
• Haga clic en el botón de Guardar Lista de Carga para
guardar la lista de carga.
• Coloque las copas de las muestras de Control de Calidad
en la charola de muestras en las posiciones respectivas.
Oprima el icono de Correr para comenzar el análisis.
(Símbolo)
Nota: Al completar la corrida, la lista de carga completada
se guardará en la memoria. En caso de que no se suprima,
puede recuperarse la próxima vez que se necesite correr el
Control de Calidad. En este caso, no se necesitaría
reprogramar las posiciones de la charola de muestras.
77
3.49
(Ilustración)
3.3.2 Ajuste del Control de Calidad
El proceso de control de calidad se inicia en la pantalla
Principal seleccionando Control de Calidad en la barra de
menú y seleccionando Ajuste/Revisión del Control de Calidad.
Lo anterior abrirá la pantalla de Revisión de Control de
Calidad que se muestra.
(Ilustración)
3.50
Bajo el encabezado de IDENTIFICACIÓN DEL LÍQUIDO, la ventana
en el lado izquierdo de la pantalla incluye a todos los
materiales de control que están configurados en el menú de
Ajustar Líquidos, en tanto que la ventana de Prueba
Configurada, en la parte media de la pantalla, incluye a las
pruebas que están asociadas a cada material.
Las estadísticas de Control de Calidad se reportan en el lado
derecho de la pantalla.
- Unidad
- Media Real
- Media que Constituye el Objetivo
- Desviación Estándar Real
- Desviación Estándar que Constituye el Objetivo
- CV Real
- Resultados en Estadísticas
- Resultados en la Base de Datos (DB)
Al marcar en el botón de Mostrar Activado, se reducirá la
lista de Líquidos y se mostrarán solamente los Líquidos que
se han ajustado para el análisis de Control de Calidad en el
sistema. Este botón es de tipo volquete. Sin hacer todavía
clic en el botón, se mostrarán solamente los líquidos
ajustados previamente.
Al hacer clic en el botón de Confirmar (v), se sale de la
pantalla y el sistema regresa a la pantalla Principal.
• Los BOTONES ACTIVOS en la parte inferior de la pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
La configuración de Control de Calidad debe introducirse en
la pantalla de Ajustar Control de Calidad que se muestra a
continuación. Seleccione el líquido de Control de Calidad en
78
el cuadro izquierdo y oprima a continuación el botón de
Ajustar debajo de la ventana de en medio.
3.51
(Ilustración)
La parte superior de la pantalla muestra el material de
Control de Calidad (Identificación del Líquido) y la
información específica acerca del mismo, tal como la Fecha de
Caducidad, el Número de Lote, más un espacio para Notas.
El siguiente paso es asociar las pruebas al Líquido de
Control de Calidad seleccionado.
Para hacer lo anterior, el operador hace resaltar una prueba
de la lista de Pruebas Activadas en la ventana izquierda y
hace clic a continuación en el icono de Flecha debajo de la
ventana. Esta acción hace que la prueba seleccionada se
desplace de la lista de Pruebas Activadas a la lista de
Pruebas Configuradas que se muestra en la ventana de en
medio. Al repetir esta secuencia, el material de control se
asocia hasta a 15 pruebas.
Para eliminar una prueba de la lista de Pruebas Configuradas,
haga clic en el icono de Tijeras debajo de la ventana. Esta
acción abre primero una ventana de confirmación Eliminar a la
prueba se eliminan todos los datos de la prueba...¿Está
seguro de que quiere eliminar la prueba seleccionada? La
selección de Sí o No recuerda al operador de que la
eliminación de la prueba significa eliminar todos los
resultados guardados para esa prueba.
Una vez que la asociación de Líquido de Control de
Calidad/Pruebas está completa, el siguiente paso es definir
las unidades, la media que constituye el objetivo, la DE que
constituye el objetivo y el Rango de la DE para todas las
pruebas asociadas al material de Control de Calidad.
Unidad: para cada prueba, la selección de unidades incluye
solamente a aquellas que son legítimas para esa prueba. La
modificación de una unidad seleccionada anteriormente no
ocasionará un cambio en los valores de la Media que
Constituye el Objetivo y de la DE. Se necesitaría actualizar
éstos en caso de que se cambiara el tipo de unidad.
Media que Constituye el Objetivo y DE que Constituye el
Objetivo: estos campos aceptan cualquier valor, el cual se
introduce tocando el campo y utilizando el teclado externo o
el teclado numérico en la pantalla.
Rango de la DE: escoja q, 2 ó 3 DE. Los rangos típicos de la
DE para los reactivos IL y los niveles de control se reportan
en la sección 3.3.8. Los laboratorios pueden utilizar estos
valores como lineamientos, pero deben establecer su propia
DE.
3.52
79
Cuando se activa el cuadro de Marcado de Rango de Control de
Calidad, se marcará el control y tendrá un indicador en caso
de que se encuentre fuera del rango definido. Los resultados
del paciente no tendrán una indicación solamente cuando se
marca este cuadro.
El cuadro de marcado de Indicador de los Resultados del
Paciente puede activarse solamente después de la activación
del cuadro de Marcado del Rango de Control de Calidad. Cuando
se marca este cuadro y el Control de Calidad está fuera de
rango, se hará notar una indicación en las muestras del
paciente procesadas en la misma corrida que las muestras de
Control de Calidad. Las muestras procesadas en corridas
subsiguientes que no tienen muestras de Control de Calidad no
tendrán el indicador.
Los cuadros de marcado de Verificación del Rango de Control
de Calidad e Resultados del Paciente con Indicación pueden
activarse mediante el simple tacto y hacer que aparezca un
signo de marcado.
El botón de Despejar Estadísticas suprime, después de la
confirmación, todos los resultados de una combinación de
Prueba – Materiales de Control de Calidad en particular.
(Símbolo)
Advertencia: El cambio del número del Lote por un líquido de
Control de Calidad bajo el menú de Ajuste de Líquido,
suprimirá todos los resultados de Control de Calidad para ese
líquido.
Al hacer clic en el icono de la Impresora, seguido por una
solicitud de confirmación ¿Quiere realmente imprimir? La
respuesta de Sí permite que el operador imprima el Ajuste de
la prueba, la respuesta de No cancelará la operación.
Al hacer clic en el botón de Confirmar permite que el
operador salga de esta pantalla y el sistema regresa a la
pantalla de Revisión de Control de Calidad.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
Cuando hay una asociación activa entre un material de Control
de Calidad y las pruebas, los iconos de Trazo y Estadística,
Resultados Acumulativos y Computadora Principal están
activos.
80
3.3.3 Revisión de los Resultados de Control de Calidad
La pantalla de Base de Datos Principal tiene un icono de
Control de Calidad en la hilera inferior. Este icono mostrará
una base de datos por separadote los 100 últimos resultados
de Control de Calidad procesados en el sistema. Se mostrará
un signo de admiración de color rojo a lo ancho del icono
cuando haya una falla de Control de Calidad en el sistema.
Los resultados fuera de 2DE se mostrarán con color azul, en
tanto que aquellos fuera de 3DE se mostrarán con color rojo.
Los resultados dentro de su rango se mostrarán con color
negro. El signo de admiración permanecerá en el icono hasta
que se despeje la falla de Control de Calidad de la lista.
Cuando todas las pruebas y los líquidos de Control de Calidad
no tengan elementos fuera de rango, no se mostrará el signo
de admiración.
3.53
(Ilustración)
La base de datos muestra lo siguiente para los resultados de
Control de Calidad: la prueba, el material de Control de
Calidad, la unidad para el resultado y cualesquiera errores.
El número de Resultados en la base de datos se muestra en el
cuadro de “Resultados” en la parte superior derecha. Los
botones de Despejar Todos y Despejar Uno Solo eliminarán a
los resultados de la base de datos de Control de Calidad; sin
embargo, se mostrarán todavía bajo las opciones de Trazo de
Control de Calidad y Resultados Acumulativos. Los resultados
en la base de datos pueden imprimirse con el uso de Imprimir
Todo el Control de Calidad o Imprimir el Control de Calidad
de Hoy
3.3.4 Control de Calidad – Trazo y Estadísticas
A fin de abrir la ventana de Trazo de Control de Calidad y
Estadísticas (que se muestra a continuación), oprima el botón
de Trazo y Estadísticas situado en la pantalla de Revisión de
Control de Calidad.
Esta pantalla muestra tanto el Trazo como las Estadísticas de
un par Material de Control de Calidad y prueba seleccionado,
mostrados en la parte superior de la pantalla.
La ventana del lado izquierdo de la pantalla muestra la
información siguiente, que no puede editarse desde esta
pantalla.
- Fecha de Inicio
- Fecha del Final
- Unidad
- Media Real
- Media que Constituye el Objetivo
- DE Real
- DE que Constituye el Objetivo
81
- CV Real
- Resultados en las Estadísticas
- Resultados en la Base de Datos (DB)
3.54
(Ilustración)
El trazo de Control de Calidad para una prueba puede verse en
la ventana en el lado derecho de la pantalla. La gráfica
indica los Días en el eje de las X, la unidad y la media que
constituye el objetivo en el eje de las Y, y la DE en el eje
de las Y derecho.
La indicación cubre un intervalo de 30 días; la ventana por
omisión muestra los resultados correspondientes al intervalo
de los 30 últimos días, pero el operador puede ver datos
anteriores y desplazarse utilizando la barra de
desplazamiento. Los 500 últimos valores de Control de Calidad
por líquido y prueba pueden mostrarse en el trazo. El sistema
conservará los 65,536 últimos valores para los cálculos
estadísticos.
Los valores de Control de Calidad se mostrarán como sigue en
la gráfica:
• Los valores omitidos aparecen como un símbolo de diamante
azul.
• Los valores de Control de Calidad fuera del rango de la
DE (1 ó 2DE) aparecen como un círculo violeta.
• Los valores de Control de Calidad fuera del rango de 3 DE
aparecen como un triángulo rojo.
• Los valores de Control de Calidad válidos aparecen como
un asterisco.
El cálculo estadístico se efectúa utilizando todos los
resultados de la base de datos. Para obtener las Estadísticas
y el Trazo para otros intervalos seleccionados de tiempo,
haga clic en el botón de Seleccionar Intervalo e introduzca
la fecha específica de inicio y final (dd mm aaaa o de
acuerdo con el formato de fecha seleccionado en la
configuración de Fecha/Hora) en los campos específicos de la
pantalla de Seleccionar Intervalo.
3.55
(Ilustración)
El nuevo intervalo debe confirmarse haciendo clic en el botón
de Confirmar, lo que da por resultado que el sistema regrese
a la pantalla de Trazo y Estadísticas de Control de Calidad,
o no confirmarse haciendo clic en el botón de Cancelar (se
aplica lo anterior solamente al intervalo seleccionado). Los
resultados estadísticos se actualizarán con base en el
intervalo seleccionado.
Al hacer clic en el icono de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir? La
82
respuesta de Sí permite que el operador imprima el trazo, No
cancelará la operación.
Al hacer clic en el botón de Resultados Acumulativos, se abre
la pantalla de Resultados Acumulativos de Control de Calidad
(consultar la subsección a continuación).
Al hacer clic en el botón de Confirmar, se sale de la
pantalla y se regresa a la pantalla de Revisión de Control de
Calidad.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.3.5 Control de Calidad – Resultados Acumulativos
Al hacer clic en el botón de Resultados Acumulativos situado
en las pantallas de Trazo y Estadísticas de Control de
Calidad, se abre la pantalla de Resultados Acumulativos de
Control de Calidad.
3.56
(Ilustración)
La parte superior de la pantalla muestra lo siguiente: el
material de Control de Calidad seleccionado (Identificación
del Líquido), la prueba seleccionada (Identificación de la
prueba), el rango de la fecha (dd.mm.aaaa) y el rango de
tiempo (hh.mm). Esta información no puede editarse en esta
pantalla.
La parte más grande de la pantalla se utiliza para mostrar
los resultados obtenidos para el par de material de Control
de Calidad-prueba.
Indicador de la columna “F” – Aparecerá una Q en este campo
en caso de que haya una alerta de Control de Calidad.
La columna “S” indica el estado de la transmisión (L es
local, T es transmitido).
La columna “O” significa omitido, que se designa mediante una
marca de verificación en esta columna.
Los resultados se muestran con el uso de una lista que puede
desplazarse verticalmente; las columnas muestran los
resultados numéricos en la unidad configurada y la fecha/hora
del análisis. Los valores fuera del rango de la DE programado
(1 ó 2 DE) se mostrarán en violeta y aquellos valores fuera
de 3 DE se mostrarán con rojo.
83
Hay también una columna para notas y columnas para posibles
indicaciones y advertencias.
Los detalles adicionales acerca de un solo resultado son
accesibles haciendo clic en el icono de Detalles, lo que abre
la pantalla de Detalles de un Solo Resultado de Control de
Calidad.
3.57
(Ilustración)
En esta pantalla, se muestra la identidad del par de
Identificación del Líquido/Identificación de la Prueba en la
primera línea de la pantalla.
Las ventanas en el lado izquierdo de la pantalla muestran la
curva de la muestra de Control de Calidad, las unidades
medidas y las unidades calculadas.
La información adicional acerca del resultado mostrado puede
verse también en el lado derecho de la pantalla.
- Estado de la transmisión (T: Transmitido a la Computadora
Principal o L: Local cuando el resultado no ha sido
transmitido a la Computadora Principal).
- Estado de omisión (Sí o No).
- Fecha y hora del análisis.
- Notas (si las hubiera).
- Lista de advertencias
Al hacer clic en el icono de Disco permite que el operador
guarde el resultado en un disco flexible para uso futuro. La
acción abre la pantalla de Teclear Nombre del Archivo.
Después de teclear el nombre del archivo y confirmar la
operación, se abre la pantalla de Operación en Proceso y se
guarda la información en el disco.
La rutina de guardar en el disco guarda las lecturas de los
puntos de los datos en bruto y no la indicación de la curva
de coagulación en el disco. El archivo debe nombrarse con una
extensión de “crv” (es decir, PTQC1.crv).
Al hacer clic en el icono de Impresora, seguido por una
ventana de solicitud de confirmación ¿Quiere realmente
imprimir? La respuesta de Sí permite que el operador imprima
el resultado solo; No cancelará la operación.
Al hacer clic en el botón de Confirmar hace que el sistema
regrese a la pantalla de Resultados Acumulativos de Control
de Calidad.
Los operadores pueden introducir sus propias notas en la
pantalla de Introducir Notas (que se muestra a continuación)
que se abre haciendo clic en el icono de Notas.
3.58
El campo de notas de texto libre permite que el operador
teclee hasta 30 caracteres alfanuméricos. Haga clic en el
84
botón de Confirmar después de introducir la nota para
guardarla.
(Ilustración)
Al hacer clic en el botón de Omitir Resultado permite que el
operador omita permanentemente el resultado seleccionado.
Antes de omitirlo, se solicita confirmación Omitir
resultado...¿Quiere realmente omitir el resultado
seleccionado? Son posibles las selecciones de Sí o No. Cuando
se omite el resultado, aparecerá una marca en la columna de
O, al lado del resultado y este resultado no se incluirá en
el cálculo estadístico. Los resultados omitidos se mostrarán
en el Trazo de Control de Calidad como un símbolo de
“diamante” azul. No se puede dejar de Omitir un resultado una
vez que se ha omitido.
Al hacer clic en el botón de Trazo y Estadísticas permite el
acceso a la pantalla de Trazo y Estadísticas de Control de
Calidad (consultar la sección 3.3.4 anterior).
Al hacer clic en el icono de Computadora Principal se abre la
pantalla de Comunicación con la Computadora Principal de
Control de Calidad (consultar la sección 3.3.6 a
continuación).
Al hacer clic en el icono de Extraer Resultados se abre la
pantalla de Extraer Datos de Control de Calidad (consultar la
sección 3.3.7 a continuación).
Al hacer clic en el icono de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir? La
respuesta de Sí permite que el operador imprima el trazo, No
cancelará la operación.
Al hacer clic en el botón de Confirmar se guardan
cualesquiera cambios y se regresa a la pantalla de Revisión
de Control de Calidad.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
3.59
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.3.6 Control de Calidad – Comunicación con la Computadora
Principal
Al hacer clic en el icono de la Computadora Principal que se
encuentra en las pantallas tanto de Resultados de Control de
Calidad como de Revisión de Control de Calidad, se abre la
85
pantalla de Comunicación con la Computadora Principal de
Control de Calidad:
(Ilustración)
La configuración de la Comunicación con la Computadora
Principal, que se muestra en la pantalla, se necesita para
decidir qué tipo de resultados de Control de Calidad se
enviará y por cuál intervalo de tiempo.
El usuario define primero el rango de la fecha y escoge
entre:
- “Todo el rango” (Todo el rango incluiría a todos los
resultados para las pruebas seleccionadas).
- “De...A...” (Rango de Fecha Específico para enviar)
En caso de que se escoja este último, deben definirse la
fecha/hora iniciales y la fecha/hora finales.
El usuario puede entonces seleccionar si deben transmitirse
los datos correspondientes a una prueba específica o todas
las pruebas, escogiendo entre las opciones siguientes:
- “Una Sola Prueba”
- “Todas las Pruebas”
Una vez que se escoge el rango de la fecha y las pruebas., el
usuario puede afinar cuáles resultados se enviarán con base
en las siguientes opciones:
- Resultados Válidos
- Resultados Inválidos
- Resultados no Numéricos
- Resultados Fuera de la Escala
- Resultados Omitidos
- “Transmitidos” o “No Transmitidos”
3.60
- “Con Indicador” o “Sin Indicador”
Al tocar el área de cuadro de marcado cerca de la opción, se
efectúan las selecciones; aparece una marca de verificación
junto a la opción. Estas opciones permiten que el usuario
agrupe los resultados transmitidos para facilidad de manejo,
es decir, resultados Válidos y Sin Indicador. Las opciones de
segundo nivel pueden también combinarse con ellos para
transmitir grupos tales como resultados Válidos y Sin
Indicador – pero Omitidos.
Una vez que se definen los criterios de transmisión, comienza
la transmisión haciendo clic en el botón de Comenzar
Comunicación.
Al hacer clic en el botón de Cancelar, se rechazan los
cambios y el sistema regresa a la pantalla de Resultados
Acumulativos de Control de Calidad o a la pantalla de
Revisión de Control de Calidad, dependiendo de en cuál
pantalla se oprimió el icono de Computadora Principal.
86
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.3.7 CONTROL DE CALIDAD – EXTRAER DATOS
Al hacer clic en el botón de “Resultados Acumulativos” en la
pantalla de Revisión de Control de Calidad, se abrirá la
pantalla de Resultados Acumulativos de Control de Calidad.
Al hacer clic en el icono de Extraer Resultados, se abrirá la
pantalla de Extraer Datos de Control de Calidad (que se
muestra a continuación), que se casi idéntica a la pantalla
de Comunicación con la Computadora Principal de Control de
Calidad.
(Ilustración)
87
3.61
La configuración de datos que se muestra en esta pantalla es
necesaria para decidir qué tipo de resultados de Control de
Calidad deben extraerse y en cuáles intervalos de tiempo. La
asociación de Identificación de Líquido/Identificación de la
Prueba puede verse en la parte superior de la pantalla.
El usuario define primero el rango de fecha y escoge entre:
- “Todo el rango” (Todo el rango incluiría a todos los
resultados para las pruebas seleccionadas)
- “De...A...” (Rango de Fecha Específico a enviar)
Cuando se selecciona el último, debe definirse la fecha/hora
de inicio y la fecha/hora finales.
Una vez que se escoge el rango de fecha y las pruebas, el
usuario puede entonces afinar cuáles resultados ver con base
en las siguientes opciones:
- Resultados Válidos
- Resultados Inválidos
- Resultados no Numéricos
- Resultados Fuera de la Escala
- Resultados Omitidos
- “Transmitidos” o “No Transmitidos”
- “Con Indicador” o “Sin Indicador”
Se efectúan las selecciones tocando el área del cuadro de
marcado próxima a la opción; aparece una marca de
verificación junto a la opción. Estas opciones permiten que
el usuario agrupe los resultados extraídos para facilidad de
manejo, es decir, resultados Válidos y Sin Indicador. Las
opciones de segundo nivel pueden también combinarse con ellos
para ver grupos tales resultados Válidos y Sin Indicador,
pero Omitidos.
Una vez que se definen los criterios de extracción, el
proceso comienza haciendo clic en el icono de Extraer. Se
mostrarán los datos acumulativos para el intervalo
seleccionado. Los datos estadísticos no se actualizan con
base en los datos seleccionados. Las estadísticas se basarán
en los datos del intervalo por omisión.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
88

3.62
3.4 Calibración
El sistema ACL Elite/Elite Pro requiere que se calibren
ciertas pruebas antes del análisis de las muestras o
simultáneamente con éste. Cuando se solicita una prueba con
una calibración especializada y no existe ninguna curva de
calibración en la memoria, se mostrará una advertencia de
“calibración faltante” durante la verificación previa al
análisis.
Aunque las calibraciones requieren el uso de reactivos
específicos para la prueba y, con frecuencia, otros
materiales específicos, el procedimiento de calibración es
común para todas las pruebas.
Esta sección contiene toda la información necesaria para
calibrar los ensayos en el ACL Elite/Elite Pro, comenzando
con un procedimiento resumido para aquellos usuarios ya
familiarizados con el sistema ACL Elite/Elite Pro, seguido
por procedimientos paso por paso con detalles específicos
acerca de las pantallas, opciones, etc.

Tabla de Calibración – características por prueba


Prueba Especializada En la Sesión Cada Rotor
PT #
Fib-Basado en PT #
Fibrinógeno C #
Factores* #
Antitrombina #
Heparina #
Proteína C #
Plasminógeno #
Inhibidor de Plasmina #
ProClot #
Crom. Factor VIII #
Proteína S Libre #
Proteína S #
Pro S #
Dímero D #
VWF (Ag. y Actividad) #
* Los Ensayos con Paralelismo importan la calibración del
mismo ensayo de factor con un modo de calibración
especializado.
Especializada significa que se inicia una sesión por separado
para efectuar una calibración. La sesión se inicia con el uso
del menú de calibración. El analizador...
3.63
89
...guardará la última curva de calibración ejecutada. La
curva puede verse bajo el submenú de revisión de la
calibración.
En la sesión significa que la calibración se ejecuta la
primera vez junto con las muestras y luego se guarda. Las
corridas subsiguientes para la prueba en la misma sesión
analítica utilizan la misma curva guardada. Para sesiones
analíticas futuras, cuando los calibradores se encuentran
colocados en la misma charola de muestras en la que se
ejecutará la calibración; en caso de no ser así, se utiliza
la calibración anterior. El sistema guardará las cinco
últimas calibraciones por prueba. Las curvas pueden verse
utilizando el menú de revisión de calibración. La curva de
prueba efectuada está activa y en uso.
Cada Rotor significa que cada vez que se carga un rotor con
muestras, se ejecuta también la calibración. Se requiere que
el material de calibración se coloque en la charola de
muestras para cada corrida. En caso de que se procesen
múltiples rotores dentro de una sesión analítica, se
efectuará una calibración en cada rotor.
3.4.1 Procedimiento de Calibración Especializada – Resumen

1. Seleccione Calibración en la barra de menú de la pantalla


Principal y seleccione Calibrar en el submenú de
Calibración.
2. Desplácese a través de la lista de pruebas que se
muestran en la ventana de Prueba para Calibrarse en el
lado superior derecho de la pantalla y seleccione la
prueba que va a calibrarse.
3. Vea la ventana del lado izquierdo o el Mapa de Materiales
y asegúrese de que se tienen a mano los materiales
incluidos en la lista para efectuar la calibración para
la prueba.
4. Oprima Comenzar para iniciar la fase Previa al Análisis.
El ACL Elite/Elite Pro verificará la presencia de los
materiales requeridos. Cuando todos los materiales
requeridos estén presentes, comenzará la corrida de
calibración.
(Ilustración)
3.64
3.4.2 Guardar una Calibración – Resumen
Al final del ciclo, puede verse la Calibración antes de
guardarla. Cuando se acepta la nueva calibración, se
suprimirá la calibración anterior. Para las calibraciones
especializadas, es posible solamente comparar los resultados
de la nueva sesión de calibración con los de la calibración
anterior antes de decidir guardarlos o no. Para las
90
calibraciones no especializadas, el sistema conserva las 5
últimas calibraciones en la memoria. La más antigua se
cancela automáticamente con cualquier nueva corrida de
calibración.
Nota: Las calibraciones deben revisarse y aceptarse antes de
que el sistema pase al estado de espera (standby).
3.4.3 Calibraciones Especializadas – Detalles
El proceso de calibración se inicia en la pantalla Principal
al seleccionar Calibración en la barra de menú y al
seleccionar Calibrar en el submenú de Calibración. Lo
anterior abrirá a la pantalla de Calibración Previa al
Análisis.
La pantalla está dividida en varias áreas:
Área superior derecha: La ventana de Prueba para Calibrar
permite que el usuario se desplace a través de la lista de
pruebas que se muestran y que escoja la prueba que va a
calibrarse. La lista incluye a todas las pruebas que
requieren una calibración especializada.
Área superior izquierda: Una ventana grande muestra a la
lista de materiales necesarios para efectuar la calibración
para la prueba seleccionada en la ventana de Prueba para
Calibrar. Por ejemplo, cuando se selecciona una prueba de
PT, el Plasma de Calibración, el Diluyente de Factor y la
Tromboplastina aparecerán como materiales requeridos.
• Cuando utilice un nuevo lote de cualquiera de los
materiales, oprima el botón de Detalles del Líquido en la
parte inferior de la ventana y modifique el número de
lote apropiado.
• Cuando utilice un nuevo lote de Plasma de Calibración,
oprima el botón de Detalles del Líquido en la parte
inferior de la ventana e introduzca el nuevo valor
asignado, como se muestra en la hoja del inserto del
paquete del Plasma de Calibración.
Nota: Para la calibración de PT, el valor introducido para el
plasma de calibración es de 100.
La ventana está dividida en 4 columnas con una hilera por
Material. La información mostrada es la misma que la
introducida cuando se define la configuración del material.

- # Número de la posición asignada en la Charola de Muestras del ACL (A1-


10) o la Posición de Reactivo (R#)
- Número de Lote Número del lote específico
- Valor Valor asignado al PRIMER Estándar, según se indica en la hoja del
inserto del paquete.
3.65
91
Al hacer clic en el botón del Mapa de Materiales en la parte
inferior de la ventana, se abre la pantalla del Estado de
Materiales, Previa al Análisis.
(Ilustración)
Esta pantalla muestra el estado de los reactivos actualmente
a bordo del sistema, junto con otra información del
analizador. Consulte la sección 3.2.3 para los detalles
acerca del Mapa de Materiales.
Al hacer clic en el botón de Iniciar en el Mapa de
Materiales, comienza la corrida de calibración.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.4.4 Calibración – Revisar Calibración
El proceso de Revisión de Calibración (calibración
especializada y en la sesión) se inicia en la pantalla
Principal seleccionando Calibración en la barra de menú y
seleccionando Revisar Calibración en el submenú de
Calibración. Lo anterior abrirá la pantalla de Revisar
Calibración.
3.66
(Ilustración)
Esta pantalla muestra la fecha y la hora registradas de todas
las calibraciones efectuadas para cada prueba activada.
• Calibraciones Especializadas: El ACL guardará la última
calibración efectuada.
• Calibración en la Sesión: El ACL guardará las 5 últimas
calibraciones. La más recientes será la activa en uso.
Las calibraciones pueden suprimirse seleccionando la
Identificación de la Prueba y la fecha/hora de Calibración y
haciendo clic en el icono de Suprimir a continuación.
Al hacer clic en el icono de Detalles en la parte inferior de
la pantalla, se abre la pantalla de Datos de Calibración (que
se muestra a continuación)
(Ilustración)

3.67
Esta pantalla proporciona al usuario la capacidad para ver de
un vistazo la información más importante relacionada con las
corridas de calibración:
92
- Nombre de la prueba (identificación)
- Fecha y hora en que se efectuó la calibración.
- Curva de calibración
- Coeficientes de Ecuación Lineal de Calibración
- Errores (haga clic en el botón de Ver Errores; ver a
continuación)
- Advertencias (haga clic en el botón de Lista de
Advertencias; ver a continuación)
- Media del valor de las réplicas, unidades de medición y %
de CV.
Al hacer clic en el icono de Detalles, se muestra información
acerca de cada réplica individual.
(Ilustración)
Esta pantalla permite que el operador revise la curva de
formación de coagulación (o la curva de absorbencia,
dependiendo de la prueba) para cada réplica individual, junto
con el valor numérico. Para las curvas de las pruebas de
coagulación, se muestra también el punto de coagulación.
Las réplicas individuales pueden omitirse oprimiendo el botón
de Omitir Réplica. La réplica seleccionada se eliminará del
cálculo de la media. Seguirá mostrándose y tendrá una marca
en la Columna de Omitir. Pueden omitirse múltiples réplicas,
pero debe dejarse por lo menos una para el cálculo de la
curva.
La media del valor para una calibración se calcula
promediando todos los valores de las réplicas. La réplica
más alejada de la media se elimina. Las réplicas restantes
se promedian a continuación. Éste es el valor que se utiliza
para construir la curva.
Los datos en bruto para el nivel y las réplicas que se
muestran, pueden guardarse con el uso del icono del disco
flexible. Debe darse un nombre a la curva. Se añadirá
automáticamente la extensión .crv al nombre.
- Los BOTONES ACTIVOS en la parte inferior de esta
pantalla son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
3.68
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
- Confirmar hace que se salga de la pantalla y el sistema
regresa a la pantalla de Revisar Calibración.
(Símbolo)
93
Advertencia: Al cambiar el valor de un calibrador que
constituye el objetivo en la pantalla de Ajuste de Líquidos
después de efectuar una calibración, da por resultado que la
calibración almacenada se actualice automáticamente para
reflejar el nuevo valor. Se presenta un mensaje de
advertencia que informa al usuario que la calibración
almacenada se actualizará. La calibración debe ejecutarse
todavía para la prueba en caso de que la calibración no se
haya efectuado nunca con el uso de este lote de calibrador.
Al hacer clic en el botón de Confirmar permitirá que el
operador salga de la pantalla y que el sistema regrese a la
pantalla de datos de calibración.
Al hacer clic en el icono de Impresora, se imprime la curva
de calibración y los datos de calibración. Cuando la curva
está compuesta por múltiples segmentos, debe imprimirse cada
segmento individualmente. Cuando se oprime el icono de
impresora mientras se ven las curvas de réplicas, se
imprimirá entonces la curva mostrada.
Al hacer clic en el botón de Ver Errores, se abre la pantalla
de Ver Errores (que se muestra a continuación).
(Ilustración)

3.69
Al hacer clic en el botón de Lista de Advertencias, se abre
la pantalla de Ver Advertencias.
(Ilustración)
Al hacer clic en el botón de Confirmar, se sale de las
pantallas y el sistema regresa a la pantalla de Datos de
Calibración.
3.70
Tabla: Número de puntos de calibración utilizados por prueba.
Prueba Estándar de Número Total Número de Número Total
Calibración de Puntos de Réplicas por de Puntos de
que se Calibración cada Punto Calibración
colocará
PT 1 3 6 18
Fib basado en PT * * * *
Fib-C 1 3 4 12
Factores # 2 6 1 6
Factores $ 1 6 2 12
AT 1 3 4 12
HEP 2 3 4 12
P-C 1 3 1 3
PLG 1 3 1 3
FVIII Crom. 1 3 1 3
P-I 1 3 1 3
ProClot 1 3 1 3
94
ProS 2 3 1 3
Dímero D 1 3 4 12
VWF (Ag/Act) 1 4 4 16
*mismo número que en las pruebas de PT
# Se utilizan 2 estándares para la calibración de los Ensayos
de Factores sin Paralelismo: el 100% es el Plasma de
Calibración tal como es (puro) y el Plasma de Calibración de
Factor Bajo es el mismo plasma de calibración diluido 1+15
con Diluyente de Factor (esta dilución tiene que ser
preparada manualmente por el operador). Los factores con
paralelismo utilizan plasma de Calibración solamente.
$ Los Factores con pruebas de Paralelismo definidas
importarán la calibración del mismo ensayo, sin las
diluciones de paralelismo. La calibración para esta prueba
requerirá 3 copas vacías durante el ciclo de calibración que
se utilizará para preparar la dilución de Plasma de
Calibración de Factor Bajo.
3.71
3.4.5 Calibración de Ensayos de Factor para Pruebas Sin
Paralelismo
Esta información es válida para todos los ensayos de 8
factores (VII, X, V, II, XII, XI, IX y VIII*) cuando se
utiliza la biblioteca de pruebas de IL. La curva de
calibración para los factores se divide en 3 segmentos:
1. Curva Alta: Se prepara con el uso de Plasma de
Calibración con niveles de 100%, 50% y 25%.
2. Curva Baja: Se prepara con el uso de Factor de
Calibración Bajo con niveles que varían de 6.25%, 3.125%
y 1.56%.
3. El segmento de en medio conecta el 25% del segmento uno y
el 6.25% del segmento tres.
*excluye al Factor VIII Cromogénico
Preparación de los estándares de Calibración
Para la calibración de los ensayos de factores, es necesario
preparar dos estándares de calibración:
100% está representado por el Plasma de Calibración
reconstituido; el valor específico asignado, contenido en la
hoja del inserto del plasma de calibración, necesita usarse
de acuerdo con el valor asignado para este material y el
factor relativo que se está sometiendo a prueba.
El Factor de Calibración Bajo (6.25%) está representado por
el Plasma de Calibración diluido 1 + 15 con el uso del
Diluyente de Factor. El ACL Elite/Elite Pro calcula
automáticamente el valor asignado con base en valor de 100%
introducido por el usuario. El estándar se prepara
pipeteando 20 µL de Plasma de Calibración + 300 µL de
95
Diluyente de Factor en una copa de 0.5 mL. Mezcle bien antes
de usar.
Se requiere el plasma de calibración de 100% para obtener una
curva de calibración válida.
Cuando no se coloca el material de plasma de calibración de
100%, una ventana indicará a los materiales faltantes. Se
proporcionan las opciones para abortar o continuar. En caso
de que el usuario opte por continuar, se efectúa un análisis
de la muestra, aunque la calibración no puede ejecutarse.
Los resultados de las muestras se calculan con base en la
calibración anterior. Se reportan los valores de respuesta y
de actividad (%). Cuando no existe ninguna curva de
calibración almacenada, los resultados se mostrarán solamente
en segundos.
Cuando el material de 100% no proporciona un resultado
válido, la calibración entera es rechazada automáticamente.
Cuando se revisa la calibración, se muestra un mensaje de
error. Además, no se mostrará ninguna estadística o curva de
calibración.
3.72
IL recomienda que el material de 100% se coloque en la
charola de muestras para cada sesión de Análisis de Factor.
El material de Factor de Calibración Bajo (6.25%) es un
material optativo. Se utiliza para obtener los segmentos
Bajo y de En Medio de la curva de calibración.
Se incluye a continuación un resumen de las 6 diluciones que
utiliza el ACL Elite/Elite Pro para efectuar una calibración
de Ensayos de Factores, cuando se efectúan todos los 3
segmentos.

Relación de Dilución en % Preparación


100 Plasma de Calibración sin Diluir
50 Plasma de Calibración – El ACL Elite/Elite efectúa
automáticamente la dilución.
25 Plasma de Calibración – El ACL Elite/Elite efectúa
automáticamente la dilución.
6.25 Factor de Calibración Bajo – Se prepara manualmente
diluyendo el Plasma de Calibración 1 + 15 con Diluyente de
Factor
3.12 Factor de Calibración Bajo – El ACL Elite/Elite efectúa
automáticamente la dilución.
1.56 Factor de Calibración Bajo – El ACL Elite/Elite efectúa
automáticamente la dilución.

3 Segmentos de calibración: Alto, Medio y Bajo


La curva de calibración para los ensayos de factores está
compuesta por 3 segmentos:
96
Se obtiene el segmento alto conectando los puntos de 100, 50
y 25%.
El segmento de en medio se obtiene conectando los puntos de
25 y 6.25%.
El segmento bajo se obtiene conectando los punto de 6.25,
3.12 y 1.56%.
La Calibración de Ensayos de Factores de la biblioteca de
pruebas de IL utiliza los criterios del modo de calibración
en la sesión. En caso de que el plasma de calibración sin
diluir esté presente en la charola de muestras del ACL
Elite/Elite Pro, se efectúa la calibración del segmento Alto
durante la sesión analítica.
3.73
Cuando el plasma de calibración sin diluir no está presente,
se utiliza la calibración Alta anterior almacenada en la
memoria para el cálculo y reporte de los resultados.
Nota: No coloque la copa de Factor de Calibración Bajo a
bordo del analizador sin colocar la copa de Plasma de
Calibración.
Se define que comienza una sesión analítica con el inicio del
análisis y que termina cuando el instrumento regresa a Listo.
Nota: Todos los resultados procesados en una curva de
calibración con un error en uno de los segmentos, recibirá un
indicador con una advertencia “Segmento adyacente inválido”
Curva alta
En caso de que el operador necesite solamente la curva Alta,
es posible efectuar la calibración solamente con el uso del
plasma de calibración sin diluir.
El ACL Elite/Elite Pro efectuará solamente 3 puntos de
calibración: 100%, 50% y 25%.
La linealidad varía de un factor a otro, pero el instrumento
proporcionará siempre un indicador de un resultado menor de
60% del punto de calibración más bajo.
En caso de que el punto de calibración más bajo sea de 25%,
se proporcionará un indicador con una “C” en la columna de
Errores y se marcará con “Resultado Extrapolado” en la Lista
de Advertencia de Detalles de la Prueba, para todos los
resultados inferiores a 15%.
En caso de que un resultado sea más alto de 150% del valor
del punto de calibración más alto, se mostrará una “C” en la
columna de Errores y se mostrará “Resultado Extrapolado” en
la Lista de Advertencia de Detalles de la Prueba.
Por ejemplo, cuando el punto más alto de la calibración sea
de 100%, todos los resultados superiores a 150% tendrán un
indicador con una “C” y se marcarán con “Resultado
Extrapolado”.
97
Cuando la curva Alta no sea válida (rechazada), los
resultados de los pacientes se presentarán solamente en
segundos.
3.74
Cuando se rechaza la curva de calibración Alta, pero el
resultado de 100% es un resultado válido, se calcularán los
segmentos de la curva Baja y la curva Media.
Cuando el 100% proporcione un resultado no válido (es decir,
número de error xx), se rechazará la curva Alta, Media y
Baja.
En ambos casos incluidos arriba, debe repetirse la
calibración junto con las muestras de Control de Calidad y de
los pacientes.
Es posible que solamente dos puntos (con inclusión del 100%)
sean válidos y, en este caso, el instrumento presentará la
condición de “calibración de 2 puntos”.
Curva Baja
En caso de que se requieran los segmentos tanto Alto como
Bajo, deben calibrarse ambos segmentos al mismo tiempo.
Cuando se rechaza la curva Alta debido a un resultado de 100%
no válido, se rechaza la curva Baja.
Cuando se rechaza la curva Baja (inválida, no monotónica,
etc.), los segmentos de la curva Alto y Medio pueden
considerarse válidos. La curva de segmento Medio debe
verificarse antes de reportar los resultados del paciente.
Es posible que sean válidos solamente dos puntos (con
inclusión del de 6.25%) y, en este caso, el instrumento
presentará la condición de “calibración de 2 puntos”.
Cualquier resultados fuera de este Rango de Pruebas
especificado, según se define en el ajuste de la prueba,
recibirá un indicador con una “C” en la columna de Errores y
“Fuera del Rango de Prueba se mostrará en la Lista de
Advertencias de Detalles de la Prueba.
3.75
Curva media
La curva Media se calculará cuando se calibran los segmentos
de la curva tanto Alto como Bajo al mismo tiempo y los puntos
tanto de 25% como de 6.25% han producido resultados válidos.
En caso de que los segmentos Alto y Bajo no produzcan una
calibración válida (es decir, pendiente fuera de rango), en
caso de que ambos resultados del segmento de curva Medio sean
válidos, se calcula el segmento de curva Medio. La curva del
segmento Medio debe verificarse antes de reportar los
resultados del paciente.
Cualquier resultado fuera del Rango de la Prueba
especificado, según se define en el ajuste de la prueba,
recibirá un indicador con una “C” en la columna de Errores y
98
se mostrará “Fuera del Rango de la Prueba” en la Lista de
Advertencias de Detalles de la Prueba.
Verificación no monotónica
Otra verificación efectuada en la calibración se denomina
“Monotónica”.
Esta verificación comprueba que los resultados obtenidos en
segundos procedan en la misma dirección: baja a alta o alta a
baja.
En caso de que uno de los puntos en segundos no sea
“monotónico”, se proporciona un indicador al segmento entero
de la curva y se rechaza.
En caso de que se halle que el segmento de la curva Alto no
sea “monotónico”, los resultados de la muestra se calcularán
con base en los segmentos de la curva Medio o Bajo en caso de
que sean válidos.
En caso de que se halle que el segmento de la curva Bajo no
es “monotónico”, los resultados de la muestra se calcularán
con base en los segmentos de la curva Medio o Alto en caso de
que sean válidos.
Para las dos condiciones anteriores, la curva debe
verificarse con anterioridad a reportar los resultados del
paciente.
Cuando está presente solamente el calibrador de 100% y se
muestra el error “no monotónico”, se rechazará la curva
entera. En este caso, los resultados de la muestra se
calcularán con base en la curva de calibración anterior. En
caso de que la curva de calibración anterior no esté
presente, se reportarán solamente los valores de respuesta.
3.76
Verificación de la pendiente
En caso de que la pendiente de calibración exceda del límite
de pendiente definido específicamente para el segmento, se
rechazará el segmento con el mensaje de error de Pendiente
Fuera de Rango.
Las muestras que se corren en esta condición recibirán el
indicador con una “C”, junto con el mensaje “Pendiente Fuera
de Rango”.
Verificación r2
En caso de que la calibración r2 para un segmento específico
exceda del límite de r2 definido específicamente para el
segmento, la r2 se presentará en rojo y se presentará un
indicador de “C” con el mensaje de “r2 fuera de Rango” junto
con los resultados de la muestra del paciente.

3.77
Indicadores en los resultados de los pacientes
99
Puede haber presentes varios indicadores en los resultados de
los pacientes y se resumen en la tabla siguiente.

Indicador Explicación
Fuera del Rango de la Prueba = el resultado El resultado está fuera del Rango de la Prueba
se muestra en violeta para esa prueba específica.
Resultado extrapolado Cuando el resultado es superior de 150% del
punto de calibración más alto o menor de 60%
del punto de calibración más bajo. Se aplica a
la curva alta o curva baja.
Calibración anterior El resultado se calcula con el uso de una
calibración almacenada anteriormente.
Segmento Adyacente Inválido La curva de calibración tiene un segmento con
un error.
Pendiente Fuera de Rango El resultado se calcula cuando por lo menos el
segmento Alto de la curva es válido.
R2 fuera de Rango El resultado se calcula y se muestra un
mensaje de error (r2 fuera de Rango)
Respuesta “no monotónica” El resultado se calcula y se muestra un
mensaje de error (respuesta “no monotónica”)
100
Recomendación:
En caso de falla en el segmento Bajo y que los resultados
obtenidos sean < 25%, repita la calibración, el Control de
Calidad y las Muestras del Paciente.
Como la calibración puede correrse simultáneamente con las
muestras de los pacientes o como puede utilizarse una
calibración almacenada anteriormente, el operador debe
verificar que todos los segmentos de calibración sean válidos
y que no haya ningunos indicadores de calibración presentes
antes de validar cualesquiera resultados
3.78
Para la buena práctica de laboratorio, deben correrse por lo
menos dos (2) niveles de controles junto con las muestras de
los pacientes.
En caso de que una calibración muestre algún indicador, la
buena práctica de laboratorio sugiere repetir la calibración,
el Control de Calidad y las muestras de los pacientes.
En caso del Factor VIII y/o IX, el tratamiento terapéutico
del paciente puede asociarse a los resultados de la muestra.
Efectúe la calibración de la curva Baja al mismo tiempo que
la calibración de la curva Alta para cubrir concentraciones
de factores de manera descendente hasta el nivel de 1.56%.
La estabilidad de una curva de calibración almacenada debe
monitorearse mediante el uso de por lo menos dos niveles de
materiales de Control de Calidad cada día de pruebas.
3.4.6 Calibración de Ensayos de Factor – Pruebas de
Paralelismo
Los ensayos de factores para las pruebas con paralelismo
importan la calibración de la misma prueba de factor definida
sin las diluciones de paralelismo. Esta prueba maestra se
calibra con el uso del modo de calibración especializada.
Esta información es válida para todos los ensayos de factores
con Paralelismo cuando se utiliza la biblioteca de pruebas de
IL. La curva de calibración para los factores se divide en 3
segmentos.
• Curva Alta: Se prepara con el uso de Plasma de
Calibración con niveles de 100%, 50% y 25%.
• Curva Baja: Se prepara con el uso de Factor de
Calibración Bajo con niveles que varían de 6.25%, 3.125%
y 1.56%.
• El segmento medio conecta el 25% del segmento uno y el
6.25% del segmento tres.
La calibración de la prueba maestra requerirá 3 copas vacías
en la charola de muestras durante el ciclo de calibración.
Estas copas se utilizarán para preparar automáticamente la
dilución del Plasma de Calibración para uso como Factor de
Calibración Bajo.
101
Las muestras que se procesan con el Paralelismo de Factor
serán procesadas con tres niveles de dilución: 100%, 50% y
25%.
3.79
3.4.7 Resultados del Paralelismo de los Ensayos de Factor
Introducción
El Paralelismo de Factores es una técnica que se emplea para
determinar la influencia o efecto que tienen los inhibidores
sobre el resultado de la actividad del Ensayo del Factor de
la muestra. La posible presencia de un inhibidor y de su
efecto puede determinarse sometiendo a ensayo al Factor con
el uso de una serie de diluciones. El impacto de las
diluciones sobre la actividad del factor puede observarse a
continuación.
La finalidad de la función de Paralelismo en el ACL
Elite/Elite Pro es ayudar a la identificación de un inhibidor
de una manera fácil y automatizada. El modo de prueba de
Paralelismo es un medio para crear diluciones definibles por
el usuario. El instrumento ejecutará todas las diluciones,
efectuará las pruebas en las diluciones y proporcionará datos
de evaluación sobre los resultados para ayudar a determinar
la presencia de un inhibidor.
El software proporciona múltiples verificaciones de los datos
generados y proporciona información valiosa al operador para
ayudar a identificar la presencia de un patrón de inhibición.
Algunas de estas verificaciones incluyen a la comparación con
el resultado original sin diluir y los datos de precisión de
las diluciones adicionales.
La ejecución del Paralelismo de Factor es un elemento
optativo y, cuando se ejecuta, proporcionará un Indicador
definible por el operador para alertar al operador si se ha
excedido un límite. Cuando se tiene sospecha de un inhibidor,
se sugieren pruebas confirmatorias.
Se obtienen los resultados corriendo una serie de diluciones
de la muestra, de manera similar a la ejecución de una
calibración. Las muestras que se corren con el uso del
paralelismo de factor se analizarán en los niveles de 100%,
50% y 25%. En el reporte acumulativo, se reportarán los
resultados para todas las 3 diluciones como Dil 1 (100%), Dil
2 (50%) y Dil 3 (25%). Cada uno de estos niveles puede
mostrar los resultados en segundos, % (sin calcular) y %
Rec (vuelto a calcular). Los resultados vueltos a
calcular serán los valores de % sin calcular multiplicados
por el factor de dilución.
Además de los resultados individuales, el sistema efectuará
cálculos para lo siguiente:
102
- AveCR% - Promedio de los tres Resultados Corregidos en %
de actividad.
- CV-CR% - % de CV de los valores porcentuales de los tres
Resultados Corregidos. Cuando este valor excede del
límite en el ajuste de la prueba, se mostrarán los
resultados en rojo en la pantalla y se imprimirá un error
en el reporte.
- Pendiente – Se calcula la pendiente para los 3 valores de
paralelismo. Esta pendiente debe coincidir con la de la
calibración de la prueba del factor. En el ajuste de la
prueba hay un límite de Pendiente permisible mínimo y
máximo, definible por el usuario. Cuando la pendiente
recuperada para las muestras está fuera de los límites
del ajuste de la prueba, aparecerá un indicador en los
resultados con color rojo y se imprimirá el error
“Pendiente fuera de rango”.
3.80
- Int – Este valor es la intercepción para la línea con
base en las 3 diluciones de paralelismo del factor. En el
ajuste de la prueba hay un límite de intercepción
permisible mínimo y máximo, definible por el usuario.
Cuando el valor recuperado para las muestras está fuera
de los límites, aparecerá un indicador en los resultados
con color rojo y se imprimirá el error “Intercepción
fuera de rango”.
- R2 – Este valor es el coeficiente de correlación
calculado con el uso de los segundos y los 3 valores
porcentuales de dilución del factor (sin corregir). En el
ajuste de la prueba hay un límite de R2 permisible mínimo
y máximo, definible por el usuario. Cuando el valor
recuperado para las muestras está fuera de los límites,
aparecerá un indicador en los resultados con color rojo y
se imprimirá el error “R2 fuera de rango”.
Los resultados de la muestra con un error en cualquiera de
las unidades anteriores debe revisarse para determinar la
presencia de un posible inhibidor del factor. Pueden
requerirse pruebas adicionales con inclusión de diluciones
fuera de línea a niveles más altos para confirmar
cualesquiera resultados cuestionables.
Ejemplo 1
Varianza Máxima del Laboratorio ± 10% de la media
Concentraciones 100%, 50%, 25%
Valores 54.7%, 51.5%, 46.4%
En el ejemplo anterior, los resultados de 54.7% y 51.5%
tienen una media de 53.1 con una concordancia de 10% del
rango de 47.8%. Cuando los resultados se encuentran fuera de
ese rango, debe hacerse otra dilución; cuando se encuentran
103
dentro del rango, son lo suficientemente próximos para
reportar. Cuando todos los puntos se encuentran dentro de 10%
de su media, debe entonces reportarse el valor de
concentración de 100%, siempre y cuando no se vean ningunos
otros indicadores.
La única finalidad del paralelismo es ayudar a la
identificación de inhibidores. En el caso de un inhibidor, la
respuesta reportada debe ser el resultado obtenido cuando 2
diluciones (CR`s) concuerdan.
3.81
3.5 Referencia Analítica
Referencia Analítica (AR por sus siglas en idioma inglés) es
el nombre asociado a un material de control que tiene como
finalidad el uso como verificación general de la precisión
del sistema.
Los resultados de la AR se manejan exactamente igual que los
resultados para un material de Control de Calidad. El trazo y
la lista de resultados acumulativos están ambos a disposición
para la AR. Estos resultados pueden transferirse a una
computadora principal, imprimirse o archivan en un disco
flexible.
3.5.1 Referencia Analítica: AJUSTE
Para Revisar los resultados de la Referencia Analítica, se
selecciona Calibración en la barra de menú de la pantalla
Principal, se selecciona Referencia Analítica a continuación
en el submenú de Calibración. Esto hará que se abra la
pantalla de Revisión de la Referencia Analítica.
(Ilustración)
Esta pantalla es similar a la pantalla de Revisión de Control
de Calidad.
El usuario puede seleccionar la prueba deseada en la lista de
pruebas activadas. Se muestran las estadísticas siguientes,
pero no pueden editarse, en el lado derecho de la pantalla.
- Unidad
- Media Real y que Constituye el Objetivo.
- DE Real y que Constituye el Objetivo.
- CV Real.
- Resultados en las Estadísticas y en la Base de Datos
(DB).
Cuando se marca el cuadro de Usar AR, el sistema verificará
la presencia de la Referencia Analítica durante la
verificación Preanalítica para todos los ensayos. Elimine la
marca del cuadro para desactivar el uso de la Referencia
Analítica para todos los ensayos. El valor por omisión es
para el cuadro que no va a marcarse.
Cuando se marca el botón de Usar AR (activado) y se crean
perfiles, el mapa de materiales correspondiente al perfil
104
reflejará la necesidad del Plasma de Calibración. Cuando el
botón de Usar AR se desactiva posteriormente, los perfiles
que contienen pruebas que utilizan la AR necesitarán
suprimirse o volverse a crear.
3.82
Al hacer clic en el botón de Ajuste, se abre la pantalla de
Ajuste de la Referencia Analítica (ver los detalles
posteriormente en esta Sección).
Al hacer clic en el botón de Trazo y Estadísticas, se abre la
pantalla de Trazo y Estadísticas de la Referencia Analítica
(ver los detalles posteriormente en esta Sección)
Al hacer clic en el botón de Resultados Acumulativos, se abre
la pantalla de Datos de la Referencia Analítica (ver los
detalles posteriormente en esta Sección).
Al hacer clic en el icono de Transferencia a la Computadora
Principal, aparece la pantalla de Comunicación con la
Computadora Principal de AR (ver los detalles posteriormente
en esta Sección).
Al hacer clic en el botón de Confirmar, se sale de la
pantalla.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
Al hacer clic en el botón de Ajustar en la pantalla de
Revisión de la Referencia Analítica, se abre la pantalla de
Ajustar Referencia Analítica.
(Ilustración)
La identificación de la prueba seleccionada aparece en la
parte superior de la pantalla; debajo de la misma, el
operador puede ver la información siguiente:
- Unidad
- Media y DE que Constituyen el Objetivo.
- DE que Constituye el Objetivo.
- Rango de la DE.
- Resultados en la Base de Datos: 10, 100, 500, 1000 pueden
seleccionarse. Cualquier cambio en el número de los
resultados en la base de datos suprimirá a los resultados
de la AR correspondientes a esta prueba.
- Nota.
3.83
105
Al hacer clic en el botón de Despejar Estadísticas, seguido
por una ventana de confirmación, ¿Despejar Resultados
Acumulativos para esta prueba?, la respuesta de Sí despeja
los resultados acumulativos, No cancelará la operación.
Al hacer clic en el botón de Confirmar guarda los cambios, en
tanto que al hacer clic en el botón de Cancelar, rechazan los
cambios; en ambos casos, el sistema regresa a la pantalla de
Revisión de la Referencia Analítica.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.5.2 Referencia Analítica – TRAZO Y ESTADÍSTICAS
Al hacer clic en el botón de Trazo y Estadísticas en la
pantalla de Revisión de la Referencia Analítica, se abre la
pantalla de Trazo y Estadísticas de la Referencia Analítica.
(Ilustración)
Esta pantalla muestra tanto el Trazo como las Estadísticas
correspondientes a la prueba seleccionada.
La información siguiente puede verse, pero no puede editarse,
en el lado izquierdo de la pantalla.
- Fecha de Inicio y de Finalización
- Unidad
- Media Real y que Constituye el Objetivo.
- DE Real y que Constituye el Objetivo.
- CV Real.
- Resultados en las Estadísticas y en la Base de Datos
(DB); las opciones son 10, 100, 500 y 1000 resultados que
pueden verse.

3.84
El trazo de la AR se muestra en el lado derecho extremo de la
pantalla; los ejes de la gráfica indican:
- eje de las X = días
- eje izquierdo de las Y = media que constituye el objetivo
y unidades escogidas.
- eje derecho de las Y = DE
La indicación cubre un intervalo de 30 días; la ventana por
omisión muestra los resultados para el último intervalo de 30
días, pero el operador puede ver datos anteriores y
desplazarse con el uso de la barra de desplazamiento.
106
El cálculo estadístico se efectúa utilizando todos los
resultados en la base de datos. Para obtener las estadísticas
para otros intervalos seleccionados de tiempo, haga clic en
el botón de Seleccionar Intervalo e introduzca la fecha
específica de inicio y finalización (dd mm aaaa o de acuerdo
con el formato de fecha seleccionado en la configuración de
la Fecha y la Hora) en los campos específicos de la pantalla
de Seleccionar Intervalo.
El nuevo intervalo debe confirmarse haciendo clic en el botón
de Confirmar, lo que da por resultado que el sistema regrese
a la pantalla de Trazo y Estadísticas de la AR, o no
confirmarse haciendo clic en el botón de Cancelar (lo
anterior se aplica solamente al intervalo seleccionado).
Al hacer clic en el icono de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir? La
respuesta de Sí permite que el operador imprima el ajuste de
la prueba; No cancelará la operación.
Al hacer clic en el botón de Resultados Acumulativos, se abre
la pantalla de Datos de la Referencia Analítica (consultar la
subsección a continuación).
Al hacer clic en el botón de Confirmar permite que el
operador salga de la pantalla y regrese a la pantalla de
Revisión de la AR.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.5.3 Referencia Analítica – RESULTADOS ACUMULATIVOS
Al hacer clic en el botón de Resultados Acumulativos en la
pantalla de Revisión de la Referencia Analítica o la de Trazo
y Estadísticas de la Referencia Analítica, se abre la
pantalla de Datos de la Referencia Analítica.
3.85
(Ilustración)
En la parte superior de la pantalla, el usuario ve la
Identificación de la Prueba seleccionada. La parte más grande
de la pantalla se utiliza para mostrar los resultados
obtenidos. Los resultados pueden mostrarse utilizando la
lista en la que es posible desplazarse vertical y
horizontalmente; las columnas muestran los resultados
107
numéricos en todas las unidades configuradas y la fecha/hora
del análisis.
Hay también espacio para notas y columnas para indicadores y
advertencias. El operador puede introducir sus propias notas
haciendo clic en el icono de Notas que abre a la pantalla de
Introducir Notas (similar a la de la pantalla de Control de
Calidad).
Al hacer clic en el botón de Confirmar permite que el
operador guarde la nota introducida o modificada y que salga
de la pantalla y regrese a la pantalla de Datos de la AR.
Al hacer clic en el botón de Omitir Resultado, permite que el
operador omita permanentemente el resultado seleccionado.
Antes de omitirlo, se solicita confirmación ¿Omitir
resultado...¿Quiere realmente omitir el resultado
seleccionado? Son posibles las selecciones de Sí o No. cuando
se omite el resultado, aparecerá una marca en la columna de O
al lado del resultado y el resultado no se utilizará en el
cálculo estadístico.
Al hacer clic en el botón de Trazo y Estadísticas, permite
que el operador tenga acceso a la pantalla de Trazo y
Estadísticas de la Referencia Analítica (consultar la
subsección anterior).
Al hacer clic en el icono de Computadora Principal, se abre
la pantalla de Comunicación con la Computadora Principal de
AR (consultar la subsección a continuación).
Al hacer clic en el icono de Extraer Resultados, se abre la
pantalla de Datos de la AR (consultar la subsección a
continuación).
Al hacer clic en el icono de Impresora, se abre la pantalla
de Reporte del Resultado de la AR con diversas posibilidades:
- TODOS
- De...a
- No numérico
3.86
- Fuera de la escala
- Omitido
- Transmitido
- No transmitido
- Con indicador
- Sin indicador
Al hacer clic en el botón de Confirmar, se sale de la
pantalla y se regresa a la pantalla de Revisión de la
Referencia Analítica.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
108
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.5.4 REFERENCIA ANALÍTICA – COMUNICACIÓN CON LA COMPUTADORA
PRINCIPAL
Al hacer clic en el icono de Transferir a la Computadora
Principal en la pantalla de Comunicación con la Computadora
Principal de la AR (similar a la funcionalidad de Control de
Calidad).
La configuración de Comunicación con la Computadora Principal
que se muestra en esta pantalla es necesaria para decidir qué
tipo de resultados de la AR se enviarán y en qué intervalos
de tiempo deben transferirse a la Computadora Principal.
El usuario define primero el rango de la fecha y escoge
entre:
- “Todo el rango”
- “De...A...”
Cuando se selecciona este último, debe definirse la
fecha/hora iniciales y la fecha/hora finales.
El usuario puede definir también si se transmitirán los datos
de una prueba específica o los datos de todas las prueba
entre las opciones siguientes:
- “Una Sola Prueba”
- “Todas las Pruebas”
El usuario toma entonces una opción de segundo nivel de cada
uno de los pares siguientes:
- Resultados no Numéricos
- Resultados Fuera de la Escala
- Resultados Omitidos
Hay también disponibles algunas selecciones de segundo nivel:
- “Transmitido” o “No Transmitido”
- “Con Indicador” o “Sin Indicador”
387
Al tocar el área próxima a las opciones se efectúan las
selecciones: aparece una marca de verificación junto a la
opción. Estas opciones permiten que el usuario agrupe los
resultados transmitidos para facilidad de manejo, es decir,
resultados No Numéricos y Sin Indicador. Las opciones de
segundo nivel pueden también combinarse con éstos para
transmitir grupos tales como los resultados No Numéricos y
Sin Indicador, pero Omitidos. Una vez que se definen los
criterios de extracción, al hacer clic en el botón de Iniciar
Comunicación, puede activarse la transmisión.
109
Al hacer clic en el botón de Cancelar, se rechazan los
cambios y se sale de la pantalla.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
3.5.5 Referencia Analítica – EXTRAER DATOS
Al seleccionar la Referencia Analítica en el menú de
Calibración, los Resultados Acumulativos y al hacer clic en
el icono de Extraer Resultados en la pantalla de Datos de la
Referencia Analítica, se abre la pantalla de Extraer Datos de
la AR (similar a la funcionalidad de Control de Calidad).
La configuración de datos que se muestra en esta pantalla es
necesaria para decidir qué tipo de resultados de Referencia
Analítica se extraerán y en cuáles intervalos de tiempo se
extraen.
El usuario define primero el rango de fecha y escoge entre:
- “Todo el rango”
- “De...A...”
Cuando se selecciona el último, debe definirse la fecha/hora
de inicio y la fecha/hora finales.
El usuario toma a continuación una opción de segundo nivel de
cada uno de los pares siguientes:
- Resultados No Numéricos
- Resultados Fuera de la Escala
- Resultados Omitidos
Hay también disponibles algunas selecciones de segundo nivel:
- “Transmitidos” o “No Transmitidos”
- “Con Indicador” o “Sin Indicador”
Se efectúan las selecciones tocando el área próxima a la
opción; aparece una marca de verificación junto a la opción.
Estas opciones permiten que el usuario agrupe los resultados
transmitidos para facilidad de manejo, es decir, resultados
No Numéricos y Sin Indicador. Las opciones de segundo nivel
pueden también combinarse con ellos para transmitir...
3.88
...grupos tales como No Numéricos y Sin Indicador, pero
Omitidos. Una vez que se definen los criterios de
extracción, al hacer clic en el icono de Extraer puede
activarse la extracción.
110
Al hacer clic en el botón de Cancelar se rechazan los cambios
y se sale de la pantalla.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.1
Ajuste y Utilidad
4.0 Introducción
La finalidad de esta Sección es familiarizar al usuario del
ACL Elite/Elite Pro con los conceptos que se incluyen en las
partes de Ajuste y Utilidad de la Interfaz del Operador. La
comprensión de los conceptos y su uso apropiado son clave
para preparar el sistema para su operación analítica óptima,
para manejar los datos y para trabajar con el software del
sistema.
4.1 AJUSTE
La parte de Ajuste del Software del ACL Elite/Elite Pro
agrupa a todas las funciones relacionadas con la definición o
configuración de los elementos o conceptos a fin de adaptar y
hacer óptimo el uso del sistema de acuerdo con las
necesidades del laboratorio, con anterioridad a la ejecución
de las operaciones analíticas.
4.1.1 Submenú de AJUSTE
Al hacer clic en el botón de AJUSTE en la barra de menú de la
pantalla Principal muestra:
PRUEBAS
- Ver/Definir
- Clasificar Pruebas
- Tabla de Interferencias
- Pruebas por Omisión
- Pruebas Reflejas
MÚLTIPLES PRUEBAS
- Perfiles
- Grupos de Pruebas
- Perfiles de los Grupos de Pruebas
- Clasificar Múltiples Pruebas
- Múltiples Pruebas por Omisión
INTERFACES DE LÍQUIDOS
- Computadora Principal
- Impresora
111
- Código de Barras Interno
- Código de Barras Externo
- Teclado
- Red (opacada) – no soportada en esta versión
- Módem (opacado) – no soportado en esta versión
CONFIGURACIÓN DEL SISTEMA
SEGURIDAD
ALARMAS AUDIBLES
FECHA/HORA
UNIDADES
4.2
4.1.2 Ajuste – PRUEBAS – Ver/Definir
Esta área del software se utiliza para definir y ver las
pruebas individuales. Se desactiva el ajuste por omisión
para todas las pruebas. La biblioteca de pruebas puede
contener hasta 300 pruebas; 200 reservadas para aplicaciones
de IL y 100 reservadas para aplicaciones con especificaciones
particulares; pueden activarse hasta 100 pruebas al mismo
tiempo, independientemente de la combinación.
Al seleccionar las Pruebas en el submenú de Ajuste y escoger
a continuación Ver/Definir, se abre la pantalla de Ver
Pruebas.
(Ilustración)
Arriba de la lista de pruebas hay un cuadro rectangular que
muestra el número de pruebas presente en la Aplicación de la
Biblioteca. El cuadro mostrará dos números; las pruebas
activadas seguidas por el número total de pruebas.
La ventana grande en el lado izquierdo de la pantalla muestra
una tabla de todas las pruebas configuradas.
Cada prueba se identifica mediante un nombre abreviado, la
Identificación de la Prueba se muestra en la columna del lado
derecho. El nombre de Identificación de la Prueba puede
ajustarse de acuerdo con especificaciones especiales en la
pantalla de detalles de las pruebas. La Identificación de la
Prueba debe ser única para cada prueba.
4.3
Las dos columnas a la izquierda de los nombres de las pruebas
contienen marcas que indican si cada prueba:
- está Activada actualmente y lista para correrse en el
ACL.
- es una aplicación de prueba de IL previamente definida.
(Símbolo)
Nota: Las pruebas de IL previamente definidas fueron
desarrolladas y efectuadas específicamente para uso con los
reactivos IL TestTM y los nuevos suministros (es decir,
rotores y R de lavado) para uso en el ACLTM Elite/Elite Pro.
El desempeño apropiado de otros reactivos y suministros, con
112
inclusión de los rotores lavados, no se ha sometido
completamente a prueba o verificado, y su uso puede ocasionar
una degradación clínicamente significativa del desempeño y
los resultados. IL no asume ningún compromiso de obligación o
garantía con respecto a la precisión y/o exactitud de las
mediciones, ni por cualquier daño al instrumento que resulte
directa o indirectamente del uso de reactivos, consumibles y
suministros desechables, que no sean aquellos que vende IL.
Toda responsabilidad por concepto del desarrollo de
parámetros y la validación de nuevas pruebas o copiadas,
corresponde al usuario exclusivamente.
El lado derecho de la pantalla contiene los campos
siguientes:
CLAVE DE LA PRUEBA
REVISIÓN DE LA PRUEBA
CLAVE DE LA PRUEBA PARA LA COMPUTADORA PRINCIPAL
NOMBRE EXTENDIDO
MODO DE CALIBRACIÓN
La información que se muestra en estos campos puede verse,
pero no editarse en esta pantalla. Se encuentran varios
botones alrededor de estos campos.
Al hacer clic en el icono de Detalles, se abre la pantalla de
Detalles de la Prueba, que permite editar los campos
(consultar la sección 4.2.2 para los detalles).
Al hacer clic en el icono de Impresora, aparece una ventana
de confirmación ¿Quiere realmente imprimir el Reporte de la
Prueba? La respuesta de Sí permite que el operador imprima el
Ajuste de la Prueba de la prueba seleccionada; No cancela a
la operación.
Al hacer clic en el botón de Activar/Desactivar, seguido por
una ventana de confirmación de Sí/No, se borra toda la
información relacionada con la prueba seleccionada de la Base
de Datos del Paciente y la Base de Datos de Control de
Calidad. Cuando se desactiva la prueba, al hacer clic en el
botón de Activar/Desactivar se activa.
Al hacer clic en el cuadro de marcado de Mostrar Activadas
permite que el operador vea solamente las pruebas activadas
en la tabla de pruebas. Cuando se marca este cuadro de
marcado, la lista que se presenta muestra únicamente las
pruebas activadas. Se guarda este ajuste al salir de esta
pantalla y también al apagar.
Al hacer clic en el botón de Copiar Prueba, se abre la
pantalla de Copiar Prueba (consultar la sección 4.2.1 a
continuación).
4.4
113
Al hacer clic en el botón de Nueva Prueba, se abre la
pantalla de Nueva Prueba (consultar la sección 4.2.2 para los
detalles).
Al hacer clic en el icono de Suprimir, seguido por una
ventana de confirmación, se borran toda la información
relacionada con la prueba actual solicitada. Las pruebas de
IL con cerrojo no pueden suprimirse.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos regresa a la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.1.3 Ajuste – Pruebas – Clasificar Pruebas
Esta área del software se utiliza para clasificar las pruebas
disponibles en el sistema.
Al seleccionar las Pruebas en el submenú de Ajuste y escoger
Clasificar Pruebas, se abre la pantalla de Clasificar
Pruebas.
(Ilustración)
La clasificación de las pruebas define el orden en que se
muestran las pruebas en la base de datos del paciente, el
orden de la lista de pruebas durante la programación y y el
orden de las pruebas en la impresión.
La ventana a la izquierda de la pantalla muestra una tabla de
todas las Pruebas activadas actualmente; una marca de
verificación en el lado izquierdo de una prueba indica que es
una Prueba Clasificada.
La ventana al lado derecho de la pantalla muestra el orden en
que se clasifican las pruebas.
4.5
Los iconos de Flecha y Tijeras en la parte inferior de las
ventanas se utilizan para crear una lista clasificada.
La condición por omisión es tener las pruebas de ambas
columnas incluidas en orden alfabético.
El operador selecciona las pruebas del cuadro de pruebas
clasificadas y oprime el icono de tijeras; se retiren
entonces las pruebas del lado derecho de la pantalla.
Esta operación es necesaria debido a que las pruebas no
pueden desplazarse hacia arriba o hacia abajo en la lista de
Pruebas Clasificadas.
114
Se utiliza la flecha para mover una prueba de la lista de la
izquierda (pruebas activadas) a la lista de la derecha
(pruebas clasificadas) en la posición deseada.
Se añaden pruebas después del cursor. En caso de que se
cometa un error, se utiliza el icono de Tijeras para eliminar
la prueba de la lista clasificada. No puede añadirse ninguna
prueba arriba de la primera prueba de la lista.
Se imprimirán las pruebas activadas que no se clasifican y se
verán después de aquellas pruebas que se clasifican.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
de Ver Base de Datos/Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos regresa a la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.6
4.1.4 Ajuste – PRUEBAS – Tabla de Interferencia
Aunque se haya diseñado el ACL para reducir a un mínimo el
traspaso de reactivos entre pruebas, se halló
experimentalmente que la ejecución de una operación
denominada “cebado de reactivos” pudiera mejorar el desempeño
del sistema. Se utiliza la opción de Tabla de Interferencia
para activar esta operación entre pares de pruebas.
Al seleccionar Pruebas en el submenú de Ajuste y escoger
Tabla de Interferencia, se abre la pantalla de Tabla de
Interferencia que se muestra a continuación.
(Ilustración)
Esta pantalla contiene tres ventanas:
PRUEBAS CON CEBADO DE REACTIVOS en el lado izquierdo, que
incluye a las pruebas que requieren cebado de aguja
preventivo, según se define en al ajuste de las pruebas.
PRUEBAS QUE INTERFIEREN en la parte media, que muestra a las
pruebas que interfieren con la prueba actual hecha resaltar
en la ventana izquierda ( Prueba con Cebado de Reactivo).
PRUEBAS ACTIVADAS en el lado derecho, muestra a todas las
pruebas activadas en el sistema.
En caso de que una prueba que interfiera se ejecute antes de
una prueba que requiera cebado de reactivo, se ejecuta el
cebado de reactivo antes de surtir el primer reactivo.
115
La tabla de pruebas de interferencia está previamente
ajustada para las pruebas de IL definidas previamente.
4.7
Los iconos de Flecha y Tijeras en la parte inferior de las
ventanas se utilizan para añadir o eliminar una prueba.
Los pasos para ajustar la tabla de pruebas de interferencia
son como sigue:
1. Seleccione una prueba con Cebado de Reactivo definida en
la lista del cuadro de la izquierda.
2. Selecciones las pruebas que interfieren que afecten a la
prueba que se ha hecho resaltar, seleccionada en el punto
1.
3. Mueva la prueba seleccionada en el paso 2 a la columna de
pruebas que interfieren, con el uso de la flecha. Utilice
las tijeras para suprimir una prueba de la columna
central.
En la parte inferior de esta pantalla, al hacer clic en el
botón de Confirmar, se guardan los cambios; al hacer clic en
el botón de Cancelar, se rechazan los cambios; en ambos
casos, el sistema regresa a la pantalla Principal.
Advertencia:
(Símbolo)
Después de efectuar cualesquiera actualizaciones de la
biblioteca de software, es importante verificar la tabla de
interferencias, especialmente cuando se tienen pruebas con
especificaciones especiales definidas. Las pruebas con
especificaciones especiales que interfieren con las pruebas
de IL con cerrojo (las pruebas con cebado de reactivo
definido) ya no se vincularán en la tabla de interferencias.
Se necesitará volver a entrar a lainterferencia.

Cebado de Reactivo Definido Prueba que Interfiere Estado después de la Actualización


Pruebas de IL con Cerrojo Pruebas según Especificaciones Especiales Después de actualización – ningún vínculo
Pruebas según Especificaciones Especiales Pruebas de IL con Cerrojo Después de la actualización – todavía
vinculadas
4.8
4.1.5 Ajuste – PRUEBAS – Pruebas por Omisión
Las pruebas por omisión se programan en las Identificaciones
de las muestras, sin una solicitud de prueba proveniente de
las bases de datos internas o la Computadora Principal.
Cuando se activa la prueba por omisión, una Identificación de
muestra sin ningunas pruebas solicitadas (estado de N) hará
que la prueba por omisión se programe automáticamente. Se
procesarán las pruebas en caso de que estén incluidas en la
sesión de Múltiples Pruebas o Pruebas Solas.
La lista a la izquierda muestra a todas las pruebas
activadas. La lista a la derecha muestra a las pruebas
seleccionadas por omisión.
116
Los iconos de Flecha y Tijeras en la parte inferior de las
ventanas se utilizan para añadir o retirar una prueba.
Seleccione las pruebas que se añadirán a la lista de Pruebas
por Omisión en el cuadro a la izquierda (Pruebas Activadas) y
oprima la tecla de Flecha. Las pruebas seleccionadas se
desplazarán al cuadro de pruebas por Omisión.
Las pruebas por omisión pueden desactivarse/activarse
utilizando el cuadro de marcado de Activar Pruebas por
Omisión.
(Ilustración)
(Símbolo)
Nota: Se añaden las pruebas por omisión a una muestra después
de marcar la base de datos y efectuar una pregunta a la
computadora principal. En caso de que ninguno de estos
marcados dé por resultado que se programen las pruebas para
una muestra, se añadirán entonces las pruebas por omisión. No
se añadirán las pruebas por omisión a una muestra corrida
anteriormente con resultados completados. No se correrán las
pruebas por omisión en caso de que no estén incluidas en la
sesión de pruebas solas o múltiples pruebas seleccionada.
4.9
4.1.6 Ajuste – PRUEBAS – Pruebas Reflejas
Las Pruebas Reflejas permiten que el usuario programe y/o
ejecute una prueba generada por una condición de la prueba
maestra. Se aplica la lógica de las Reflejas una sola vez a
cada muestra. No se efectúa la verificación lógica adicional
en los resultados que se originaron en órdenes de pruebas con
base en las reglas de las pruebas reflejas.
Pueden definirse hasta 60 reglas. Una regla está compuesta de
1 a 3 condiciones. Una condición puede basarse en un
resultado numérico (en una unidad específica), o depender de
errores que ocurrieron en la prueba maestra (es decir, error
6, error 7, error 12, etc.)
Cada regla puede programar y/o ejecutar automáticamente hasta
10 pruebas.
(Ilustración)
Al hacer clic en el icono de Detalles, cuando el cursor se
encuentra en una regla específica, se muestran todas las
condiciones y pruebas. Pueden modificarse todas éstas.
Al mover el cursor con el uso de las flechas de hacia arriba
y hacia abajo y al hacer clic en el botón de
Activar/Desactivar, se seleccionará o dejará de seleccionar
cada regla individual. Cuando se activa una regla, aparece
una marca de verificación cerca del número de la regla.
Cuando se marca una regla, se aplicará la misma (ver la
Configuración del Sistema para la activación de las Reglas
Reflejas en general en la sección 4.1.20).
117
4.10
Al hacer clic en el icono de Suprimir, se suprime la regla.
Al hacer clic en el icono de Imprimir, se imprimen las reglas
reflejas.
Al hacer clic en el icono de Detalles, aparece la ventana de
Detalles de las Reglas Reflejas.
(Ilustración)
El icono de Detalles permite ver/editar las condiciones
correspondientes a la regla refleja actual.
La ventana superior permite la introducción de la condición
de la regla al oprimir el icono de Introducir.
4.11
Aparece la ventana de Condiciones de las Reglas Reflejas.
(Ilustración)
La prueba que genera a la prueba refleja puede escogerse de
la lista de Identificaciones de las Pruebas.
Para la clase de resultados numéricos, utilice el campo de
Unidades apropiado para seleccionar cuál unidad debe ser
marcada por la regla.
Hay disponibles dos clases de condiciones: valor basado en
los resultados numéricos; error basado en el error que
ocurrió.
Para los resultados numéricos, puede seleccionarse la unidad
de acuerdo con la prueba y las unidades definidas en el
ajuste de la prueba específico.
Seleccione a continuación Comparación en términos de >; =; <
para el valor introducido arriba.
En el campo del Valor, después de marcar el cuadro de marcado
del valor, introduzca el valor numérico para comparación.
Oprima el cuadro de marcado verde para confirmar y guardar la
condición.
La segunda clase incluye ala error del resultado (errores de
reducción de datos), por ejemplo, error 6, error 7, error 12,
etc. La mayoría de los errores se basa en la unidad medida;
por lo tanto, debe utilizarse esta unidad cuando se defina la
lógica. Ver la sección 6 de Localización de Fallas para
información adicional acerca de cada error específico.
Para las condiciones de errores, es posible agrupar múltiples
errores (hasta 5) en una sola regla con el uso del icono de
Seleccionar.
Mueva el cursor sobre el error que va a seleccionarse y
oprima a continuación el botón de Seleccionar; aparece una
marca de verificación cerca de los errores seleccionados.
Oprima el cuadro de marcado verde para confirmar y guardar la
condición.
4.12
118
Se marcan múltiples condiciones utilizando los calificadores
“Y/O”.
En caso de que se seleccione la condición de Y, deben
cumplirse ambas condiciones seleccionadas para generar la(s)
prueba(s) refleja(s).
Cuando se selecciona la condición O, debe cumplirse solamente
una de las condiciones para generar la(s) prueba(s)
refleja(s).
La parte inferior de la pantalla de Detalles de las Reglas
Reflejas permite seleccionar las pruebas reflejas con el uso
de los iconos de Flecha y Tijeras.
Las reglas y las condiciones pueden revisarse o suprimirse
oprimiendo los iconos de detalles o suprimir.
El icono de Imprimir imprime a toda la información pertinente
correspondiente a todas las reglas y condiciones almacenadas.
Se incluyen a continuación algunos ejemplos posibles de las
reglas reflejas. Estas reglas no representan a ningún aspecto
clínico en particular, sino solamente ejemplos selectivos
posibles. Cada cliente debe definir sus propias reglas
reflejas. Para la ejecución de las reglas reflejas, consulte
la sección de Configuración del Sistema.
Ejemplos de Reglas Reflejas
• PT > 50 segundos entonces PT-e
• PT (seg) = error 6 entonces PT-e
• PT (seg) = error 7 entonces PT-e
• APTT > 110 segundos entonces APTT-e
• APTT (seg) = error 6 entonces APTT-e
• APTT (seg) = error 7 entonces APTT-e
• Fib-C > 600 mg/dL (o g/L) Fib-C H
• Fib-C < 100 mg/dL (o g/L) Fib-C I
• Dímero D > 1050 ng/mL D-D h
• VWF > 150 % VWF h

(Símbolo)
Nota: Se aplica solamente un nivel de marcados de lógica
refleja a cada muestra. No se aplican ningunos marcados de
lógica refleja a los resultados de las pruebas que se
añadieron a una muestra del primer nivel de marcado de lógica
refleja.
La tabla siguiente incluye a las claves de errores de la
curva de reacción cuando se define una lógica refleja para
ese error.
4.13
Clave Definición Causa Unidad refleja
de Error
5 Falla Óptica Saturación de ADC Medida
6 Ninguna Coag. No se pasó el primer umbral Medida
7 Error de Coag. No se pasó el segundo umbral Medida
119
8 Error de Coag. El tiempo Delta entre umbrales es mayor que el valor Medida
seleccionado
9 Error de Coag. La pendiente inicial de la curva de reacción es más Medida
elevada que el valor seleccionado
10 Error de Coag. La Pendiente Final de la curva de reacción es más Medida
elevada que el valor seleccionado
11 Error Delta Final La delta final de la reacción es más elevada que el valor Medida
seleccionado
12 Error de Coag. El pico máximo de la primera derivada es inferior al Medida
valor límite seleccionado
13 Error de Coag. El pico máximo de la segunda derivada es inferior al Medida
valor límite seleccionado
14, 30 Error de Valor de compensación fuera de los límites Medida
Compensación

31 Error Delta de la La delta de la curva de reacción no cumple con el límite Medida


Curva especificado para la prueba.
32 Línea de Base con Lecturas erráticas de la reacción Medida
Ruido
33 Reacción con Ruido Lecturas erráticas de la reacción Medida
45 y 46 Media no Calculada Uno de los dos resultados de la prueba no es válido Medida
(resultado no numérico)

4.1.7 Ajuste – Múltiples Pruebas – Perfiles


Esta área del software permite que los usuarios definan y
vean su propia elección de las Múltiples Pruebas (Perfiles o
Perfiles de Grupo de Pruebas). Los Perfiles de las Múltiples
Pruebas se componen de pruebas solas y los Perfiles de Grupos
de Pruebas se componen de grupos de pruebas. Consultar la
sección 4.1.10 para los detalles acerca del ajuste de
Múltiples Pruebas-Perfiles de Grupos de Pruebas.
Pueden crearse hasta 30 perfiles de Múltiples Pruebas
(números de clave de 1 a 99). No puede utilizarse el mismo
número para un perfil de múltiples pruebas y un perfil de
grupos de pruebas. Un perfil de múltiples pruebas puede
contener un máximo de 20 pruebas. Un perfil de grupos de
pruebas puede contener un máximo de 20 grupos de pruerbas.
Al seleccionar Múltiples Pruebas y Perfiles del submenú de
Ajuste y escoger a continuación Ver/Definir, se abre la
pantalla de Ver Perfiles que se muestra a continuación.
El orden en que se introducen las pruebas en el Perfil es uno
de los determinantes importantes de la secuencia de análisis
de las pruebas cuando se selecciona el perfil.
4.14
(Ilustración)
La ventana del lado izquierdo de la pantalla muestra a una
lista de Perfiles definidos, en tanto que la ventana de en
medio muestra las pruebas individuales en el Perfil que se
hace resaltar a la izquierda.
120
A cada Perfil se le asigna una clave numérica (clave de
perfil: 1-99) y, para cada uno, hay un campo de NOTAS
asociado. Las notas pueden verse solamente en esta pantalla.
La información que se muestra para estos campos puede verse,
pero no editarse en esta pantalla. Se encuentran varios
botones cerca de estos campos.
Al hacer clic en el icono de Detalles, se abre la pantalla de
Detalles del Perfil, que permite editar los campos (consultar
la sección específica a continuación).
Al hacer clic en el icono de Suprimir, seguido por una
ventana de confirmación ¿Quiere suprimir el perfil actual?,
la respuesta de Sí permite que el operador suprima el perfil
seleccionado; No cancelará la operación.
Al hacer clic en el icono de Imprimir, seguido por una
ventana de confirmación ¿Quiere realmente imprimir el perfil
actual?, la respuesta de Sí imprime el ajuste del perfil
seleccionado; No cancelará la operación.
Al hacer clic en el botón de Nuevo Perfil, permite que el
operador tenga acceso a la pantalla de Nuevo Perfil
(consultar la sección específica a continuación).
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
4.15
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
La pantalla de Detalles de los Perfiles:
Como se mencionó antes, cualesquiera cambios que se efectúen
en los campos que se muestran en la pantalla de Ver Perfiles,
se hacen por medio de la pantalla de Detalles de los
Perfiles, que se abre al hacer clic en el icono de Detalles.
(Ilustración)
(Símbolo)
NOTA: En caso de que el usuario desee definir un NUEVO
perfil, al hacer clic en el botón de Nuevo Perfil se abre la
pantalla de Nuevo Perfil, que tiene campos en blanco para
llenarse (ver a continuación). Dado que la finalidad de las
pantallas de Nuevo Perfil y Detalles de los Perfiles es muy
similar, tienen un diseño idéntico. Cuando se completan los
campos en la pantalla de Nuevo Perfil, se convierte en una
pantalla de Detalles de los Perfiles.
121
Dos campos en la parte superior de la pantalla muestran la
Identificación del Perfil y la Clave del Perfil asignada. Hay
dos ventanas situadas abajo: la ventana a la izquierda
muestra a todas las Pruebas Activadas y la ventana a la
derecha contiene a todas las pruebas que integran al perfil
seleccionado. Las pruebas que utilizan una dilución dentro de
la copa o una calibración dentro de la sesión, no pueden
colocarse en un perfil de múltiples muestras.
El usuario define a las pruebas en el perfil con la ayuda de
los iconos de Flecha y Tijeras para añadir o suprimir las
pruebas de la ventana de pruebas activadas a las pruebas en
la ventana del perfil. El campo de NOTAS hasta la derecha
está abierto para que el usuario añada los comentarios
deseados (texto libre).
El mapa de materiales se crea automáticamente tan pronto como
se introducen las pruebas, de acuerdo con la posición por
omisión de los líquidos del Ajuste. Cuando la posición por
omisión de un reactivo...
4.16
...para el mapa de materiales de un perfil ya esté ocupada
por otro reactivo, la siguiente posición “similar” disponible
se asigna entonces automáticamente. Cuando todas las
posiciones de un área homogénea R1 a R4, R9 a R12 (ACL Elite
Pro solamente), R7 a R8, A1 a A10 y R5 a R6 estén llenas, el
líquido no puede colocarse y un mensaje advierte al usuario
que la muestra no puede añadirse al perfil.
La ventana grande en la parte inferior de la pantalla reporta
la información actualmente almacenada para este perfil en el
Mapa de Materiales.
- Identificación del Líquido: el nombre de los materiales
empleados para analizar el perfil seleccionado
- Posición: la posición seleccionada (A!...A10 o R1...R12)
para el material líquido específico.
- Refrigerado: una marca indica que el material líquido
seleccionado debe mantenerse a 15ºC, posiciones R1 a R4,
R9 a R12 (ACL Elite Pro solamente)
- Agitado: una marca indica que el material líquido
seleccionado debe agitarse mediante la barra agitadora
magnética (posiciones R1 a R4)
- Aguja: indica qué aguja (muestra o reactivo) surte el
material seleccionado.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
de Ver Perfiles.
El icono de Globo permite la modificación de los nombres de
los perfiles en el idioma seleccionado.
122
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.17
4.1.8 Ajuste – Múltiples Pruebas – Grupos de Pruebas
El Grupo de Pruebas es una combinación de pruebas que
utilizan la misma longitud de onda, referencia óptica y mismo
ciclo de adquisición.
Los Grupos de Pruebas son definidos previamente por IL. Un
Usuario puede crear un nuevo grupo de pruebas cuando se
registran en el nivel de seguridad del Administrador del
Laboratorio.
Al seleccionar Múltiples Pruebas en el submenú de Ajuste y
escoger a continuación Grupos de Pruebas, se abre la pantalla
de Grupos de Pruebas que se muestra a continuación.
La ventana en el lado izquierdo de la pantalla muestra una
lista de los grupos actuales de pruebas, “Identificación de
los Grupos de Pruebas”, en tanto que la ventana en el lado
derecho muestra las pruebas individuales en el Grupo hecho
resaltar.
A cada Grupo de Pruebas se le asigna una clave numérica y a
la derecha hay un espacio para introducir una NOTA para cada
uno. Las notas pueden verse, pero no definirse en esta
pantalla.
Varios botones están situados alrededor de estas ventanas.
Al hacer clic en el icono de Detalles, permite que el
operador tenga acceso a la pantalla de Detalles de los Grupos
de Pruebas (consultar la sección específica a continuación).
Al hacer clic en el icono de Imprimir, seguido por una
ventana de confirmación ¿Quiere realmente imprimir el Grupo
de Pruebas?, la respuesta de Sí imprime el ajuste del grupo
de pruebas; No cancelará la operación.
(Ilustración)
4.18
Al hacer clic en el botón de Confirmar, se guardan los
cambios y el sistema regresa a la pantalla Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
123
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
La pantalla de Detalles de los Grupos de Pruebas:
Al hacer clic en el icono de Detalles en la pantalla de
Grupos de Pruebas, se abre la pantalla de Grupos de Pruebas
que se muestra a continuación.
La Identificación y la clave de los grupos de pruebas se
muestran en la parte superior de esta pantalla; a la derecha
hay un espacio para que el usuario introduzca notas.
La ventana más grande a la izquierda de la pantalla se
utiliza para describir la secuencia de operaciones para cada
una de las pruebas incluidas en el grupo de pruebas
específicas, en tanto que la ventana más pequeña a la derecha
incluye a las pruebas activadas.
(Ilustración)
Al hacer clic en el botón de Mapa de Materiales, se abre la
pantalla del Mapa de Materiales de la Prueba. Esta pantalla
se utiliza para verificar el número y las características de
las posiciones en las que están colocados los reactivos para
estas pruebas (refrigerados o no, mezclados o no, uso de
aguja para muestra o reactivo). Nota: el ajuste de los
materiales líquidos se describe en la Sección 4.1.13.
Al hacer clic en el botón de Verificar el Material, se
muestran las acciones que el instrumento debe efectuar cuando
se detecta un nivel de líquido bajo. Las acciones pueden
cambiarse solamente después de que se haya guardado
inicialmente un grupo de pruebas.
4.19
(Ilustración)
Al hacer clic en el botón de Confirmar, se guardan los
cambios y el sistema regresa a la pantalla de Detalles de los
Grupos de Pruebas.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
Creación de un Nuevo Grupo de Pruebas
124
El usuario puede crear grupos de pruebas cuando se registran
en el nivel del Administrador del Laboratorio. Cuando se crea
un nuevo grupo, hay varios conceptos que necesitan
considerarse para las pruebas para que sean compatibles con
el grupo
- El grupo de pruebas debe tener una prueba como mínimo
- Las pruebas deben utilizar la misma longitud de onda
- Las pruebas deben tener ajustes de Adquisición
similares. El tiempo real de adquisición no tiene que
ser el mismo; sin embargo, el mezclado, la pendiente y
los ajustes dentro de la pendiente deben ser los mismos.
- El tiempo para pipetear la segunda prueba del grupo debe
ser menor que el tiempo de incubación para la primera
prueba.
- El grupo de pruebas puede tener un RP (siglas en el
idioma inglés) (Cebado de Reactivo) y que ocurra esto
como la primera aspiración en el grupo.
- El grupo de pruebas puede tener un CL (siglas en el
idioma inglés) (ciclo de limpieza) al final del grupo.
- El grupo puede tener solamente una Referencia Óptica y/o
paso de Referencia.
- La pantalla de verificación del material puede
modificarse solamente después de que se guarda un grupo
de pruebas.
4.20
Al hacer clic en el botón de Nuevo Grupo de Pruebas, se abre
la pantalla de detalles del Grupo de Pruebas.
(Ilustración)
- El cuadro de Activar Valor Máximo de las Muestras
permite limitar el número de muestras que pueden
procesarse cuando se utilice este grupo. Para las
pruebas de IL con cerrojo, puede editarse este campo en
el nivel de seguridad del Servicio.
- La lista de pruebas disponibles se muestra en el cuadro
de Pruebas Activadas. Haga resaltar la prueba deseada y
desplace la prueba al grupo con el uso del icono de
flecha. Repita el paso para todas las pruebas deseadas
del grupo. Se observará que la segunda prueba y todas
las posteriores que se añaden al grupo se colocan debajo
de las anteriores.
- Una vez que se colocan todas las pruebas en el grupo, se
necesita modificar a continuación la secuencia de los
pasos de pipeteado. Cuando se haga lo anterior, se
necesita considerar conceptos tales como agrupar
operaciones similares o mover los pasos de pipeteado de
manera de que ocurran durante las incubaciones.
125
- La siguiente cosa que se necesita considerar son los
relojes del tiempo de incubación. Para los pasos con una
restricción de tiempo de “cronómetros ajustado”, se
necesita tener “espere hasta que el cronómetro termine”
que lo siga. En caso de que se tengan múltiples pasos
con “cronómetro ajustado”, el sistema respetará el
tiempo para el primer paso cuando encuentre “espere
hasta que el cronómetro termine”. En este caso, se hace
caso omiso del segundo cronómetro cuando se corren ambas
pruebas.
- Deben suprimirse los pasos de referencia óptica
excesivos. El grupo requiere solamente uno.
Identificación del Grupo de Pruebas: Introduzca un nombre de
Identificación para el grupo (8 caracteres alfanuméricos)
Clave del Grupo de Pruebas: Introduzca un valor numérico
único entre 501-999.
Muestras Dobles: Una marca en este cuadro iniciará todas las
pruebas que se efectuarán por duplicado para este grupo.
Notas: Este campo puede utilizarse para comentarios con texto
libre acerca del grupo de pruebas.
4.21
Mapa de Materiales: Muestra el mapa de materiales para el
grupo.
Asignar No. de Paso: Al oprimir este botón, se muestra una
ventana que permite cambiar el número de paso correspondiente
al paso actual hecho resaltar.
Añadir Paso: Este botón abre la ventana que permite programar
un nuevo paso para el grupo.
(Ilustración)
Consulte Ajustar Definición de las Pruebas para los detalles
acerca del llenado de esta pantalla.
Al hacer clic en el botón de Confirmar, se guardan los
cambios.
4.22
La siguiente tabla contiene una lista de Grupos de Pruebas de
IL con cerrojo y las pruebas contenidas en los mismos.

Nombre del Grupo de Pruebas Pruebas dentro del Grupo de Pruebas


PT SP APTT SP, FIB(g/L), PT
PT_SP APTT SP, FIB_(mg/Dl), PT
HS LYOTT APTT LY, FIBHS(g/L), PTHS, TT-8
HS_LYOTT APTT Ly, FIBHS_(mg/dL), PTHS, TT-8
HS LYO APTT Ly, FIBHS(g/L), PTHS
HS_LYO APTT Ly, FIBHS_(mg/dL), PTHS
HS+ LYO APTT Ly, FIBHS+(g/L), PTHS+
HS+_LYO APTT Ly, FIBHS+_(mg/dL), PTHS+
HS+ SP APTT SP, FIBHS+(g/L), PT HS+
126
HS+_SP APTT SP, FIBHS+_(mg/dL), PT HS+
RPT SYS APTTSYS, R-FIB(g/L), R-PT
Nombre del Grupo de Pruebas Pruebas dentro del Grupo de Pruebas
RPT_SYS APTTSYS, R-FIB_(mg/dL), R-PT

Nombre del Grupo de Pruebas Pruebas dentro del Grupo de Pruebas


ATDD FIB AT*, DD, DDh, FIB-C(g/L)
ATDDFIB_ AT*, DD, DDh, FIB-C_(mg/dL)
HS SP APTT SP, FIBHS(g/L), PTHS
HS_SP APTT SP, FIBHS_(mg/dL), PTHS

4.1.9 Ajuste – Múltiples Pruebas – Perfiles de Grupos de


Pruebas
Esta área del software permite que los usuarios definan y
vean su propia elección de los Grupos de Pruebas que se
correrán en las sesiones analíticas de Múltiples Pruebas.
Pueden crearse hasta 30 perfiles de Múltiples Pruebas
(números de claves de 1 a 99). Cada perfil puede contener un
máximo de 20 combinaciones de pruebas cada uno. El número
máximo real de pruebas que puede añadirse, dependerá de las
posiciones de reactivos disponibles.
Al seleccionar Múltiples Pruebas y Perfiles de los Grupos de
Pruebas en el submenú de Ajuste y escoger a continuación
Perfil del Nuevo Grupo de Pruebas, se abre la pantalla que se
muestra a continuación.
4.23
(Ilustración)
La ventana en el lado izquierdo de la pantalla muestra una
lista de los Grupos de Pruebas definidos, en tanto que la
ventana en medio muestra los grupos de pruebas en el Perfil
actual.
A cada Perfil se le asigna una identificación del Perfil
(máximo de 8 caracteres alfanuméricos), clave numérica (clave
del perfil: 1-99) y hay un campo de NOTAS asociado para cada
uno.
El usuario define los grupos de pruebas en el perfil con la
ayuda de los iconos de Flecha y Tijeras para añadir y
suprimir los grupos de la ventana izquierda a la ventana
derecha. El campo de NOTAS en la extrema derecha está abierto
para que el usuario añada los comentarios deseados (texto
libre).
El mapa de materiales se crea automáticamente tan pronto como
se introduce el grupo de pruebas de acuerdo con la posición
por omisión de los líquidos de Ajuste. Cuando la posición por
omisión para un reactivo ya está ocupada por otro reactivo,
se asigna entonces la siguiente posición “similar”
disponible. Cuando estén llenas todas las posiciones en un
127
área homogénea R1 a R4, R9 a R12 (ACL Elite Pro solamente),
R7 a R8, A1 a A10, no puede colocarse el líquido y un mensaje
advierte al usuario que el grupo de pruebas no puede añadirse
al perfil.
La ventana grande en la parte inferior de la pantalla reporta
la información actualmente almacenada para el Mapa de
Materiales para este perfil.
- Identificación del Líquido: el nombre de los materiales
empleados para analizar el perfil seleccionado
- Posición: la posición seleccionada (A!...A10 o R1...R12)
para el material líquido específico.
4.24
- Refrigerado: una marca indica que el material líquido
seleccionado debe mantenerse a 15ºC, posiciones R1 a R4,
R9 a R12 (ACL Elite Pro solamente)
- Agitado: una marca indica que el material líquido
seleccionado debe agitarse mediante la barra agitadora
magnética (posiciones R1 a R4)
- Aguja: indica qué aguja (muestra o reactivo) surte el
material seleccionado.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
de Ver Perfiles.
El icono de Globo permite la modificación de los nombres de
los perfiles en el idioma seleccionado.
La pantalla de Detalles de los Perfiles de los Grupos de
Pruebas
Como se mencionó antes, cualesquiera cambios que se efectúen
en los campos que se muestran en la pantalla de Ver Perfiles
se hacen por medio de la pantalla de Detalles de los
Perfiles, que se abre al hacer clic en el botón de Detalles.
(Ilustración)
(Símbolo)
NOTA: Dado que la finalidad de las pantallas de Nuevo Perfil
y Detalles de los Perfiles es muy similar, tienen un diseño
idéntico. Cuando se completan los campos en la pantalla de
Nuevo Perfil, se convierte en una pantalla de Detalles de los
Perfiles.
4.25
Al hacer clic en el icono de Suprimir, seguido por una
ventana de ¿Quiere suprimir el perfil actual?, la respuesta
de Sí permite que el operador suprima el perfil seleccionado;
No cancelará la operación.
• Al hacer clic en el icono de Imprimir, seguido por una
ventana de confirmación ¿Quiere realmente imprimir el
perfil actual?, la respuesta de Sí imprime el ajuste del
128
perfil seleccionado; No cancelará la operación. Los
BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.26
4.1.10 Múltiples Pruebas – Clasificar Múltiples Pruebas
Esta área del software se utiliza para clasificar los
perfiles de las pruebas definidos en el sistema. Los
Perfiles, los Grupos de Pruebas y los Perfiles de los Grupos
de Pruebas que no se encuentran en la lista de clasificación
no serán visibles como modos de corrida bajo Análisis. El
operador necesita solamente clasificar los perfiles, los
grupos de pruebas y los perfiles de los grupos de pruebas que
correrán.
Al seleccionar las Múltiples Pruebas – Clasificar Múltiples
Pruebas en el submenú de Ajuste, se abre la pantalla de
Clasificar Múltiples Pruebas que se muestra a continuación.
(Ilustración)
Las 3 ventanas en el lado izquierdo de la pantalla incluyen a
los Perfiles, los Grupos de Pruebas y los Perfiles de los
Grupos de Pruebas. Una marca de verificación en el lado
izquierdo indica que el concepto se encuentra en la lista de
Perfiles Clasificados.
La ventana en la parte derecha de la pantalla muestra a todos
los Perfiles Clasificados.
Los iconos de Flecha y Tijeras se utilizan para clasificar
perfiles y grupos. Al seleccionar el operador la primera
introducción y oprimir los iconos de Flechas, se copia wl
perfil/grupo de una posición a otra de la lista de los
perfiles clasificados en la ventana de lado derecho. En caso
129
de que se cometa un error, se utiliza el icono de Tijeras
para eliminar el perfil de la lista clasificada. El perfil se
introduce debajo del cursor. Los perfiles que no se
clasifican no serán visibles en la selección desplegable
descendente del menú de Análisis.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
Principal.
130
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
4.27
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.1.11 Ajuste – Múltiples Pruebas por Omisión
La selección del Perfil de Múltiples Pruebas por Omisión
determina las pruebas que pueden correrse y su ajuste del
mapa de materiales asociado cuando un usuario activa una
corrida con el uso del icono de “Correr” en la pantalla de
base de datos principal.
Al seleccionar Múltiples Pruebas en el submenú de Ajuste y
escoger Múltiples Pruebas por Omisión a continuación, se abre
la pantalla de Grupos de Pruebas que se muestra a
continuación.
(Ilustración)
El cuadro a la izquierda incluye a todos los Perfiles de
Múltiples Pruebas y los Perfiles de Grupos de Pruebas.
Seleccione la selección por Omisión deseada en la lista y
muévala a la columna a la derecha con el uso de la Flecha. En
caso de que se quiera cambiar el Perfil por Omisión
seleccionado, utilice el icono de Tijeras para eliminar.
Para Activar las Múltiples Pruebas por Omisión, ponga una
marca en el cuadro. Las pruebas que se desea correr necesitan
programarse todavía para la muestra, aunque las Múltiples
Pruebas por Omisión estén activadas.
4.1.12 Ajuste – LÍQUIDOS
Esta área del software permite que el usuario para definir y
ver el ajuste correspondiente a todos los materiales líquidos
necesarios para correr las pruebas en el ACL Elite/Elite Pro.
El sistema almacenará 300 líquidos, de los cuales 200 se
reservan para el uso por IL y 100 están disponibles para que
los defina el operador.
4.28
Al seleccionar Líquidos en el submenú de Ajuste, se abre la
pantalla de Ajuste de Líquidos.
(Ilustración)
Una lista de líquidos definidos previamente por IL se
encuentra ya almacenada en el software.
Esta pantalla muestra las características de todos los
materiales líquidos configurados actualmente en el sistema.
131
- IDENTIFICACIÓN DEL LÍQUIDO: el nombre breve del material
líquido. Para los líquidos de Control, esta
Identificación puede ser completamente numérica(1 a 10
caracteres). Ésta es la Identificación de control que se
envía a la Computadora Principal cuando hay interfaz con
el analizador. Todos los demás líquidos deben tener una
identificación alfanumérica.
- NOMBRE EXTENDIDO: el nombre completo del material líquido
(Máximo de 15 caracteres alfanuméricos).
- No. DE LOTE: el número del lote del material.
- FECHA DE CADUCIDAD: la fecha de caducidad como se muestra
en la etiqueta del frasquito. Es posible utilizar la
fecha de caducidad como una función de la Advertencia del
Mapa de Reactivos (ver el Mapa de Reactivos, sección
3.2.3).
4.29
- ESTABILIDAD A BORDO: la estabilidad que se reivindica en
la hoja de inserto. Es posible utilizar el valor de la
estabilidad a bordo para el cronómetro de estabilidad de
tiempo real como una función de las Advertencias del Mapa
de Reactivos (ver Mapa de Reactivos, sección 3.2.3).
Introduzca el número seguido por h para horas y d para
días.
- VOLUMEN ACTUAL: cantidad de líquido (en mL) que permanece
en el contenedor, dependiendo del reactivo específico
utilizado (no puede editarse en esta pantalla).
- VALOR ASIGNADO: cantidad de líquido (en mL) presente en
un nuevo contenedor antes de comenzar la sesión analítica
(volumen por omisión como se define en la etiqueta del
producto).
- VOLUMEN DE ADVERTENCIA: cantidad de líquido (en mL) por
debajo de la cual, los colores del icono del mapa de
reactivos y la posición del mapa del material cambiarán
de verde a anaranjado. Este campo debe llenarse para
todos los reactivos que se monitorearán.
- TIPO DE LÍQUIDO: calibrador, control, reactivo, solución.
Esta pantalla muestra también una tabla de “Utilizado por”
que muestra las pruebas para las cuales se utiliza cada
material. En esta tabla, el usuario puede también registrar
los valores ISI. Para los Calibradores, el usuario puede
introducir el valor asignado para el estándar reportado en la
hoja de inserto del producto.
Los valores asignados ISI y del Plasma de Calibración pueden
introducirse haciendo clic en el botón de Asignar Valor e
introduciendo el valor con el uso del teclado o el teclado
numérico. El ajuste por omisión para todas las asignaciones
se pone en blanco. El usuario debe introducir los valores del
132
calibrador y el valor ISI antes de correr el analizador. El
valor del calibrador para la corrida de prueba de PT debe
ajustarse en 100. El valor ISI se encuentra en la hoja de
inserto del reactivo de PT y es específico del lote.
(Símbolo)
Nota: Siempre que se modifique el valor ISI, todos los
resultados utilizarán el nuevo valor ISI para calcular INR.
El valor ISI introducido debe caer dentro del rango ISI
especificado como se define en los detalles de los Líquidos
para el reactivo de PT.
Nota: El ajuste del lector de código de barras optativo
permite que el operador configure el sistema para reajustar
automáticamente la estabilidad a bordo y/o el volumen
asignado siempre que se lea una etiqueta de frasquito.
Consulte la sección 4.1.16 para mayores detalles.
Nota: Para las pruebas de PT de IL con cerrojo, el valor ISI
introducido para la prueba de PT primaria se importa
automáticamente a las pruebas secundarias (es decir, las
pruebas extendidas (e) y dobles (d). Esta opción está también
disponible para las pruebas de PT con especificaciones
especiales (que no son de IL con cerrojo). Consulte la
sección 4.2.6 para mayores detalles.
4.30
ACL Elite/Elite Pro – AVISO INR IMPORTANTE DEL BOLETÍN TÉCNICO
FÓRMULA INR
INR = (PT del Paciente / PT Normal)ISI
PT DEL PACIENTE = PT del Paciente en segundos
PT NORMAL = *Media del Rango Normal (en el ACL Elite/Elite
Pro se denomina el Valor de Referencia).
Valor ISI = Índice de Sensibilidad Internacional del # de
lote del reactivo de tromboplastina que se está
utilizando.
Para asegurar el reporte apropiado de los resultados INR,
deben seguirse estos pasos:
1. Asegúrese de que el instrumento se encuentre en el modo
de LISTO. En el MENÚ DE AJUSTE, seleccione el SUBMENÚ DE
LÍQUIDOS y seleccione a continuación el REACTIVO DE
TROMBOPLASTINA (IDENTIFICACIÓN DEL LÍQUIDO) apropiado de
la lista en la parte superior de la pantalla.
2. Seleccione la PRUEBA DE PT que utilice este reactivo de
Tromboplastina y haga clic en ASIGNAR VALOR.

3. Introduzca el VALOR ISI del Lote de Tromboplastina en


uso y seleccione Confirmar dos veces para introducir
el valor. Asegúrese de que todas las pruebas de PT que
utilizan la misma Tromboplastina importen la
asignación de ISI apropiada. Pueden estar presentes
133
varias PRUEBAS DE PT que utilicen la misma
Tromboplastina, tal como PT extendida, PT estándar por
duplicado y PT por duplicado de tiempo de adquisición
extendido. Estas pruebas importarán el valor de la
prueba estándar.
NOTA: El valor ISI es específico para el número de lote
del reactivo de tiempo de protrombina que se está usando.

4. En el MENÚ DE AJUSTE, seleccione VER/DEFINIR PRUEBAS.


Seleccione la prueba de PT apropiada y haga clic en los
detalles.
5. Seleccione AJUSTE DEL CÁLCULO y el instrumento mostrará,
en la parte derecha de la pantalla, la selección del
VALOR DE REFERENCIA. Esto representa a la Media del Valor
Normal de la Población en SEGUNDOS, que se utiliza como
el DENOMINADOR en el CÁLCULO de la RELACIÓN y de INR.
6. Asegúrese de que el valor introducido en el campo
represente a la MEDIA DEL RANGO NORMAL DE LA POBLACIÓN de
la población local para PT. Este valor puede editarse y
puede modificarse para reflejar la media del rango normal
establecido para el laboratorio.
7. Confirme que las Pruebas PT que utilizan el mismo lote de
tromboplastina para la Relación/INR se calculen con el
uso del mismo valoren segundos que el denominador (Media
del Rango Normal de la Población).
8. El instrumento utiliza la fórmula siguiente para el
CÁLCULO DE LA RELACIÓN.
CÁLCULO DE LA RELACIÓN = PLASMA DEL PACIENTE (segundos)
VALOR DE REFERENCIA (segundos)
Valor de Referencia significa la MEDIA DE LA POBLACIÓN
NORMAL (segundos)
MEDIA DEL RANGO NORMAL DE LA POBLACIÓN = Media del Tiempo
de PT Normal = Media Normal del Paciente
El rango en segundos según lo recomendado por CLSI,
Documento C28-A, Vol. 15 No. 4.
9. INR se calculará como sigue:
INR = (PT del Paciente/PT del Valor de Referencia)ISI
Con el uso del elemento del Valor de Referencia, el
denominador utilizado en el cálculo de la Relación e INR
reflejará con exactitud a la Media del Rango Normal de la
Población.
* o la media Geométrica

ADVERTENCIAS IMPORTANTES:
• Cuando los cálculos de INR no se ajustan de manera
apropiada, pueden reportarse resultados erróneos del
paciente.
134

• En caso de que cambie el número de lote del producto,


debe introducirse entonces el nuevo valor ISI del
inserto del paquete.
• En el ACL Elite/Elite Pro, tanto la pantalla como la
impresión muestran/reportan las unidades de INR y la
Relación por separado.

4.31
Nota: Siempre que se modifiquen los valores del Plasma de
Calibración que constituyen el objetivo, las calibraciones
almacenadas para las pruebas se actualizan automáticamente y
todos los resultados futuros se calcularán de acuerdo con el
nuevo valor asignado.
Un campo de “Notas” está disponible para que el usuario
introduzca comentarios (texto libre).
Al hacer clic en el icono de Detalles, se abre la pantalla de
Detalles de los Líquidos que proporciona detalles adicionales
acerca del material seleccionado (consultar los detalles
específicos a continuación).
Al hacer clic en el botón del Nuevo Líquido, se abre la
pantalla del Nuevo Líquido para que el usuario introduzca las
características de un nuevo material (consultar los detalles
específicos a continuación).
Al hacer clic en el botón de Confirmar, se guardan los
cambios efectuados y al hacer clic en el botón de Cancelar,
se rechazan los cambios.
Al hacer clic en el icono de Imprimir y confirmar la
selección, se imprime el reporte del líquido.
Al hacer clic en el cuadro de marcado de Mostrar Activadas,
se reducirá la lista de líquidos a la izquierda, para mostrar
solamente los líquidos empleados por las pruebas activadas.
Cuando se marca el cuadro de Mostrar Activadas, los líquidos
de Control de Calidad no serán visibles en la lista. Para ver
los líquidos de Control de Calidad, quite la marca del
cuadro.
Se abre una ventana de advertencia después de que se efectúa
un cambio en cualquier campo: Se han cambiado los parámetros
de los líquidos. ¿Quiere guardarlos antes de proceder? El
operador debe seleccionar Cancelar, Sí o No.
• Cancelar: Se cierra la ventana; se muestra el nuevo valor
introducido, pero no se guarda todavía.
• Sí: Se cierra la ventana y se guardan los cambios.
• No: Se cierra la ventana; se suprimen los cambios
introducidos y se muestra el valor guardado anterior.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
135
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.32
Pantalla de Detalles de los Líquidos
Al hacer clic en el botón de Detalles en la pantalla de
Ajuste de los Líquidos, se abre la pantalla de Detalles de
los Líquidos. Esto permite el acceso a información adicional
acerca del material líquido seleccionado.
(Ilustración)
La información en esta pantalla puede verse, pero no
editarse. La única excepción es la Posición por Omisión para
los líquidos de IL exclusivamente. La información que se
proporciona en la pantalla es:
- Identificación del Líquido (Identificación con 10
caracteres alfanuméricos como máximo).
- Clave del Líquido (los números válidos para el líquido
definido por el usuario son 501-999).
- TIPO DE LÍQUIDO (calibrador, control, reactivo,
solución).
- NOMBRE EXTENDIDO (nombre con 15 caracteres alfanuméricos
como máximo).
- POSICIÓN POR OMISIÓN (Debe coincidir con las 3
selecciones siguientes).
- AGUJA DE ACCESO
- Muestra: Válida para posiciones A1-A10 y R7, 8
- Reactivo: Válida para posiciones R1-R6 y R9-R12
- REFRIGERADO (cuadro de marcado)-El líquido debe usar la
aguja para Reactivos y colocarse en R1-R4 o R9-R12 (ACL
Elite Pro solamente).
- AGITADO (cuadro de marcado)-El líquido debe usar la aguja
para Reactivos y colocarse en las Posiciones R1-R4.
- Valores ISI Mínimo y Máximo aceptables para un Reactivo.
- LÍQUIDO IL (disponible para uso de IL exclusivamente).
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
136
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.33
Pantalla de Nuevo Líquido
Al hacer clic en el botón de Nuevo Líquido en la pantalla de
Ajuste de Líquidos, se abre la pantalla de Nuevo Líquido.
Ésta es la pantalla en donde el operador introduce toda la
información correspondiente a un nuevo material líquido que
se utilizará en el sistema ACL, que se mostrará en otros
sistemas.
(Ilustración)
Los campos siguientes están “abiertos” para que el operador
introduzca los dígitos alfanuméricos deseados (los campos con
un * son obligatorios).
- IDENTIFICACIÓN DEL LÍQUIDO: el nombre abreviado del
material (10 caracteres). Para los líquidos de Control
solamente, esta Identificación puede ser completamente
numérica.
- NOMBRE EXTENDIDO: el nombre completo del material líquido
(15 caracteres alfanuméricos).
- CLAVE DEL LÍQUIDO*: la clave numérica del material (las
claves de IL están reservadas de 1 a 500; las claves del
usuario son de 501 a 999).
- No. DE LOTE: el número del lote del material (8
caracteres).
- FECHA DE CADUCIDAD: la fecha de caducidad como se muestra
en la etiqueta del frasquito. El sistema monitoreará esta
fecha y alertará al operario en la pantalla de historia
de errores de la sesión cuando la fecha del líquido haya
caducado.
- VALOR ASIGNADO: cantidad de líquido (en mL) presente en
un nuevo contenedor antes de comenzar la sesión analítica
(volumen por omisión como se declara en la etiqueta del
producto).
4.34
- VOLUMEN DE ADVERTENCIA: cantidad de líquido (en mL) por
debajo de la cual, los colores del icono del mapa de
reactivos y la posición del mapa del material cambiarán
de verde a anaranjado. Este campo debe llenarse para
todos los reactivos que se monitorearán.
- ESTABILIDAD A BORDO: la estabilidad que se reivindica en
la hoja de inserto. Puede introducirse el tiempo con el
137
uso de las abreviaturas siguientes: h=horas y d=días (es
decir, 24h o 1d).
- Valor ISI Mínimo: Cuando se define este líquido como un
Reactivo, puede introducirse el valor ISI mínimo
aceptable para el reactivo.
- Valor ISI Máximo: Cuando se define este líquido como un
Reactivo, puede introducirse el valor ISI máximo
aceptable para el reactivo.
En los campos siguientes, el operador debe hacer una elección
entre las opciones proporcionadas:
- AGUJA DE ACCESO*: Muestra, (aguja externa) puede aspirar
solamente de A1 a A10 y R7 y R8. Reactivo (aguja interna)
puede aspirar solamente de R1 a R6 y de R9 a R12 (ACL
Elite Pro solamente).
- POSICIÓN POR OMISIÓN*: A1 a A10 o R1 a R5 o (R9 a R12 en
el ACL Elite Pro solamente). La posición por omisión
puede modificarse también para los líquidos de IL,
manteniendo las características de los requisitos para
los líquidos (refrigeración, agitación, aguja, etc.).
- TIPO DE LÍQUIDO*: Calibrador, Reactivo, Control o
Solución
En las dos áreas siguientes, el operador debe “marcar” el
cuadro de marcado en caso de que el líquido requiera la
característica a bordo (marque = SÍ).
- REFRIGERADO (debe utilizar la aguja para Reactivos y las
posiciones R1-R4 y R9-R12).
- MEZCLADO (debe utilizar la aguja para Reactivos y las
posiciones R1-R4).
- LÍQUIDO DE IL (atenuado).
Como pueden refrigerarse y mezclarse solamente las cuatro
primeras posiciones del Área de Reactivos (R1...R4) (en el
ACL Elite Pro, las posiciones solamente refrigeradas
adicionales están ubicadas en el área de R9 a R12), aparece
una ventana de advertencia cuando el operador intenta definir
un ajuste inapropiado (es decir, se coloca un líquido en la
posición R5 y el operador marca el cuadro de marcado
“Refrigerado”.
La advertencia dice:
“Ajuste de Líquido Inválido”. El ajuste específico del
líquido es inválido y no puede almacenarse. Sírvase corregir
el ajuste antes de guardarlo”.
Cuando el material líquido es un “líquido de IL previamente
definido”, se marca automáticamente otro cuadro de marcado;
este cuadro de marcado no puede editarse, lo que significa
que un “Líquido del Usuario” no puede identificarse como un
“Líquido de IL”.
4.35
138
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, rechazan los
cambios; en ambos casos, el sistema regresa a la pantalla de
Ajuste de Líquidos.
Al hacer clic en el icono de Globo, permite que el usuario
modifique la Identificación del líquido y nombre en el idioma
seleccionado.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.36
4.1.13 Ajuste – INTERFACES – Computadora Principal
Esta área del software permite que el usuario defina algunas
características de la comunicación entre el ACL Elite/Elite
Pro y la Computadora Principal con la que tiene interfaz.
Al seleccionar Interfaces en el submenú de Ajuste y
seleccionar Computadora Principal, se abre la pantalla de
Ajuste de la Computadora Principal que se muestra a
continuación.
(Ilustración)
Dos campos en esta pantalla permiten que el operador defina:
- La VELOCIDAD EN BAUDIOS- Las opciones son 2400, 4800,
9600, 19200 ó 38400.
- La TRANSMISIÓN AUTOMÁTICA DE DATOS (TX)-Las opciones son
“No se Requiere”, “Muestras de Pacientes” o “Control de
Calidad, AR y Muestras de Pacientes”.
Al seleccionar la transmisión automática de datos, se efectúa
la transmisión de los resultados al final de cada corrida de
las pruebas, durante la sesión analítica.
El operador “marca” otros botones en la pantalla cuando se
desea la característica (marca = SÍ).
- PREGUNTA A LA COMPUTADORA PRINCIPAL
- SUPRIMIR AUTMÁTICAMENTE DESPUÉS DE LA TRANSMISIÓN (TX)
Al seleccionar suprimir automáticamente, no se permitirá
la retransmisión de resultados en un momento posterior.
- IDENTIFICACIÓN DE INSTRUMENTO ÚNICA (puede definirse un
dígito entre 1 y 99).
4.37
Las pruebas que se bajan del LIS y que están desactivadas en
el analizador, no se mostrarán en la base de datos.
139
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
Para información adicional acerca de la comunicación con la
computadora principal, consulte el Apéndice A (Protocolo de
Comunicación con la Computadora Principal) ubicado al final
de este manual. Consulte la sección 2.5 para los detalles
acerca de la configuración de pins de cables.
4.38
4.1.14 Ajuste – INTERFACES – Impresora
Esta área del software permite que el usuario configure la
impresora externa optativa del ACL Elite/Elite Pro.
Al seleccionar Interfaces en el submenú de Ajuste y
seleccionar Impresora, se abre la pantalla de Ajuste de la
Impresora.
(Ilustración)
En la parte superior de la pantalla, el operador define:
- MUESTRAS IMPRESAS: Cualesquiera pruebas solamente
analizadas (independientemente del estado de la muestra)
o solamente las Completadas (el estado de la muestra está
completo).
- TIPO DE REPORTE: Reporte Acumulativo (múltiples muestras
por página) o Reporte de la Muestra (Muestra Sola por
página)
- PROTOCOLO DE LA IMPRESORA: ESC/P2 (para impresoras
similares a la Epson) o HO-PCL (para impresoras similares
a la HP).
- DIMENSIÓN DEL PAPEL: A4 (210 x 297 mm) o Carta (216 x 280
mm/8 ½ x 11 pulgadas).
- FORMATO DEL PAPEL: Una sola hoja u hoja continua.
Una marca en el cuadro de Impresión Automática indica que se
desea esta característica.
La Impresión Automática tiene lugar al final de cada corrida
dentro de un rotor, de acuerdo con los criterios
seleccionados (cualquier reporte analizado, completado,
acumulativo o de muestra).
140
4.39
El usuario define el área de DATOS DE REPORTE DE LA MUESTRA
oprimiendo el botón de Activar/Desactivar. Las opciones son:
Nombre del Instrumento, los Rangos Normales y la Fecha/Hora.
Al hacer clic en el botón de Ajustar Encabezado de Acuerdo
con Especificaciones Particulares, permite el ajuste
adicional de especificaciones particulares del reporte al
proporcionar 5 líneas de 30 caracteres cada una de texto
libre para el usuario, que se introduce en la pantalla de
Ajustar Encabezado de Acuerdo con Especificaciones
Particulares.
En ambas pantallas de Ajustar Impresora y Ajustar Encabezado
de Acuerdo con Especificaciones Particulares, al hacer clic
en el botón de Confirmar, se guardan los cambios y al hacer
clic en el botón de Cancelar, se rechazan los cambios; en
ambos casos, el sistema regresa a la pantalla Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
(Símbolo)
Nota: El ACL Elite/Elite Pro soporta el uso de una conexión
USB o Paralela para la impresora externa. Cuando se usa la
conexión USB, la impresora debe conectarse y encenderse antes
de que se cargue el sistema. Cuando se apaga la impresora
mientras el instrumento está encendido, debe volverse a
cargar el analizador a fin de que ocurra la impresión.
4.40
4.1.15 Ajuste – INTERFACES – Código de Barras Interno
Esta área del software permite que el usuario configure el
lector de código de barras interno que se utiliza para la
identificación de las muestras en el sistema ACL Elite/Elite
Pro.
Al seleccionar Interfaces en el submenú de Ajuste y
seleccionar Código de Barras, se abre la pantalla de Ajuste
del Código de Barras.
El primer paso es activar el Lector de Código de Barras
Interno marcando el cuadro de marcado Lector de Código de
Barras (BCR por sus siglas en idioma inglés) activado que se
ve en la parte superior de la pantalla.
141
Los cuatro campos visibles en la pantalla corresponden a las
cuatro familias de códigos de barras que pueden activarse en
el ACL, junto con sus subtipos de códigos de barras
correspondientes.
Para cada campo, el usuario debe escoger una de las opciones
de acuerdo con las necesidades del laboratorio, según se
muestra a continuación.
(Ilustración)
CODABAR: Desactivada
Ninguna suma de comprobación
AIM Mod 16
NW7 Mod 11
NW7 Mod 16
CLAVE 39: Desactivada
Ninguna suma de comprobación
Mod 43
INTERPUESTA 2 DE 5 Desactivada
4.41
Ninguna suma de comprobación
USS Mod 10
OPCC Mod 10
CLAVE 128 Desactivada
Ninguna suma de comprobación.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.42
4.1.16 Ajuste – INTERFACES – Código de Barras Externo
(optativo)
(Ilustración)
El lector de código de barras externo es una opción que
permite leer los códigos de barras de los frasquitos de
reactivos cuando se muestra el mapa de materiales. Haga clic
en el botón de BCR Externo Activado para activar a este
elemento.
142
El cuadro de despliegue descendente de la Clave 128
proporciona dos selecciones: Activado; ninguna suma de
comprobación.
Reajustar Volumen de Reactivo cuando se Escanea: Al marcar
este cuadro, se reajustará automáticamente el volumen del
reactivo en el mapa al volumen por omisión definido para este
líquido.
Reajustar Cronómetro cuando se Escanea: Al marcar este
cuadro, se Ajusta automáticamente el cronómetro de
estabilidad a bordo al valor por omisión definido para el
líquido. Cuando se marca el cronómetro de pausa para un
reactivo, cuando se lee la etiqueta del frasquito, se dejará
de marcar el botón de pausa. Cuando se lee el frasquito una
segunda vez, se reajustarán el cronómetro y el volumen en
este punto.
Las estabilidades a bordo y los volúmenes de líquidos por
omisión deben definirse para que las dos opciones incluidas
arriba sean funcionales.
Cuando se muestra el mapa de materiales, el lector de código
de barras está activo. El lector de código de barras externo
puede usarse para leer la etiqueta en los reactivos.
Centelleará la posición para colocar el frasquito a bordo del
sistema. En caso de que la fecha de Caducidad del número del
lote sea inválida, se mostrará un mensaje de advertencia.
Notas:
- El dispositivo del código de barras ha sido sometido a
prueba de acuerdo con la EN 60825-1, seguridad de los
LED, y ha sido certificado en el sentido de que se
encuentra bajo los límites de un dispositivo de LED Clase
1.
- El alojamiento del escáner no es impermeable al agua; por
lo tanto, no debe sumergirse el escáner en agua. El
alojamiento y la ventana del escáner deben limpiarse con
un trapo suave o pañuelo facial humedecido con agua o un
detergente suave a base de agua. No se limpie el escáner
y la ventana con alcohol o solventes.
4.43
4.1.17 Ajuste – INTERFACES – Teclado
Esta área del software permite que el usuario configure el
teclado estándar del ACL Elite/Elite Pro para el idioma que
se utiliza en el laboratorio y para decidir acerca del uso
del teclado numérico desplegable en pantalla.
Al seleccionar las Interfaces del submenú de Ajuste y
seleccionar Teclado, se abre la pantalla de Ajuste del
Teclado.
La ventana en esta pantalla selecciona:
- TIPO DE TECLADO:
143
Inglés (Británico), Francés, Alemán, Italiano, Español o
EUA (Inglés)
- TECLADO NUMÉRICO
Desactivado, Todos los campos numéricos, o Todos los
campos numéricos y la Identificación de la Muestra.
(Ilustración)
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
de Ajuste del Teclado.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.1.18 Ajuste – INTERFACES – Red
No soportadas en esta Revisión de Software
4.44
4.1.19 Ajuste – INTERFACES – Módem
No soportadas en esta Revisión de Software
4.1.20 Ajuste – CONFIGURACIÓN DEL SISTEMA
Esta área del software permite que el usuario configure
algunas de las características del sistema del ACL
Elite/Elite Pro.
Al seleccionar Configuración del Sistema en el submenú de
Ajuste, se abre la pantalla de Configuración del Sistema.
(Ilustración)
Esta pantalla permite que el usuario seleccione las funciones
preferidas para lo siguiente:
LISTA DE BASE DE DATOS DE LOS PACIENTES: Define el orden de
las muestras de los pacientes en la base de datos; 4 opciones
están disponibles.
1. La última muestra se encuentra en la parte superior.
2. La última introducida se encuentra al final.
3. Orden ascendente de identificación de las muestras.
4. Orden descendente de identificación de las muestras.
Las opciones 1 y 2 se basan en la fecha/hora de introducción
de la muestra y las opciones 3 y 4 se basan en la
clasificación alfanumérica de Identificación de las Muestras.
LA LISTA DE BASE DE DATOS DE CONTROL DE CALIDAD/AR: Define el
orden de los materiales de Control de Calidad en la base de
144
datos: el último material introducido se encuentra en la
parte superior o el último introducido se encuentra al final.
ESTADO REFLEJO: En caso de que se definan las reglas en
Ajuste/Pruebas/Pruebas Reflejas, hay tres opciones
disponibles: Programar reflejas, Ejecutar reflejas antes de
cerrar la sesión, Desactivadas. Para información adicional,
sírvase consular 4.1.7.
4.45
• Programar Refleja solamente: se añaden las pruebas a la
Identificación de la muestra, pero no se ejecuta el
análisis. La prueba permanecerá pendiente hasta que se
ejecute en una sesión posterior.
• Ejecutar refleja antes de cerrar la sesión: programa las
pruebas y las ejecuta durante la sesión actual, siempre y
cuando las pruebas estén definidas dentro de la sesión
del perfil actual en uso.
• Desactivadas: apagar TODA la programación y las pruebas
reflejas.
IDIOMA ACTUAL: Ingles, Francés, Alemán, Italiano, Español o
Japonés (Kanji). Vuelva a cargar el analizador después de
cambiar el ajuste del idioma. Las introducciones en el libro
de registro, Error de Archivo e historia de Errores de la
Sesión no se actualizan para las introducciones anteriores a
la fecha y la hora del cambio de idioma.
PANTALLA POR OMISIÓN: Cuando se carga el sistema, puede
seleccionarse de las dos pantallas siguientes como pantalla
inicial: Vista de la Base de Datos o Múltiples Pruebas
Previas al Análisis (se muestra la última sesión de múltiples
pruebas previa al análisis de la sesión de múltiples
pruebas).
Cuadro de marcado de SENSOR DE LÍQUIDOS: activa/desactiva el
uso del sensor de nivel de líquido de sonda de muestra y
reactivo.
Cuadro de marcado del sensor de emulsión de Lavado-R:
activa/desactiva el uso de este sensor.
(Símbolo)
Advertencia: Cuando los Sensores de Líquidos y el Sensor de
Lavado-R están desactivados, se presentará tanto un mensaje
de advertencia como un indicador en todos los resultados de
las muestras. Cuando se desactiva el Sensor de Líquidos, el
operador debe monitorear con cuidado el volumen de los
líquidos y las muestras para asegurar que haya presentes
cantidades adecuadas para las pruebas. La transmisión
automática de resultados a la computadora principal se
desactiva cuando los sensores están desactivados. Al final de
cada sesión, un cuadro desplegable alertará al operador para
confirmar que permanezcan muestra/reactivo suficientes a
145
bordo del analizador. Después de la confirmación de los
volúmenes, el operador puede iniciar la acción de subir
manualmente los resultados a la computadora principal. Cuando
se reactiva el sensor, se reactivará automáticamente la
comunicación con la computadora principal.
REM Activado: activa/desactiva el uso del Módulo de
Intercambio de Rotores. No es aplicable para
el ACL Elite. Cuando se desactiva el REM, el
operador puede utilizar el sistema cargando
manualmente los rotores.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
Principal.

• Los BOTONES ACTIVOS en la parte inferior de esta pantalla


son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.46
4.1.21 Ajuste – SEGURIDAD
Esta área del software permite que el Administrador de
Laboratorio configure el nivel de privilegio para los
usuarios (Supervisor u Operador) y defina las
identificaciones y contraseñas para todo el personal que
utiliza el sistema del ACL Elite/Elite Pro.
Pueden definirse hasta 99 usuarios en el área de Seguridad.
La primera operación que efectuará el Administrador del
Laboratorio es la definición del nivel de introducción para
los otros dos grupos de usuarios.
(Ilustración)
El Administrador del Laboratorio, mediante el uso de su
contraseña, tendrá acceso al botón de Vista del Administrador
del Laboratorio.
Nota: Al tener lugar la instalación del sistema, es
aconsejable introducir una nueva identificación y contraseña
del Administrador del Laboratorio.
Al hacer clic en el botón de Vista del Administrador del
Laboratorio, aparecerá una pantalla en la que tanto el
Supervisor como el Operador tienen acceso a la definición.
4.47
146
(Ilustración)
En esta pantalla, para cada menú/submenú, el Administrador
del Laboratorio puede definir el nivel de introducción de
acuerdo con las necesidades específicas del laboratorio.
NIVEL: En el menú desplegable descendente, seleccione el
nivel para definir: Supervisor u Operador.
Nota: El Administrador del Laboratorio debe definir los
niveles de acceso a la pantalla tanto del Supervisor como del
Operador. Al definir ningún acceso en el nivel del
supervisor para un submenú, no excluye automáticamente al
acceso en el nivel del operador.
Para cada menú/submenú, el Administrador del Laboratorio
tiene tres opciones básicas:
• Ningún Acceso
• Acceso, Ver* solamente
• Acceso, Editar*
*La V y la E incluidas bajo la columna de Ambiente
representan Ver y Editar. Ningún Acceso significa que no
será posible entrar en un menú o submenú; la opción estará
opaca.
Acceso – Ver Solamente significa que el acceso es posible.
Las pantallas pueden verse, pero no puede efectuarse ninguna
modificación.
Acceso – Editar significa que el acceso es posible y que la
capacidad de Editar está disponible (dependiendo del tipo de
pantalla).
4.48
(Ilustración)
Al seleccionar el icono de Detalles después de escoger el
menú/submenú, aparecerá la pantalla que se muestra arriba.
En el cuadro de Modo de Acceso, el Administrador del
Laboratorio puede definir el Acceso/No Acceso para el
menú/submenú específicos.
En caso de que se escoja la opción de Acceso, el
Administrador del Laboratorio puede definir Ver Solamente o
capacidad de Editar para el menú/submenú seleccionado.
4.49
Cuando tenga que introducirse a un nuevo usuario en el
sistema, tiene que escogerse el botón de Nuevo Usuario en la
pantalla de introducción de Seguridad principal.
(Ilustración)
Aparecerá la siguiente pantalla
(Ilustración)
4.50
En esta pantalla, necesita introducirse la información
siguiente.
147
NOMBRE DEL USUARIO: Teclee el nombre del usuario (debe ser
único). Es aconsejable mantener el nombre de manera breve
(mínimo de tres y máximo de quince caracteres), dado que se
utilizará para entrar en el sistema.
NOMBRE EXTENDIDO DEL USUARIO: Teclee el nombre extendido del
usuario para diferenciar entre usuarios. (Máximo de 20
caracteres).
NIVEL: El Administrador del Laboratorio definirá el nivel de
entrada para cada usuario:
• Administrador del Laboratorio
• Supervisor
• Operador
CONTRASEÑA: El nuevo usuario introducirá su contraseña.
CONFIRMAR CONTRASEÑA: Vuelva a introducir la misma contraseña
para confirmación. La contraseña tiene que ser de un mínimo
de 3 y un máximo de 9 caracteres.
Cuando entre en el sistema, se requerirá el Nombre del
Usuario y la Contraseña.
(Ilustración)
Se recomienda que, cuando el sistema no esté en uso, se salga
del sistema (utilizando el icono de llave) y se requiera que
el siguiente usuario entre en el sistema.
Cuando se utilice el sistema de Seguridad/Contraseña, las
operaciones sumamente importantes se registran en el Libro de
Registro (ver la sección 5, Diagnóstico).
4.51
4.1.22 Ajuste – Alarmas Audibles
La pantalla de ajuste de alarmas audibles permite que los
laboratorios activen/desactiven la alarma que suena para
diversas condiciones del sistema.
Al seleccionarse Alarmas Audibles en el menú de Ajuste, se
abre la siguiente pantalla:
(Ilustración)
El Analizador fija previamente 3 sonidos de alarma, a los que
se hace referencia como A, B, C. Las alarmas audibles pueden
activarse/desactivarse para las condiciones siguientes:
- FIN DE LA SESIÓN ANALÍTICA (Alarma A)
- RETENER ESTADO (Alarma B): Esta condición ocurre durante
una interrupción stat, cuando la prueba actual en proceso
está completa.
- ESTADO DE FALLA (Alarma C): Se encontró una condición de
error del sistema.
- REACTIVO INSUFICIENTE (Alarma B): Escasez de Reactivo
durante la sesión analítica.
- EMULSIÓN DE LAVADO-REFERENCIA INSUFICIENTE (Alarma B): La
botella de Lavado-Referencia está vacía.
148
- CONTROL DE CALIDAD FUERA DEL RANGO DE DE (Alarma B):
Alerta cuando ocurre una falla de Control de Calidad en
el sistema.
- MATERIAL /CALIBRACIÓN FALTANTE ANTES DE COMENZAR EL
ANÁLISIS (Alarma B): Material faltante observado durante
la verificación preanalítica.
- MATERIAL FALTANTE/MUESTRAS FALTANTES (Alarma B): Material
o muestras faltantes durante la verificación
preanalítica.
- REUTILIZACIÓN DE CUVETAS (Alarma B): Mapa de cuvetas
físico para el rotor no coincide con el mapa lógico; el
operador debe introducir/confirmar las posiciones de las
cuvetas.
Mueva el cursor a la Condición de Alarma Audible y oprima el
botón de Dejar de Seleccionar para activar/desactivar la
alarma para esta condición.
Cuando se activa la alarma, sonará a un intervalo de 60
segundos durante un período de hasta una hora.
4.52
4.1.23 Ajuste – FECHA/HORA
Esta área del software permite que el usuario configure el
formato de la Fecha para ajustar la Fecha actual y de la Hora
para uso en todas las pantallas e impresiones apropiadas del
ACL Elite/Elite Pro.
Al seleccionar Fecha/Hora en el submenú de Ajuste, se abre la
pantalla de la Fecha/Hora.
(Ilustración)
FORMATO DE LA FECHA: en este campo, el usuario escoge entre
las opciones siguientes:
dd.mm.aaaa (estilo europeo)
aaaa.mm.dd (estilo japonés)
mm.dd.aaaa (estilo norteamericano)
A fin de ajustar la fecha y la hora, hay dos campos numéricos
disponibles.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
149
(Símbolo)
Advertencia: El cambio de la fecha por una anterior puede
tener un impacto sobre el resultado de operación “FIFO” (lo
que entra primero sale primero) de la base de datos
(Paciente, Control de Calidad, Calibración y AR). Los
resultados procesados en las fechas más alejadas de la fecha
actual del sistema serán las primeras en suprimirse
automáticamente.
4.53
4.1.24 Ajuste – UNIDADES
Esta área del software permite que el usuario configure las
unidades utilizadas para la temperatura en el sistema ACL
Elite/Elite Pro.
Al seleccionar Unidades en el submenú de Ajuste, se abre la
pantalla de Unidades.
(Ilustración)
El campo de UNIDADES DE TEMPERATURA tiene las opciones
siguientes: ºC o ºF.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la Pantalla
Principal.
• Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
4.54
4.2 Ajuste – PRUEBAS – Definir
Esta área del software se utiliza para ver y definir las
pruebas.
(Símbolo)
Advertencia: Después de definir una nueva prueba o una prueba
copiada, los ajustes de la prueba deben imprimirse y
verificarse para confirmar la introducción correcta. IL no
asume ninguna responsabilidad por el desempeño en el
analizador de las pruebas con cerrojo que no sean de IL. Cada
laboratorio debe verificar y confirmar la validez y los
resultados de las definiciones de las pruebas definidas por
el usuario.
150
Al seleccionar Pruebas en el submenú de Ajuste y escoger
Ver/Definir a continuación, se abre la pantalla de Ver
Pruebas.
(Ilustración)
En la parte superior de la lista de pruebas, un cuadro
rectangular mostrará el número de pruebas presentes en la
Aplicación de Biblioteca. El cuadro mostrará dos números: las
pruebas activadas y el número total de pruebas.
La ventana grande a la izquierda de la pantalla muestra una
tabla de todas las pruebas configuradas. Cada prueba se
identifica mediante un nombre abreviado, la Identificación de
la Prueba, que se muestra en la columna del lado derecho.
Ambas columnas a la izquierda de los nombres de las pruebas
contienen marcas para indicar si cada prueba:
- está actualmente Activada y lista para correrse en el ACL
- es una prueba de IL con cerrojo, definida previamente.
4.55
(Símbolo)
Advertencia: las pruebas previamente definidas de IL se
desarrollaron y llevaron a cabo específicamente para uso con
los reactivos HemosILTM y los suministros soportados por IL
para uso en el ACL Elite/Elite Pro.
El desempeño apropiado de otros reactivos y suministros no ha
sido sometido a prueba o verificado completamente, y el uso
de los mismos puede ocasionar una degradación clínicamente
significativa del desempeño y los resultados. IL no asume
ninguna obligación o compromiso de garantía con respecto a la
precisión y/o la exactitud de las mediciones o por concepto
de cualquier daño al instrumento que resulte directa o
indirectamente del uso de reactivos, consumibles (nuevos o
lavados) y suministros desechables que no sean los que vende
IL.
Toda la responsabilidad por concepto del desarrollo de
parámetros y la validación de nuevas pruebas o pruebas
copiadas, corresponde exclusivamente al usuario.
El lado derecho de la pantalla contiene los campos
siguientes:
CLAVE DE LA PRUEBA
REVISIÓN DE LA PRUEBA
CLAVE DE LA PRUEBA PARA LA COMPUTADORA PRINCIPAL
NOMBRE EXTENDIDO
MODO DE CALIBRACIÓN
La información que se muestra en estos campos puede verse,
pero no editarse en esta pantalla. Se encuentran varios
botones alrededor de estos campos.
151
Al hacer clic en el icono de Detalles, se abre la pantalla de
Detalles de las Pruebas que permite editar los campos
(consultar la sección específica a continuación).
Al hacer clic en el icono de Impresora, seguido por una
ventana de confirmación “¿Quiere realmente imprimir?, la
respuesta de Sí permite que al operador la opción de imprimir
el Ajuste de la Prueba de la prueba seleccionada; No
cancelará la operación.
Al hacer clic en el botón de Activar/Desactivar, seguido por
una ventana de confirmación de Sí/No, borra toda la
información relacionada con la prueba seleccionada de la Base
de Datos del Paciente y la Base de Datos de Control de
Calidad. Cuando se desactiva la prueba, al hacer clic en el
botón de Activar/Desactivar la activará.
La base de datos de la prueba puede contener hasta 300
pruebas; 200 reservadas para las aplicaciones de IL y 100
reservadas para las aplicaciones según especificaciones
particulares; pueden activarse hasta 100 pruebas al mismo
tiempo.
4.56
Al hacer clic en el cuadro de marcado de Mostrar Activadas,
permite que el operador vea solamente las pruebas activadas
de la tabla de pruebas. Cuando se marca este cuadro de
marcado, la lista presentada es relativa a las pruebas
activadas. Esta información se guarda al salir de esta
pantalla y también al apagar.
Al hacer clic en Suprimir, se borran solamente las pruebas
abiertas (ajustadas según especificaciones particulares); las
pruebas de IL previamente definidas no pueden suprimirse.
4.2.1 COPIAR PRUEBA
Al hacer clic en el botón de Copiar Prueba, se abre la
pantalla de Copiar Prueba.
(Ilustración)
El campo superior indica la “Prueba que Va a Copiarse”; la
lista contiene todas las pruebas presentes en la base de
datos de las pruebas.
El campo de IDENTIFICACIÓN DE LA NUEVA PRUEBA permite que el
operador nombre a la nueva prueba (máximo de 8 caracteres).
Éste es un campo obligatorio.
El campo de NOMBRE EXTENDIDO permite que el operador nombre a
la nueva prueba con un nombre más detallado (máximo de 15
caracteres).
La CLAVE DE LA PRUEBA PARA LA COMPUTADORA PRINCIPAL
representa la clave numérica para la comunicación con la
Computadora Principal. Éste es un campo obligatorio. El rango
de claves de pruebas aceptable para las pruebas con cerrojo
que no son de IL es de entre 501 y 999.
152
4.57
La REVISIÓN DE LA PRUEBA ayuda a que el operador efectúe el
seguimiento de los cambios en la aplicación. El número debe
introducirse tecleando manualmente (máximo de 4 caracteres).
4.2.2 Ajuste – DETALLES DE LAS PRUEBAS
La pantalla de Detalles de las Pruebas se muestra a
continuación. Los campos estarán en blanco para las nuevas
pruebas, en tanto que, para las pruebas copiadas, contendrán
los ajustes de la prueba original que se copió.
(Ilustración)
En los detalles de la nueva prueba, la siguiente información
es accesible.
• IDENTIFICACIÓN DE LA PRUEBA – 8 caracteres
Este campo puede editarse para todas las pruebas, con
inclusión de las pruebas de IL previamente definidas. La
IDENTIFICACIÓN DE LA PRUEBA debe ser única para cada
prueba. La IDENTIFICACIÓN DE LA PRUEBA se utiliza para
ordenar las pruebas, así como para revisar los resultados
(es decir, columna de IDENTIFICACIÓN DE LAS PRUEBAS).
La IDENTIFICACIÓN DE LA PRUEBA se imprime en el reporte
acumulativo. Por lo menos un caracter alfanumérico es
obligatorio.
• CLAVE DE LA PRUEBA – 3 caracteres.
Este campo puede editarse en una prueba abierta, pero no
en las pruebas de IL con cerrojo. Los números disponibles
para los ensayos abiertos son de 501 a 999.
4.58
• NOMBRE EXTENDIDO DE LA PRUEBA – 15 caracteres.
Este campo puede editarse en las pruebas de IL y las
abiertas. Este campo se imprime en el reporte de las
muestras. Por lo menos un caracter alfanumérico es
obligatorio.
• CLAVE DE LA PRUEBA PARA LA COMPUTADORA PRINCIPAL – 4
caracteres (pueden editarse).
Este campo puede editarse para todas las pruebas.
Este campo representa a la Clave para la transmisión a la
Computadora Principal.
• REVISIÓN DE LA PRUEBA – 4 caracteres.
Este campo puede editarse en una prueba abierta.
El formato es de 0.00 a 99.99.
• MODO DE CALIBRACIÓN – Puede seleccionarse una de las
siguientes opciones:
- Ninguna: No se necesita ninguna calibración para esta
prueba.
- Una Vez por Sesión – Esta prueba no tiene un ciclo de
calibración especializado; la calibración se efectúa
153
con la sesión analítica y puede almacenarse y
utilizarse para análisis ulteriores.
- Cada Rotor. Esta prueba no tiene un ciclo de
calibración especializado; la calibración se efectúa
para cada sesión analítica dentro del rotor. La
calibración anterior puede revisarse, pero no puede
usarse para análisis ulteriores.
- Especializado Este prueba tiene un ciclo de calibración
especializado y esta calibración puede almacenarse.
• IMPORTAR CALIBRACIÓN – Puede seleccionarse una de las
opciones siguientes:
- Ninguna. Ninguna importación de calibración es
necesaria para esta prueba.
- Lista de Pruebas desplegable descendente: En caso de
que sea necesario importar una calibración, escoja la
prueba de la lista de pruebas que se muestra.
Aparecerán solamente las pruebas activadas con un
calibrador definido.

• IMPORTAR DATOS EN BRUTO DE – Pueden seleccionarse las


opciones siguientes:
- Ninguna. Esta prueba no importa datos en bruto de
ninguna otra prueba.
- Lista de Pruebas desplegable descendente: En caso de
que sea necesario importar los datos en bruto, escoja
la prueba de la lista de pruebas que se muestra. Se
muestran todas las pruebas.
(Símbolo)
Seleccione Rangos en la pantalla de ajuste de la prueba para
modificar la opción de reporte de unidades, los rangos para
la unidad seleccionada y la escala del eje de las Y de las
curvas de reacción.
Nota: Cuando se define una nueva prueba, deben introducirse
los Rangos después de que se definen todas las subsecciones
(Análisis, Calibración, Adquisición y Cálculo) del ajuste de
la prueba.
4.59
(Ilustración)
La tabla de Rangos y Unidades contiene la información
siguiente:
• Se muestra en la lista de muestras – cuando se ha marcado
la unidad (Sí), se muestra la unidad en la base de datos
del paciente y se imprime.
(Símbolo)
Nota: Este ajuste no tiene ningún impacto sobre la
transmisión de los resultados al sistema de la Computadora
154
Principal. Todas las unidades para una prueba se transmiten
independientemente del ajuste en este cuadro de marcado.
• Parámetros de corrección – En caso de que se aplique
algún factor de corrección a una unidad específica,
aparecerá un asterisco.
• Unidades de los Resultados – Unidades que están
disponibles en la prueba seleccionada (de 1 a 4).
• Rango Normal – Define el rango normal para cada unidad.
Los valores mínimo y máximo pueden teclearse. El rango
normal se utiliza para establecer un indicador en los
resultados de los pacientes. En la pantalla, los
resultados se muestran en negro cuando se encuentran
dentro del Rango Normal; los resultados se muestran en
violeta cuando están fuera del Rango Normal; en la
impresión, se imprimirá un asterisco (próximo a los
resultados fuera del rango normal).
• Rango de la Prueba – Define el rango de la prueba para
cada unidad (es decir, Rango de Linealidad). Los valores
Mínimo y Máximo no pueden editarse en las aplicaciones de
las pruebas de IL, pero pueden editarse en las
aplicaciones de acuerdo con especificaciones
particulares. El rango de la prueba se utiliza para
establecer indicadores en los resultados de los
pacientes. Los valores fuera del Rango de la Prueba se
muestran en rojo; en la impresión, estos resultados se
imprimirán en negrita.
4.60
• Rango de la Escala – Rango de reporte numérico para la
prueba. Los valores numéricos altos fuera del rango de la
escala se presentan con asteriscos (***) y los valores
numéricos bajos fuera del rango se representan con
guiones (---). Los valores Mínimo y Máximo no pueden
editarse en las aplicaciones de las pruebas de IL, pero
pueden editarse en las aplicaciones con especificaciones
particulares.
• Gráfica de la Curva de Reacción – Define al eje de las Y
de la curva de reacción (valores mínimo y máximo). En
caso de que los campos se dejen en blanco, el sistema
efectuará su escala automática con base en los datos en
bruto obtenidos.
El Valor de Referencia se introduce en la sección de Ajuste
del Cálculo.
Se utiliza el valor para el cálculo de R (Relación) e INR
para las pruebas. Este valor es el denominador del cálculo de
R e INR y debe representar a la media del tiempo de la
población normal para la prueba seleccionada.
155
El valor de referencia para la prueba estándar puede
importarse automáticamente a las pruebas relacionadas
secundarias. Por ejemplo, el valor de referencia de PT
(prueba estándar) se importará automáticamente a las pruebas
de PTe, PTd y Pted (secundarias). La importación automática
se incorpora a las pruebas de IL con cerrojo. Para las
pruebas con cerrojo que no son de IL, puede utilizarse esta
característica cuando las pruebas están ajustadas para que
sea así. Consulte la sección de Ajuste del Cálculo para más
detalles.
Al hacer clic en el botón de Corrección de Unidades, es
posible corregir las unidades de los resultados con base en
una ecuación matemática.
Las unidades calculadas para las pruebas pueden corregirse en
esta pantalla (es decir, %, R, INR, g/L, mg/dL, U/mL, etc.),
en tanto que las unidades primarias (es decir, segundos,
delta, absorbencia, etc.) pueden corregirse en la Sección
4.2.8 del Cálculo. Los resultados de las pruebas para las
pruebas de IL con cerrojo, que tienen parámetros de
corrección introducidos para la unidad primaria (medida),
mostrarán “Correlación de Laboratorio aplicada” en el cuadro
de la lista de advertencias cuando se muestre la curva de
coagulación.
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección se representa mediante la fórmula siguiente:
Y = mX + q
en que “m” representa la pendiente y “q” la intercepción en
el eje de las Y.
X es el resultado original y Y son los resultados corregidos.
4.61
(Ilustración)
Los valores del intervalo mínimo y máximo representan el
rango de la unidad, en el que se espera que la corrección sea
activa. Los valores para estos campos deben ser números
positivos dentro del rango de la prueba para la prueba
seleccionada.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes con valores tanto positivos como negativos.
La definición de los Parámetros de Corrección (cuando no los
define IL en las Aplicaciones de Pruebas de IL con Cerrojo)
es responsabilidad del personal del laboratorio.
(Símbolo)
Advertencia: No se recomienda la modificación de los
parámetros de corrección para las unidades calculadas en las
Pruebas de IL con Cerrojo (es decir, Dímero D Alto). Se
156
mostrará un cuadro de mensajes para alertar al usuario en
caso de que intente cambiar los ajustes.
La secuencia recomendada de operaciones cuando se cree una
nueva prueba es la siguiente:
1. Análisis: Ajustar carga.
2. Calibración: Ajustar carga.
3. Ajustar adquisición.
4. Ajustar cálculo.
5. Ajustar rangos.
(Símbolo)
Advertencia: Cuando se define una nueva aplicación, debe
considerarse que los cambios de importancia en el ajuste del
paso del Análisis (es decir, la adición o eliminación de
pasos), en el ajuste del paso de Calibración (es decir, la
adición o eliminación de pasos de calibración) y el ajuste de
la Adquisición (es decir, cambio en el tiempo de adquisición)
borrarán a todas las condiciones del ajuste del Cálculo. Se
efectúa lo anterior para evitar condiciones de posibles
contradicciones de las pruebas. Por esta razón, es importante
asegurarse de que...
4.62
...al cargar el Análisis, cargar la Calibración y efectuar el
Ajuste de la Adquisición, su condición sea correcta antes de
definir el Ajuste del Cálculo.
Antes de efectuar cualquier cambio en una prueba abierta, ya
sea nueva o copiada, es aconsejable imprimir los parámetros a
fin de tener una referencia para usarla cuando se necesite la
introducción del ajuste del cálculo de nueva cuenta.
Cuando se defina una nueva aplicación, debe considerarse que
los cambios menores en el ajuste del paso del Análisis (es
decir, un cambio del nombre o volumen de un líquido en un
paso existente) no borrarán a las condiciones del ajuste del
Cálculo.

4.2.3 Análisis – Ajustar Carga

DETALLES DE LA
PRUEBA

LIMPIEZA

ANÁLISIS:
AJUSTAR CARGA

CEBADO DEL
REACTIVO
157

AJUSTE DEL PASO


(un solo paso)

VERIFICACIÓN
DEL MATERIAL

PARÁMETROS PARÁMETROS
Línea de muestra Línea de Reactivo

4.63

Al hacer clic en el botón de Análisis: Ajustar Carga permite


que el usuario vea/edite el ajuste de los reactivos y la
muestra en las charolas durante el análisis.
(Ilustración)
Se utiliza esta pantalla para definir todos los pasos para
llevar a cabo el análisis.
Identificación de la Prueba: en este campo, se muestra la
Identificación de la prueba previamente definida. Este campo
está presente en todas las pantallas del ajuste de la prueba.
COPAS VACÍAS EN EL ANILLO EXTERIOR, A PARTIR DEL NÚMERO DE LA
POSICIÓN: este campo se utiliza cuando es necesario colocar
una copa vacía (0.5 mL) en la charola de muestras para fines
previos a la dilución.
REPLICAS DE LOS PUNTOS DE CALIBRACIÓN: vista del campo
solamente; se define en el ajuste de la calibración.
Cuadro de marcado para Muestras Dobles: se marca este cuadro
para correr las muestras en el modo por duplicado. Se activa
el marcado de la media del valor bajo Ajustar Calibración.
Paso: es el orden de la ejecución del análisis paso por paso.
Botón de Añadir: se utiliza este botón para definir en
detalle todos los pasos del análisis. Un solo paso es la
acción de aspirar/surtir líquidos. Puede llevarse a cabo un
paso mediante la aguja de las muestras, la aguja de los
reactivos o ambas agujas. El resultado final de un paso es
completar un ámbito.
4.64
- Referencia Óptica (Emulsión de Lavado-R) que se utilizará
con las definiciones de los canales tanto de 660 nm como
de 405 nm.
158
- Referencia (en las pruebas de Absorbencia) que se
utilizará con la definición del canal de 405 nm
solamente.
- Muestra
- Muestra a (muestra activada como en la prueba APCR-V)
- Muestra 1, 2, 3 (Para uso con el paralelismo de factor)
- Referencia Analítica
- Referencia Analítica a (referencia analítica activada
como en la prueba APCR-V)
Los iconos de Flecha/Tijeras añaden o suprimen un ámbito
posible.
(Ilustración)
La lista de “ámbito posible” que se presenta en esta pantalla
es solamente un ejemplo; las selecciones reales de los
ámbitos posibles se indican en el texto anterior.
Una vez que se define el ámbito, es necesario definir qué
aguja se utilizará para aspirar/surtir los líquidos.
El botón de parámetros para introducir la línea de Muestras o
Reactivos, abre la ventana de Parámetros de Ajuste de los
Pasos.
4.65
(Ilustración)
Los parámetros de carga para la aguja de las Muestras o
Reactivos pueden definirse como Ninguna Carga, Ninguna
Dilución, Dilución en Línea o Dilución en la Copa.
(Símbolo)
Notas: un volumen de carga de 10 microlitros se añade siempre
automáticamente a cada condición de paso total, tanto en la
línea de muestras como en la línea de reactivos para todas
las tres condiciones: Ninguna Dilución, Dilución en Línea y
Dilución en la Copa. Todos los volúmenes de líquidos deben
introducirse como volúmenes en microlitros. La aspiración
del ciclo de lavado es de 130 µl de Lavado-R por ciclo.
Ninguna Carga: Esta línea no aspira/surte ningún líquido en
este paso.
Ninguna Dilución: Se aspira el líquido y se surte en la
condición en que está, sin ninguna dilución. Deben
introducirse los campos siguientes:
• Identificación del Líquido: escoja de la lista de
líquidos.
• Volumen: introduzca los volúmenes en microlitros (mínimo
de 10, máximo = 140).
Dilución en Línea: Se aspira un diluyente y la muestra, uno
después de la otra y se surten juntos. Deben introducirse
los campos siguientes:
• Identificación del Líquido Diluyente: escoja el líquido
diluyente de la lista.
159
• Identificación del Líquido Diluido: escoja el líquido
que va a diluirse de la lista.
• Volumen: introduzca los volúmenes para cada líquido en
microlitros (mínimo de un solo líquido = 2; volumen
máximo total de 140).
Dilución en la Copa (aguja de Muestras solamente): El
diluyente y la muestra se surten a una copa vacía (0.5 mL)
cuando se necesita una dilución muy elevada.
4.66
La opción de Dilución en la Copa no está disponible para la
aguja de reactivos, ya que esta aguja no puede aspirar/surtir
en el área de la charola de muestras.
• Identificación del Líquido previa al surtido: escoja el
diluyente de la lista de líquidos*.
• Identificación del Líquido Diluyente: escoja el
diluyente de la lista de líquidos*.
• Identificación del Líquido Diluido: escoja el líquido
que va a diluirse de la lista (es decir, plasma).
• Volumen: introduzca los volúmenes en microlitros (mínimo
para un solo líquido = 2; volumen mínimo total de la
copa = 150; el volumen máximo total de la copa es de
250).
El campo de Lavado debe introducirse cuando se necesite un
ciclo de lavado después de que se completa la dilución en
cada copa. El valor se refiere al número de ciclos y el
rango es de 1-5.
La posición de la copa vacía (0.5 mL) en la charola de
muestras se define marcando el cuadro de marcado de Anillo
Interior (A1-A10) o del Anillo Exterior.
*Cuando se requiere una muestra sumamente diluida, debe
añadirse el diluyente en dos fases. El diluyente utilizado
en la primera fase se denomina “líquido previo al surtido”.
El diluyente utilizado en la segunda fase, junto con la
muestra, se denomina “líquido diluyente”.
(Símbolo)
Advertencia: Cuando necesita surtirse una muestra de bajo
volumen, es aconsejable utilizar la opción de Dilución en
Línea o la opción de Dilución en la Copa. No se recomienda
surtir una muestra con volumen bajo (menos de 10 microlitros)
sola, sin ningún diluyente/tampón.
Cuadro de marcado de Enjuague Intermedio: Cuando se marca, la
aguja se sumerge en el reservorio de desechos/enjuague para
lavar el exterior de la sonda. Se recomienda esta acción
cuando se utilicen volúmenes bajos.
160
Cuadro de marcado de Lavado R: cuando se marca, se lavan las
agujas en el enjuague antes de comenzar el siguiente paso.
Debe activarse para correr el lavado entre cargas.
Lavado entre cargas: define cuántos ciclos de enjuague se
efectúan entre cualquier carga de línea de muestras o entre
cualquier carga de línea de reactivos. El mínimo es de 0 y
el máximo es de 5.
Lavado al completar el paso: define cuántos ciclos de
enjuague se efectúan al terminar la fase de cargado, tanto
para la línea de muestras como para la línea de reactivos
para este paso. El mínimo es de 0 y el máximo es de 5.
Restricción de tiempo: algunos pasos pueden ser más críticos
en lo que se refiere al tiempo que otros. Para éstos, es
necesario definir un intervalo de tiempo que debe respetarse
en el(los) paso(s) definido(s).
Ninguna: Se ejecuta el paso siguiente inmediatamente
después de que se completa el surtido del líquido
actual.
Longitud del paso: Es posible definir el intervalo de
tiempo dentro del cual debe completarse un solo paso.
El tiempo de cargado se incluye en la longitud total del
paso. El sistema esperará al resto del tiempo de
longitud del paso cuando...
4.67
...se completa la carga antes de que transcurra el
límite de tiempo. El mezclado tendrá lugar después de
que expire el tiempo de la longitud del paso.
Demora al Completar: Después de cargar los líquidos en
el paso, se añade una demora fija; el tiempo de carga no
está incluido dentro del tiempo de Demora al Completar.
No ocurre ningún mezclado antes de iniciar al cronómetro
de demora.
La Longitud del Paso y Demora al Completar se aplican
siempre a una sola definición de paso únicamente.
Ajustar cronómetro: Al terminar la fase de carga del
paso definido, se ajusta un CRONÓMETRO para una cierta
cantidad de segundos; este cronómetro se utilizará en
el(los) siguiente(s) paso(s) de carga (es decir, el
tiempo de incubación del paso de Cefalina en la prueba
de APTT, tiene que esperar al paso del Cloruro de
Calcio). Los pasos posteriores, hasta un paso de
cronómetro de Espera, se ejecutan inmediatamente; solo
se ajusta el cronómetro.
Esperar hasta que el intervalo del cronómetro haya
expirado: Se ejecuta el paso de carga después del
momento en que expire el paso de AJUSTAR CRONÓMETRO
161
previo (es decir, el paso de CaCl2 en la prueba de APTT
tiene que cerrar al cronómetro previamente abierto).
(Símbolo)
Nota: Ajustar Cronómetro y Esperar hasta que haya
expirado el intervalo del cronómetro se utilizan cuando
un cronómetro abarca varios pasos (mínimo de dos). En
este caso, el tiempo abarcará múltiples pasos. Cuando
se define Ajustar Cronómetro en un solo paso, un paso
posterior debe tener una condición de Esperar hasta que
haya expirado el intervalo del cronómetro a fin de
cerrar el cronómetro abierto previamente. Ambas
condiciones de Ajustar Cronómetro y Esperar hasta que
haya expirado el intervalo del cronómetro tienen que
utilizarse en una sola definición de aplicación.
El tiempo en segundos para el campo de restricción de tiempo
puede definirse de 1 a 999 segundos (0 significa
desactivado).
4.68
Área de mezclado: en el paso actual, en caso de que fuera
necesario mezclar el contenido de la cuveta del rotor, debe
marcarse el cuadro de marcado de la rampa.
Deben llenarse los campos siguientes:
Tiempo de Centrifugación: el rotor puede girar de 1 segundo a
999 segundos. Cuando se introduce el valor de 0, el rotor no
girará.
Intervalo entre Rampas: cuando se detiene el rotor después de
la primera aceleración, debe definirse este intervalo. El
mínimo es de 1 segundo y el máximo es de 10 segundos. En
caso de que se introduzca 0, no habrá intervalo entre rampas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Tan pronto como se introduce un paso, el botón de detalles se
activa y puede oprimirse para revisar y editar los campos.
Puede utilizarse el icono de Suprimir para suprimir un paso
en la secuencia de análisis.
• LIMPIEZA
En la Pantalla de Análisis: Ajustar Carga, oprima el botón de
Limpieza para mostrar la pantalla de ajuste de la limpieza.
(Ilustración)
Esta pantalla se utiliza para definir el líquido y su
volumen, que se utiliza para limpiar la línea de reactivos y
la línea de muestras.
Cuando se define el procedimiento de limpieza, se lleva a
cabo después del último paso del ciclo de pruebas.
4.69
162
Los líquidos pueden definirse como Identificación del Líquido
Diluyente y/o Identificación del Líquido Diluido, lo que
significa que es posible usar una sola solución o diluir la
solución con otro líquido.
El volumen total tiene que estar dentro de 10-140
microlitros, independiente del Líquido Diluyente solamente,
el Líquido Diluido solamente, ambos Líquidos Diluyente y
Diluido.
No. de Ciclos: es el número de ciclos (mínimo 1 – máximo 5).
En caso de que se introduzca 0, no se efectúa ninguna
limpieza.
Ejecutar en Secuencia: cuando se marca, se limpia una línea
(línea de la aguja de muestras) antes de la otra línea (aguja
de muestra-reactivo); cuando no se marca, se efectúa la
limpieza al mismo tiempo.
Lavado al Completar: define el lavado efectuado por la
Emulsión de Lavado – R en el número de ciclos al final del
ciclo de limpieza (mínimo de 1 – máximo de 5).
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
• CEBADO DE REACTIVO
En la Pantalla de Análisis: Ajustar Carga, oprima el botón de
Cebado de Reactivo para mostrar la pantalla de ajuste de
cebado del reactivo.
(Ilustración)
Se utiliza esta pantalla para definir el líquido y su
volumen, que se utilizará para el cebado del reactivo para la
línea de reactivos y/o la línea de muestras.
Cuando se define el procedimiento de cebado del reactivo,
puede llevarse a cabo al principio del ciclo de la prueba
(antes del primer paso).
Cuando se define el Cebado del Reactivo, las pruebas que
interfieren y que lo ocasionan, necesitan activarse con el
uso del ajuste de la Tabla de Interferencia de la sección
4.1.5.
4.70
Lavado al comenzar: define el lavado efectuado por la
Emulsión de Lavado-R en el número de ciclos al principio del
ciclo de cebado del reactivo.
Los líquidos pueden definirse como Identificación del Líquido
Diluyente e Identificación del Líquido Diluido, lo que
significa que es posible utilizar una sola solución o diluir
la solución con otro líquido.
El volumen total tiene que estar dentro de 10-140
microlitros, independiente del Líquido Diluyente solamente,
163
Líquido Diluido solamente, ambos Líquidos Diluyente y
Diluido.
No. de Ciclos: Es el número de los ciclos (mínimo de 1 –
máximo de 5). En caso de que se introduzca 0, no se efectúa
ningún cebado de reactivo.
Antes y después del cebado del reactivo, puede tener lugar un
procedimiento de lavado (con el uso de emulsión de Lavado-R);
puede definirse un número (mínimo de 1 – máximo de 5).
Ejecutar en Secuencia: cuando se marca, se ceba una línea
(línea de la aguja de muestras) antes de la otra línea (línea
de la aguja de reactivos); cuando no se marca, se efectúa el
cebado del reactivo al mismo tiempo.
Lavado al Completar: define el lavado efectuado por la
Emulsión de Lavado – R en el número de ciclos al final del
ciclo de cebado del reactivo (mínimo de 1 – máximo de 5).
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios efectuados y el sistema
regresa a la pantalla Principal.
• VERIFICACIÓN DE LOS MATERIALES
Una vez que todos los líquidos están configurados, es posible
definir si el instrumento verificará la presencia del
contenedor de líquido durante la verificación previa al
análisis.
(Ilustración)
4.71
Cuando se selecciona un líquido para verificarse, puede
definirse qué acciones se llevarán a cabo en caso de que el
nivel del líquido llegara a ser bajo durante el análisis.
La Verificación en la opción Previa al Análisis define si el
análisis puede comenzar aunque el líquido no esté presente
(presencia optativa). Lo anterior se aplica a los materiales
en las posiciones A1-A10 en la charola de muestras.
Cuando se marca el líquido como obligatorio, el análisis no
puede comenzar sin éste y se presentan las opciones de
Verificar y Continuar o Abortar después de las verificaciones
previas al análisis.
Cuando el líquido no está marcado como obligatorio, el
análisis puede comenzar sin éste y se presenta también la
opción de continuar después de las verificaciones previas al
análisis, y permite que el análisis continúe sin un líquido
específico.
El cuadro de Verificar la Hilera Seleccionada se utiliza para
definir el líquido como obligatorio.
La opción de Verificar la Hilera Seleccionada puede
utilizarse solamente para los líquidos situados en A1 a A10
(posiciones auxiliares en la charola de muestras).
164
Las Acciones disponibles en el sistema cuando el nivel de un
líquido es bajo, son como sigue:
• Abortar prueba: en algunos casos, la presencia del
líquido se requiere para completar la sesión (es decir,
calibración): cuando el nivel del líquido es bajo, se
abortará la sesión. No se analizarán las muestras y los
reactivos pipeteados en el rotor antes de la escasez.
• Completar posible y señal: en este caso, cuando el nivel
de líquido se hace bajo durante la sesión, se
completarán las muestras que tenían líquido suficiente
aspirado y surtido; en tanto que, aquellas con respecto
a las cuales se detectó después la condición de nivel
bajo de reactivo, se mantendrán retenidas y el sistema
advertirá al usuario. Las pruebas después de la
condición de nivel bajo permanecen pendientes. La
corrida puede reiniciarse volviendo a llenar los
reactivos después de que se completa la sesión.
• Señal de apenas: el instrumento informará solamente al
operador de que el nivel de un líquido es bajo, pero
continuará efectuando todas las operaciones de
pipeteado.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios efectuados y el sistema
regresa a la pantalla Principal.
165
4.72

4.2.4 Calibración: Ajustar Carga

Análisis: Flujo de la Pantalla de Ajustar Carga

DETALLES DE
LA PRUEBA

LIMPIEZA

CALIBRACIÓN:
AJUSTAR
CARGA
CEBADO DEL
REACTIVO

AJUSTAR PASO
(un solo paso)

VERIFICACIÓN
DEL MATERIAL

PARÁMETROS PARÁMETROS
Línea de muestra Línea del Reactivo

4.73
Haga clic en el botón de Calibración: Ajustar Carga para
ver/editar el ajuste de los líquidos (reactivos,
calibradores) en las charolas durante la calibración de la
prueba.
(Ilustración)
Se utiliza esta pantalla para definir todos los pasos
necesarios para llevar a cabo una calibración.
Identificación de la Prueba: en este campo, se muestra la
Identificación de la Prueba definida previamente. Este campo
está presente en todas las pantallas del ajuste de la prueba.
166
COPAS VACÍAS EN EL ANILLO EXTERIOR, A PARTIR DEL NÚMERO DE LA
POSICIÓN: este campo se utiliza cuando es necesario colocar
una copa vacía (0.5 mL) en la charola de muestras para fines
previos a la dilución.
Replicas de los Puntos de Calibración: el número máximo de
réplicas es de 6. Como la calibración debe efectuarse en un
solo rotor, el número total de cuvetas de rotor utilizables
es de 18; las combinaciones posibles (niveles
estándar/réplicas) son como sigue: 2 niveles y 3, 4, 5, 6
réplicas; 3 niveles y 3, 4, 5, 6 réplicas, 4 niveles y 3, 4
réplicas; 5 niveles y 3 réplicas; 6 niveles y 3 réplicas.
El icono de Suprimir puede usarse para suprimir un paso en la
secuencia de calibración.
Botón de Añadir: se utiliza este botón para definir un paso
de la calibración. Un solo paso es la acción de
aspirar/surtir líquidos. Puede llevarse a cabo un paso
mediante la aguja de las muestras, la aguja de los reactivos
o ambas agujas. El resultado final de un paso es completar un
ámbito.
4.74
(Ilustración)
Paso: es el orden de la ejecución de la corrida de
calibración.
Pueden seleccionarse varios ámbitos.
- Referencia Óptica (Emulsión de Lavado-R) que se utilizará
con la definición de los canales tanto de 660 nm como de
405 nm.
- Referencia (en las pruebas de Absorbencia) que se
utilizará con la definición del canal de 405 nm
solamente.
- Muestra
- Estándar (1-2-3-4-5-6)
- Todos (solamente cuando todos los pasos tienen las mismas
condiciones).
Los iconos de Flecha/Tijeras añaden o suprimen un paso.
Una vez que se define el ámbito, es necesario definir qué
agujas se utilizarán para aspirar/surtir los líquidos en el
paso.
Puede definirse el tipo de carga para la aguja de la línea de
muestras; tenemos aquí la definición de la línea de Muestras
y/o Reactivos.
Ninguna Carga: Esta línea no aspira/surte ningún líquido en
este paso.
• Ninguna Dilución: Se aspira el líquido y se surte en la
condición en que está.
• Dilución en Línea: Se aspira un diluyente y la muestra,
uno después de la otra y se surten juntos.
167
Dilución en la Copa: El diluyente y la muestra se surten a
una copa vacía cuando se necesita una dilución muy elevada.
4.75
El botón de parámetros para la línea de Muestras o Reactivos
abre a la ventana de Ajustar Parámetros en Pasos.
(Ilustración)
Ninguna Dilución: se aspira y se surte el líquido en la
condición en que está. Deben introducirse los campos
siguientes:
• Identificación del Líquido: escoger de la lista de
líquidos.
• Volumen: introducir los volúmenes en microlitros (mínimo
de 10; máximo de 140)
Dilución en Línea: se aspira un diluyente y el líquido uno
después del otro y se surten juntos. Deben introducirse los
campos siguientes:
• Identificación del Líquido Diluyente: escoger el
diluyente de la lista de líquidos.
• Identificación del Líquido Diluido: escoger el líquido
que va a diluirse de la lista (es decir, plasma de
calibración).
• Volumen: introducir los volúmenes en microlitros (mínimo
de 2 de un solo líquido; el volumen total máximo es de
140).
La opción de Dilución en la Copa (opción de Sonda de Muestras
solamente) diluye el material en una copa vacía de 0.5 mL
antes de cargar en una cuveta en el rotor. Se utiliza cuando
se requiere una relación de dilución elevada del material.
Deben introducirse los campos siguientes:
• Identificación del Líquido previa al surtido: escoja el
diluyente de la lista de líquidos*.
• Identificación del Líquido Diluyente: escoja el
diluyente de la lista de líquidos*.
• Identificación del Líquido Diluido: escoja el líquido
que va a diluirse de la lista (es decir, plasma de
calibración).
• Volumen: introduzca los volúmenes en microlitros (mínimo
para un solo líquido = 2; volumen mínimo total = 150; el
volumen máximo total es de 250).
4.76
*Cuando se requiere una muestra sumamente diluida, debe
añadirse el diluyente en dos fases. El diluyente utilizado
en la primera fase se denomina “líquido previo al surtido”.
El diluyente utilizado en la segunda fase, junto con la
muestra, se denomina “líquido diluyente”.
168
La opción de Dilución en la Copa no está disponible para la
aguja de reactivos, dado que esta aguja no puede
aspirar/surtir en el área de la charola de muestras.
(Símbolo)
Nota: un volumen de carga de 10 microlitros se añade siempre
automáticamente a cada condición de paso total, tanto en la
línea de muestras como en la línea de reactivos para todas
las tres condiciones: Ninguna Dilución, Dilución en Línea y
Dilución en la Copa.
El campo del lavado debe introducirse cuando se necesita un
ciclo de lavado después de que se completa cada dilución en
la copa. El valor se refiere al número de ciclos y el rango
es de 1-5. Cada ciclo de lavado efectúa el enjuague con 130
µL de Lavado-R.
La posición de la copa vacía (0.5 mL) en la charola de
muestras se define marcando el cuadro de marcado de Anillo
Interior o Anillo Exterior. Las diluciones estándar deben
utilizar al Anillo Exterior.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios.
(Símbolo)
Advertencia: Cuando necesita surtirse una muestra de bajo
volumen, es aconsejable utilizar la opción de Dilución en
Línea o la opción de Dilución en la Copa. No se recomienda
surtir una muestra con volumen bajo (menos de 10 microlitros)
sola, sin ningún diluyente/tampón.
(Ilustración)
Cuadro de marcado de Enjuague Intermedio: Cuando se marca, la
aguja se sumerge en el reservorio de desechos/enjuague para
enjuagar el exterior de la sonda. Se recomienda esta acción
en caso del uso de un volumen bajo.
4.77
Cuadro de marcado de Lavado R: cuando se marca, se lavan las
agujas en el enjuague antes de comenzar el siguiente paso.
Lavado entre cargas: define cuántos ciclos de enjuague se
efectúan entre cualquier carga de línea de muestras o entre
cualquier carga de línea de reactivos. El mínimo es de 0 y
el máximo es de 5. Cada ciclo de lavado se enjuaga con 130 µl
de Lavado-R.
Lavado al completar el paso: es posible definer cuántos
ciclos de enjuague se efectuarán al terminar la fase de
cargado, tanto para la línea de muestras como para la línea
de reactivos para este paso. El mínimo es de 0 y el máximo
es de 5. Cada ciclo de lavado se enjuaga con 130 µl de
Lavado-R.
169
Restricción de tiempo: como algunos pasos pueden ser más
críticos que otros, es necesario definir algún intervalo de
tiempo que debe respetarse en el(los) paso(s) definido(s).
Ninguna: Se ejecuta el paso siguiente inmediatamente
después de que se completa el surtido del líquido
actual.
Longitud del Paso y Demora al Completar: se aplican
siempre a la definición de un solo paso únicamente. Es
posible definir el intervalo de tiempo dentro del cual
debe completarse un solo paso. El tiempo de cargado se
incluye en la longitud total del paso. El sistema
esperará al resto del tiempo de longitud del paso
cuando...
Longitud del paso: es posible definir el intervalo de
tiempo dentro del cual debe completarse un solo paso. El
tiempo de cargado está incluido en la longitud total del
paso. Por ejemplo, la carga del substrato en la prueba
de AT: debe respetarse el tiempo de activación, debido a
que es un paso crítico en la reacción.
Demora al Completar: Después de cargar los líquidos en
el paso, se añade una demora fija; el tiempo de carga no
está incluido dentro del tiempo de Demora al Completar.
No ocurre ningún mezclado antes de iniciar al cronómetro
de demora.
(Símbolo)
Nota: Ajustar Cronómetro y Esperar hasta que haya expirado el
intervalo del cronómetro se utilizan cuando un tiempo tiene
que abarcar varios pasos (mínimo de dos). En este caso, el
tiempo abarcará múltiples pasos. Cuando se define Ajustar
Cronómetro en un solo paso, un paso posterior debe tener una
condición de Esperar hasta que haya expirado el intervalo del
cronómetro a fin de cerrar el cronómetro abierto previamente.
Ambas condiciones de Ajustar Cronómetro y Esperar hasta que
haya expirado el intervalo del cronómetro tienen que
utilizarse en una sola definición de aplicación.
Ajustar cronómetro: Al terminar la fase de carga del paso
definido, se ajusta un CRONÓMETRO para una cierta cantidad de
segundos; este cronómetro se utilizará en los siguientes
pasos de carga (es decir, el tiempo de incubación del paso de
Cefalina en la prueba de APTT, tiene que esperar al paso del
Cloruro de Calcio). Los pasos posteriores, hasta un paso de
Cronómetro de Espera, se ejecutan inmediatamente; solo se
ajusta el cronómetro.
Esperar hasta que el intervalo del cronómetro haya expirado:
Se ejecuta el paso de carga cuando expira el tiempo de un
paso anterior de AJUSTAR CRONÓMETRO (es decir, el paso de
170
CaCl2 en la prueba de APTT tiene que cerrar al cronómetro
previamente abierto).
4.78
El tiempo en segundos para el campo de restricción de tiempo
puede definirse de 1 a 999 segundos (0 significa
desactivado).
Área de mezclado: en el paso actual, en caso de que fuera
necesario mezclar el contenido de la cuveta del rotor, debe
marcarse el cuadro de marcado de la rampa.
Deben llenarse los campos siguientes:
Tiempo de Centrifugación: el rotor puede girar de 1 segundo a
999 segundos. Cuando se introduce el valor de 0, el rotor no
girará.
Intervalo entre Rampas: cuando se detiene el rotor después de
la primera aceleración, debe definirse este intervalo. El
mínimo es de 1 segundo y el máximo es de 10 segundos. En
caso de que se introduzca 0, no habrá intervalo entre rampas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios.
Tan pronto como se introduce un paso, el botón de detalles se
activa y puede oprimirse para revisar y editar los campos.
• LIMPIEZA
En la Pantalla de calibración: ajustar Carga, oprima el botón
de Limpieza para mostrar la pantalla de ajuste de la
limpieza.
(Ilustración)
Esta pantalla se utiliza para definir el líquido y su
volumen, que se utiliza para limpiar la línea de reactivos y
la línea de muestras.
Cuando se define el procedimiento de limpieza, se lleva a
cabo después del último paso del ciclo de pruebas.
Los líquidos pueden definirse como Identificación del Líquido
Diluyente y/o Identificación del Líquido Diluido, lo que
significa que es posible usar una sola solución o diluir la
solución con otro líquido.
4.79
El volumen total tiene que estar dentro de 10-140
microlitros, independiente del Líquido Diluyente solamente,
el Líquido Diluido solamente, ambos Líquidos Diluyente y
Diluido.
No. de Ciclos: es el número de ciclos (mínimo 1 – máximo 5).
En caso de que se introduzca 0, no se efectúa ninguna
limpieza.
Después de la limpieza, puede tener lugar un procedimiento de
lavado (con el uso de la emulsión de Lavado-R): puede
definirse un número de ciclos (mínimo 1 – máximo 5).
171
Ejecutar en Secuencia: cuando se marca, se limpia una línea
de la aguja de muestras antes de la línea de reactivos;
cuando no se marca, se efectúa la limpieza al mismo tiempo.
Lavado al completar: define el lavado efectuado por la
Emulsión de Lavado – R en el número de ciclos al final del
ciclo de limpieza (mínimo de 1 – máximo de 5).
Cada ciclo de lavado se enjuaga con 130 µl de Lavado-R.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
• CEBADO DE REACTIVO
En la Pantalla de Calibración: Ajustar Carga, oprima el botón
de Cebado de Reactivo para mostrar la pantalla de ajuste de
cebado del reactivo.
(Ilustración)
Se utiliza esta pantalla para definir el líquido y su
volumen, que se utilizará para el cebado del reactivo para la
línea de reactivos y/o la línea de muestras.
Cuando se define el procedimiento de cebado del reactivo, se
lleva a cabo al principio del ciclo de la prueba (antes del
primer paso).
Cuando se define el Cebado del Reactivo, las pruebas que
interfieren y que lo ocasionan, necesitan activarse con el
uso del ajuste de la Tabla de Interferencia de la sección
4.1.5.
4.80
Lavado al comenzar: define el lavado efectuado por la
Emulsión de Lavado-R en el número de ciclos al principio del
ciclo de cebado del reactivo.
Los líquidos pueden definirse como Identificación del Líquido
Diluyente e Identificación del Líquido Diluido, lo que
significa que es posible utilizar una sola solución o diluir
la solución con otro líquido.
El volumen total tiene que estar dentro de 10-140
microlitros, independiente del Líquido Diluyente solamente,
Líquido Diluido solamente, ambos Líquidos Diluyente y
Diluido.
No. de Ciclos: Es el número de los ciclos (mínimo de 1 –
máximo de 5). En caso de que se introduzca 0, no se efectúa
ningún cebado de reactivo.
Ejecutar en Secuencia: cuando se marca, se ceba la línea de
muestras antes de la línea de reactivos; cuando no se marca,
se efectúa el cebado del reactivo al mismo tiempo.
Lavado al completar: define el lavado efectuado por la
Emulsión de Lavado – R y el número de ciclos al final del
ciclo de cebado del reactivo (mínimo de 1 – máximo de 5).
Cada ciclo de lavado se enjuaga con 130 µl de Lavado-R.
172
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios efectuados y el sistema
regresa a la pantalla Principal.
• VERIFICACIÓN DE LOS MATERIALES
Una vez que se han configurado todos los líquidos, es posible
definir si el instrumento verificará la presencia del líquido
y también que acción se llevará a cabo en caso de que el
volumen de líquido sea bajo.
(Ilustración)
Cuando se selecciona un líquido para verificarse, puede
definirse qué acciones se llevarán a cabo en caso de que el
nivel del líquido llegara a ser bajo durante el análisis.
4.81
La Verificación en la opción Previa al Análisis define si el
análisis puede comenzar aunque el líquido no esté presente
(presencia optativa).
Cuando se marca el líquido como obligatorio, el análisis no
puede comenzar sin éste y se presenta el mensaje de Verificar
y Continuar o Abortar después de las verificaciones previas
al análisis.
Cuando el líquido no está marcado como obligatorio, el
análisis puede comenzar sin éste y se presenta también la
opción de Continuar después de las verificaciones previas al
análisis, y permite que el análisis continúe sin un líquido
específico.
El cuadro de Verificar la Hilera Seleccionada se utiliza para
definir el líquido como obligatorio.
La opción de Verificar la Hilera Seleccionada puede
utilizarse solamente para los líquidos situados en A1 a A10
(posiciones auxiliares en la charola de muestras).
Las Acciones disponibles en el sistema cuando el nivel de un
líquido es bajo, son como sigue:
• Abortar prueba: en algunos casos, la presencia del
líquido se requiere para completar la sesión (es decir,
calibración): cuando el nivel del líquido es bajo, se
abortará la sesión.
• Completar posible y señal: en este caso, cuando el nivel
de líquido se hace bajo durante la sesión, se
completarán las muestras que tenían líquido suficiente
aspirado y surtido; en tanto que, aquellas con respecto
a las cuales se detectó después la condición de nivel
bajo de reactivo, se mantendrán retenidas y el sistema
advertirá al usuario (las pruebas después de la
condición de nivel bajo permanecen pendientes).
• Señal de apenas: el instrumento informará solamente al
operador de que el nivel de un líquido es bajo, pero
173
continuará efectuando todas las operaciones de
pipeteado.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios efectuados y el sistema
regresa a la pantalla Principal.
174
4.82
4.2.5 Ajuste de Adquisición
Haga clic en el botón de Adquisición: Ajustar para abrir la
pantalla para ver/editar los ajustes de la adquisición de
datos para la prueba.
Esta pantalla se utiliza para definir todos los parámetros de
adquisición.
El perfil de la adquisición está representado en el siguiente
dibujo.

INTERVALO ENTRE DATOS


RAMPAS TIEMPO DE ADQUISICIÓN
DEMORA HORA
RAMPA RAMPA RAMPA
0.4s 0.4s # 0.4s
Cada Rampa de mezclado se fija en 0.4 segundos.
El Intervalo entre Rampas, el Tiempo de Demora y el Tiempo de
Adquisición se definen de acuerdo con la aplicación.
En términos generales, las reacciones de coagulación tienen
siempre un Intervalo entre Rampas, en tanto que las
reacciones cromogénicas y de látex no utilizan el intervalo
entre Rampas.
4.83
(Ilustración)
Cuando se marca el cuadro de marcado de Rampa, pueden
introducirse los otros parámetros.
Las primeras rampas de mezclado (rampa ascendente y
descendente) se establecen en un total de 0.8 segundos.
INTERVALO ENTRE RAMPAS: el tiempo en segundos entre las dos
rampas (0 significa que no hay intervalo entre rampas; ó 1 a
10 segundos definen el tiempo entre las dos rampas).
La segunda rampa ascendente después del intervalo entre
rampas y antes de la demora de adquisición se establece en
0.4 segundos.
DEMORA DE ADQUISICIÓN: el tiempo en que no se registran
puntos de datos durante la adquisición (1-60). Cuando se
introduce 0, no se considera ninguna demora.
VELOCIDAD DE MUESTREO: el intervalo entre los puntos de datos
en milisegundos (50 a 1000 milisegundos en un intervalo de 50
milisegundos).
TIEMPO DE ADQUISICIÓN: el tiempo empleado para leer la
reacción (1-1200 segundos).
VELOCIDAD: 600 a 1200 rpm.
CANAL DE ADQUISICIÓN: 405 (Absorbencia) o 660 (nefalométrico)
nm.
175
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.

4.84
4.2.6 Ajuste de Cálculo
Flujo de la pantalla de Cálculo: Ajuste

DETALLES DE LA
PRUEBA

VERIFICACIONES

AJUSTE DEL
CÁLCULO

DEFINIR
PARÁMETROS

AJUSTE DE
CALIBRACIÓN

ALGORITMOS DE
CÁLCULO

AJUSTE DE LA DEFINIR
CURVA DE PARÁMETROS
CALIBRACIÓN

CÁLCULO DE
ALGORITMOS

4.85
176
Haga clic en el botón de Cálculo: Ajuste para ver/editar los
ajustes del cálculo para la prueba.
Esta pantalla se utiliza para definir todos los pasos
necesarios para manejar los datos en bruto (calibración y
análisis).
(Ilustración)
Identificación de la Prueba: En este campo, se muestra la
Identificación de la prueba que se ha definido previamente.
Este campo está presente en todas las pantallas del ajuste
del cálculo.
Normalización: pueden seleccionarse dos criterios: S/R * 100
o log(R/S). el primer algoritmo se utiliza comúnmente para
los ensayos de coagulación, en tanto que el segundo se
utiliza en mayor parte para los ensayos cromogénicos. S
significa el valor (en mV) de la muestra y R significa el
valor (en mV) de la emulsión de Lavado-R (para S/R**100) y
también la Referencia Óptica (para log R/S).
Ámbito: Define el cálculo para todos los pasos definidos en
el ajuste del paso de carga.
- Referencia Óptica (Emulsión de Lavado-R)
- Referencia (en las pruebas de Absorbencia)
- Muestra, Muestra a (muestra activada como en la
prueba APCR-V).
- Referencia Analítica, Referencia Analítica a
(referencia analítica activada como en la prueba
APCR-V)
- TODO
Relación: Seleccione la fórmula utilizada para calcular la
Relación. Las opciones disponibles son:
- Ninguna (No se efectuó ningún cálculo de la
relación).
- R = S/Valor de Referencia
4.86

- R = S / Estándar 1
- R = S / Estándar 2
- R = S / Estándar 3
Importar Valor de Referencia de: Seleccione Ninguno o una
prueba de la lista desplegable descendente.
El valor de referencia introducido para la prueba primaria se
importa automáticamente a las pruebas secundarias (es decir,
pruebas extendidas (e) y dobles (d)). Este valor es el
denominador del cálculo de R e INR y debe representar a la
media geométrica del tiempo de la población normal para la
prueba seleccionada.
Relación Normalizada: Seleccione la fórmula de la lista
desplegable descendente.
177
- Ninguna (no se efectúa ningún cálculo).
- INR = R^ISI
- NR = R(S)/Ref
Importar Valor ISI de: Seleccione Ninguno o una prueba de la
lista desplegable descendente.
El valor ISI introducido para la prueba primaria se importa
automáticamente a las pruebas secundarias (es decir, pruebas
extendidas (e) y dobles (d)).
Tipo de Algoritmo – Hay siete selecciones disponibles:
Ninguno, Algoritmo de Tendencia, Umbral, Umbral/Segunda
Derivada, Primera Derivada y Delta.

4.87

NINGUNO

ALOGARITMO DE
TENDENCIA
Página 4.88

UMBRAL
Página 4.89

TIPO DE UMBRAL
ALOGARITMO 2ª DERIVADA
Página 4.92

PRIMERA
DERIVADA
Página 4.96


DERIVADA
Página 4.98

DELTA
Página 4.110
178

4.88
Una vez que se ha seleccionado el tipo de Algoritmo, puede
tenerse acceso a la pantalla de Definir Parámetros para
definir el cálculo del Tipo de Algoritmo seleccionado.
• Ninguno
No se aplica ningún logaritmo. Solamente los datos en
bruto estarán disponibles.
• Algoritmo de Tendencia
Al seleccionar Tendencia, las siguientes selecciones son
posibles:
(Ilustración)
Pueden seleccionarse dos Afinaciones en términos del número
de puntos.
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación o Mínima) y la Parte Final (Final
o Máxima). Puede definirse el número de puntos que se
utilizarán para calcular el promedio o el Mínimo/Máximo para
el algoritmo de tendencia.
Unidades Presentadas
Las únicas unidades disponibles para el algoritmo de
Tendencia son la Compensación/Mínimo de la primera parte de
la curva de reacción y Final/Máximo para la parte final de la
curva.
4.89
Verificaciones de la Curva
El cuadro de marcado de Verificar Saturación activa a un
monitor sobre las lecturas de la curva de reacción para
asegurar que estén dentro del límite del hardware de la
lámpara utilizada.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
• Algoritmo de Umbral
Seleccione Umbral, las siguientes selecciones son posibles.
(Ilustración)
Pueden seleccionarse dos afinaciones en términos del número
de puntos: 1ª Afinación y 2º Afinación.
Las afinaciones se calculan con el uso de los criterios de la
media de promedio movible. Los criterios para calcular la
media de promedio movible se definen por el número de puntos
(grado) que se utilizan para los nuevos valores afinados.
La Verificación Delta define a la delta mínima aceptable para
la curva de reacción de los datos normalizados.
179
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación o Mínimo) y la Parte Final (Final
o Máximo). Puede definirse el número de puntos que se
utilizarán para calcular el promedio o determinar el
Mínimo/Máximo para las partes primera y final.
Al oprimir el botón de Parámetros de Umbral, se mostrará la
ventana siguiente.
4.90
(Ilustración)
La ventana de Parámetros del 1er Umbral permite ajustar los
parámetros siguientes:
La Dirección de Búsqueda del Umbral proporciona la opción de
buscar el valor del umbral en la dirección Hacia Adelante (a
partir del principio de la reacción) o Hacia Atrás (a partir
del final de la reacción y desplazándose hacia el principio).
El Modo de Umbral permite la selección de Absoluto (total) o
% de la Curva para calcular el umbral.
El 1er Umbral define en donde debe tomarse el tiempo de
coagulación; debe introducirse un valor numérico. El umbral
representa un cambio fijo en la turbiedad desde la
compensación inicial de la curva de reacción.
Ajustes del Umbral Hacia Atrás: ajustes no aplicables a este
algoritmo.
Unidades Presentadas
El Tiempo en segundos (calculado contra el primer umbral) es,
en general, la unidad presentada; pueden escogerse otras
unidades, tales como la Compensación/Mínimo de la Reacción
Inicial y la parte de Final/Máximo de la reacción.
Verificaciones de la Curva
El cuadro de marcado de Verificar Saturación activa a un
monitor sobre las lecturas de la curva de reacción para
asegurar que se encuentren dentro del límite del hardware de
la lámpara utilizada.
El 2º Umbral define en donde debe tomarse una de las
verificaciones sobre la curva de coagulación; debe
introducirse un valor numérico. Este valor se utiliza como
una verificación de que una curva de coagulación real está
presente.
En general, el segundo umbral se utiliza para discriminar
entre las curvas de coagulación real o las curvas de
coagulación inestable o Fibrinógeno bajo.
El Tiempo Delta se utiliza para verificar las curvas
bifásicas; representa a la diferencia en segundos entre dos
umbrales.
4.91
La Pendiente Inicial se utiliza para verificar las curvas que
no son bifásicas; representa a la pendiente inicial de la
180
curva de reacción al principio del tiempo de adquisición. En
caso de que no se cumpla con la verificación, se generará un
error.
Corrección de Unidad Primaria
Al tener acceso a la ventana de Corrección de Parámetros, es
posible establecer correcciones de los valores con base en la
compensación de la reacción.
Los Parámetros de Corrección se aplican aquí a la unidad
primaria, segundos en este caso.
(Ilustración)
El Intervalo de Compensación puede definirse y puede
establecerse una curva de corrección en términos de la
pendiente (m) y la intercepción (q).
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección está representada por la fórmula siguiente:
Y = mX + q
en que “m” representa a la pendiente y “q” a la intercepción
en el eje de las Y.
Los valores de intervalo Mínimo y Máximo representan al rango
de la unidad, en que se espera que la corrección esté activa.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes de valor tanto positivo como negativo.
Por ejemplo, se utiliza esta corrección para el método de
Fibrinógeno basado en PT en muestras muy lipémicas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
4.92
• Algoritmo de Umbral/Segunda Derivada
Al seleccionar Umbral/Segunda Derivada, las siguientes
selecciones son posibles:
(Ilustración)
Cálculo de la 1ª y 2ª Derivadas en términos del número de
puntos que se utilizarán. Pueden seleccionarse cinco
afinaciones en términos del número de puntos: la 1ª
Afinación, la 2ª Afinación y la 3ª Afinación se utilizan para
los datos en bruto; la 4ª y la 5ª Afinaciones se utilizan
para la Primera Derivada.
Las afinaciones se calculan con el uso de los criterios de la
media de promedio movible. Los criterios para calcular la
media de promedio movible se definen por el número de puntos
(grado) que se utilizan para los nuevos valores afinados.
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación o Mínima) y la Parte Final (Final
o Máxima). Puede definirse el número de puntos que se
181
utilizarán para calcular el promedio o determinar el
Mínimo/Máximo para las dos partes.
La Verificación Delta define a la delta mínima aceptable para
la curva de reacción de los datos normalizados.
Unidades Presentadas
El Tiempo en segundos (calculado contra el primer umbral o el
pico máximo de la segunda derivada; ver la Pendiente Inicial
y el Tiempo Delta) es, en general, la unidad presentada;
pueden escogerse otras unidades, tales como la
Compensación/Mínimo de la Reacción Inicial y la Parte de
Final/Máximo.
Al oprimir el botón de Parámetros del Umbral, se muestra la
ventana siguiente:

4.93
(Ilustración)
La ventana de los Parámetros del 1er Umbral permite
establecer los parámetros siguientes:
La Dirección de Búsqueda del Umbral proporciona la opción de
buscar el valor del umbral en la dirección Hacia Adelante (a
partir del principio de la reacción) o Hacia Atrás (a partir
del final de la reacción y desplazándose hacia el principio).
El Modo de Umbral permite la selección de Absoluto (total) o
% de la Curva para calcular el umbral.
El 1er Umbral define en donde debe introducirse el tiempo de
coagulación; debe introducirse un valor numérico. El umbral
representa un cambio fijo en la turbiedad desde la
compensación inicial de la curva de reacción.
Haga clic en el cuadro de Ajustes del Umbral Hacia Atrás para
activar el cálculo del final del tiempo de adquisición,
moviéndose hacia atrás en dirección al principio.
El Modo de Umbral permite la selección de Absoluto (total) o
% de la Curva para calcular el umbral.
El campo de Valor define en donde debe tomarse el tiempo de
coagulación; debe introducirse un valor numérico. El umbral
representa a un cambio fijo en la turbiedad desde la
compensación inicial de la curva de reacción.
Verificación de la Curva
Al tener acceso a la ventana de los Parámetros de
Verificación de la Curva, es posible efectuar las selecciones
siguientes:
4.94
El cuadro de marcado de Verificar Saturación activa a un
monitor sobre las lecturas de la curva de reacción para
asegurar que estén dentro del límite del hardware de la
lámpara utilizada.
182
El 2º Umbral define en donde debe tomarse una de las
verificaciones sobre la curva de coagulación; debe
introducirse un valor numérico. Este valor se utiliza como
una verificación de que una curva de coagulación real está
presente.
En general, el segundo umbral se utiliza para discriminar
entre las curvas de coagulación real y con ruido, o las
curvas de coagulación inestable o Fibrinógeno bajo.
El Tiempo Delta se utiliza para verificar las curvas
bifásicas; representa a la diferencia en segundos entre dos
umbrales. En caso de que no se cumpla con el tiempo delta, se
analizarán los datos en bruto con el uso de los criterios de
la Segunda Derivada.
La Pendiente Inicial se utiliza para verificar las curvas que
no son fásicas; representa a la pendiente inicial de la curva
de reacción al principio del tiempo de adquisición. Puede
introducirse el número de puntos y el valor de la pendiente
(valores numéricos). En caso de que no se cumpla con la
verificación de la pendiente, se analizarán los datos en
bruto con el uso de los criterios de la Segunda Derivada.
Cálculo de la Segunda Derivada en términos del número de
puntos que se utilizarán. La Segunda Derivada representa a la
aceleración de la reacción y puede utilizarse como criterios
para encontrar el punto de coagulación en búsqueda del pico
máximo de la segunda derivada.
Haga clic en el botón de Verificación de Ruido 1 para
activar. Cuando se activa, el sistema determinará el tiempo
de coagulación en búsqueda, hacia atrás a través de la curva
de datos, de un valor que sea un porcentaje de delta de la
curva. El porcentaje deseado se introduce en el campo de
Porcentaje. Se determina delta entre el tiempo original
(tiempo o umbral) y el tiempo del cálculo hacia atrás. El
valor Delta de Tiempo Máximo es la delta de tiempo tolerable
máximo entre los dos valores.
Haga clic en el botón de Verificación del Ruido 2 para
activar. Cuando se activa, el sistema busca el siguiente
tiempo o valor máximo a partir del tiempo o valor original.
En caso de que no haya ninguna reducción ulterior en la curva
de los datos normalizados, entonces el tiempo y el valor
máximos locales serán iguales a los originales.
4.95
En el campo de Puntos, introduzca el número mínimo de puntos
en que debe quedar la curva para que el máximo local se
considere como un verdadero pico. La Delta de Pico Mín es el
porcentaje de delta global de la curva que el valor máximo
local debe exceder a fin de que se considere como un pico
verdadero. La Disminución Mínima es la diferencia mínima en
183
la señal (absoluta) para que los máximos locales se
consideren como un verdadero pico.
Haga clic en el botón de Verificar Ubicación de la
Coagulación para activar. Cuando se activa, el sistema
verificará el punto de coagulación para asegurar que quede
dentro del Porcentaje de la delta total de la curva.
Corrección de Unidad Primaria
Al tener acceso a la ventana de Corrección de Parámetros, es
posible establecer correcciones de los valores con base en la
compensación de la reacción.
Los Parámetros de Corrección se aplican aquí a la unidad
primaria, segundos en este caso.
(Ilustración)
El Intervalo de Compensación puede definirse y puede
establecerse una curva de corrección en términos de la
pendiente (m) y la intercepción (q).
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección está representada por la fórmula siguiente:
Y = mX + q
en que “m” representa a la pendiente y “q” a la intercepción
en el eje de las Y.
Los valores de intervalo Mínimo y Máximo representan al rango
de la unidad, en que se espera que la corrección esté activa.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes de valor tanto positivo como negativo.
Por ejemplo, se utiliza esta corrección para el método de
Fibrinógeno basado en PT en muestras muy lipémicas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
4.96
• Algoritmo de Primera Derivada
Al seleccionar la Primera Derivada, las siguientes
selecciones son posibles:
(Ilustración)
Cálculo de la 1ª Derivada en términos del número de puntos
que van a utilizarse. Representa a la velocidad de la
reacción y puede utilizarse para encontrar el punto de
coagulación en búsqueda del pico máximo de la primera
derivada.
Pueden seleccionarse cinco afinaciones en términos del número
de puntos: la 1ª Afinación, la 2ª Afinación y la 3ª Afinación
se utilizan para los datos en bruto; la 4ª y la 5ª
Afinaciones se utilizan para la Primera Derivada.
Las afinaciones se calculan con el uso de los criterios de la
media de promedio movible. Los criterios para calcular la
184
media de promedio movible se definen por el número de puntos
(grado) que se utilizan para calcular los nuevos valores
afinados.
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación/Mínima) y la Parte Final (Final
/Máxima). Puede definirse el número de puntos que se
utilizarán para calcular el promedio o determinar el
Mínimo/Máximo para las partes primera y final.
La Verificación Delta define a la delta mínima aceptable para
la curva de reacción de los datos normalizados.
Unidades Presentadas
El Tiempo en segundos (calculado en el pico máximo de la
primera derivada) es, en general, la unidad presentada;
pueden escogerse otras unidades, tales como la
Compensación/Mínimo de la Reacción Inicial y la Parte de
Final/Máximo.
Corrección de Unidad Primaria
Al tener acceso a la ventana de Corrección de Parámetros, es
posible establecer correcciones de los valores con base en la
compensación de la reacción.
Los Parámetros de Corrección se aplican aquí a la unidad
primaria, segundos en este caso.
4.97
(Ilustración)
El Intervalo de Compensación puede definirse y puede
establecerse una curva de corrección en términos de la
pendiente (m) y la intercepción (q).
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección está representada por la fórmula siguiente:
Y = mX + q
en que “m” representa a la pendiente y “q” a la intercepción
en el eje de las Y.
Los valores de intervalo Mínimo y Máximo representan al rango
de la unidad, en que se espera que la corrección esté activa.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes de valor tanto positivo como negativo.
Por ejemplo, se utiliza esta corrección para el método de
Fibrinógeno basado en PT en muestras muy lipémicas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Verificación de la Curva
Al tener acceso a la ventana de los Parámetros de
Verificación de la Curva, es posible efectuar las selecciones
siguientes:
4.98
185
(Ilustración)
El cuadro de marcado de Verificar Saturación activa a un
monitor sobre las lecturas de la curva de reacción para
asegurar que estén dentro del límite del hardware de la
lámpara utilizada.
Verificación del límite de la Primera Derivada en términos
del valor absoluto que se utilizará, para verificar que esté
ocurriendo una coagulación apropiada.
La Primera Parte es el valor de la verificación de la
turbiedad inicial de la reacción.
Cálculo de la Segunda Derivada en términos del número de
puntos que se utilizarán y del valor límite de verificación,
para verificar que esté ocurriendo una coagulación apropiada.
• Algoritmo de Segunda Derivada
Al seleccionar la Segunda Derivada, las siguientes
selecciones son posibles:
(Ilustración)
4.99
Cálculo de la 1ª Derivada en términos del número de puntos
que se utilizarán.
Cálculo de la Segunda Derivada en términos del número de
puntos que se utilizarán. La Segunda Derivada representa a la
aceleración de la reacción y puede utilizarse como criterios
para encontrar el punto de coagulación en búsqueda del pico
máximo de la segunda derivada.
Pueden seleccionarse cinco afinaciones en términos del número
de puntos: la 1ª Afinación, la 2ª Afinación y la 3ª Afinación
se utilizan para los datos en bruto; la 4ª y la 5ª
Afinaciones se utilizan para la Primera Derivada.
Las afinaciones se calculan con el uso de los criterios de la
media de promedio movible. Los criterios para calcular la
media de promedio movible se definen por el número de puntos
(grado) que se utilizan para los nuevos valores afinados.
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación o Mínima) y la Parte Final (Final
o Máxima). Puede definirse el número de puntos que se
utilizarán para calcular el promedio o determinar el
Mínimo/Máximo para las partes primera y final.
La Verificación Delta define a la delta mínima aceptable para
la curva de reacción de los datos normalizados.
Unidades Presentadas
El Tiempo en segundos (calculado sobre el pico máximo de la
segunda derivada) es, en general, la unidad presentada;
pueden escogerse otras unidades, tales como la
Compensación/Mínimo de la Reacción Inicial y la Parte de
Reacción Final/Máximo.
Verificación de la Curva
186
Al tener acceso a la ventana de los Parámetros de
Verificaciónes de la Curva El cuadro de marcado de Verificar
Saturación activa a un monitor sobre las lecturas de la curva
de reacción para asegurar que estén dentro del límite del
hardware de la lámpara utilizada.
El valor de la Segunda Derivada define cuando el pico máximo
de la segunda derivada debe dar un resultado como el tiempo
en segundos; debe introducirse un valor numérico.
Corrección de Unidad Primaria
Al tener acceso a la ventana de Corrección de Parámetros, es
posible establecer correcciones de los valores con base en la
compensación de la reacción.
Los Parámetros de Corrección se aplican aquí a la unidad
primaria, segundos en este caso.
4.100

(Ilustración)
El Intervalo de Compensación puede definirse y puede
establecerse una curva de corrección en términos de la
pendiente (m) y la intercepción (q).
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección está representada por la fórmula siguiente:
Y = mX + q
en que “m” representa a la pendiente y “q” a la intercepción
en el eje de las Y.
Los valores de intervalo Mínimo y Máximo representan al rango
de la unidad, en que se espera que la corrección esté activa.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes de valor tanto positivo como negativo.
Por ejemplo, se utiliza esta corrección para el método de
Fibrinógeno basado en PT en muestras muy lipémicas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
4.101
• Algoritmo Delta
Al seleccionar Delta, las selecciones siguientes son
posibles:
(Ilustración)
Pueden seleccionarse dos Afinaciones (1ª y 2ª) en términos
del número de puntos.
Las afinaciones se calculan con el uso de los criterios de la
media de promedio movible; los criterios para calcular la
media de promedio movible se definen por el número de puntos
(grado) que se utilizan para los nuevos valores afinados.
187
La curva de reacción puede analizarse en dos áreas: la
Primera Parte (Compensación/Mínima) y la Parte Final (Final
/Máxima). Puede definirse el número de puntos que se
utilizarán para calcular el promedio o determinar el
Mínimo/Máximo para las partes primera y final.
La Verificación Delta define a la delta mínima aceptable para
la curva de reacción de los datos normalizados.
Unidades Presentadas
Delta es, en general, la unidad presentada; pueden escogerse
otras unidades, tales como la Compensación/Mínimo y
Final/Máximo de la reacción.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Verificaciones de la Curva
Al tener acceso a la ventana de los Parámetros de
Verificación de la Curva, es posible efectuar las selecciones
siguientes:
4.102
(Ilustración)
El 1er Umbral define en donde debe tomarse una de las
verificaciones sobre la curva de coagulación; debe
introducirse un valor numérico. Este valor se utiliza como
una verificación de que una curva de coagulación real está
presente.
El umbral representa un cambio fijo en la turbiedad a partir
de la compensación inicial de la curva de reacción.
Compensación Min. verifica para ver si el valor de
compensación es inferior a este valor. Cuando la compensación
es menor que el valor, ha fallado la respuesta.
El cuadro de marcado de Verificar Saturación activa a un
control sobre las lecturas de la curva de reacción para
asegurar que estén dentro del límite del hardware de la
lámpara utilizada.
El 2º Umbral define en donde debe tomarse una de las
verificaciones sobre la curva de coagulación; debe
introducirse un valor numérico. Este valor se utiliza como
una verificación de que una curva de coagulación real está
presente. En general, el segundo umbral se utiliza para
discriminar entre las curvas de coagulación real o las curvas
de coagulación inestable o Fibrinógeno bajo.
El Tiempo Delta se utiliza para verificar las curvas
bifásicas; representa a la diferencia en segundos entre dos
umbrales.
La Pendiente Inicial se utiliza para verificar las curvas que
no son fásicas; representa a la pendiente inicial de la curva
de reacción al principio del tiempo de adquisición. Puede
188
introducirse el número de puntos y el valor de la pendiente
(valores numéricos).
La Pendiente Final se utiliza para verificar las curvas que
no son fásicas; representa a la pendiente inicial de la curva
de reacción al final del tiempo de adquisición. Puede
introducirse el número de puntos y el valor de la pendiente
(valores numéricos).
La Primera Parte verifica la mezcla de reacción inicial para
asegurar que no exceda del valor introducido (reacción
turbia).

4.103
Máx / Final verifica si la mezcla de reacción final es turbia
o no. La lectura de la absorbencia máxima menos la lectura de
la absorbencia final no puede exceder de este límite.
Al oprimir el botón de Parámetros del Umbral, se mostrará la
siguiente ventana.
(Ilustración)
La ventana de Parámetros del 1er Umbral permite ajustar los
parámetros siguientes:
La Dirección de Búsqueda del Umbral proporciona la opción de
buscar el valor del umbral en la dirección Hacia Adelante (a
partir del principio de la reacción) o Hacia Atrás (a partir
del final de la reacción y desplazándose hacia el principio).
El Modo de Umbral permite la selección de Absoluto (total) o
% de la Curva para calcular el umbral.
El 1er Umbral define en donde debe tomarse el tiempo de
coagulación; debe introducirse un valor numérico. El umbral
representa un cambio fijo en la turbiedad desde la
compensación inicial de la curva de reacción.
Ajustes del Umbral Hacia Atrás: ajustes no aplicables a este
algoritmo.
Parámetros de Corrección
Al tener acceso a la ventana de Corrección de Parámetros, es
posible establecer correcciones de los valores con base en la
compensación de la reacción. Los Parámetros de Corrección se
aplican aquí a la unidad primaria, segundos en este caso.
4.104
(Ilustración)
El Intervalo de Compensación puede definirse y puede
establecerse una curva de corrección en términos de la
pendiente (m) y la intercepción (q).
Pueden activarse hasta 3 intervalos de correcciones basados
en el rango de los resultados.
La corrección está representada por la fórmula siguiente:
Y = mX + q
189
en que “m” representa a la pendiente y “q” a la intercepción
en el eje de las Y.
Los valores de intervalo Mínimo y Máximo representan al rango
de la unidad en que se espera que la corrección esté activa.
Para los coeficientes “m” y “q”, pueden introducirse
coeficientes de valor tanto positivo como negativo.
Por ejemplo, se utiliza esta corrección para el método de
Fibrinógeno basado en PT en muestras muy lipémicas.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
4.105
Una vez que se selecciona y define el tipo de Algoritmo,
pueden definirse algunos ajustes adicionales en el ajuste del
cálculo principal.
(Ilustración)
Suprimir Parámetros: se utiliza para suprimir los parámetros
definidos con un solo botón.
Campo de Calcular media: cuando se escogió la opción de
correr la prueba por duplicado (doble campo de prueba), puede
utilizarse calcular media para obtener la media de las
unidades seleccionadas con cada resultado individual del
duplicado.
Campo de Verificar media: este campo activa al indicador de
los valores por duplicado cuando están lejos de la media;
esta unidad esta representada en un % de variación de la
unidad seleccionada.
Por ejemplo, cuando el valor introducido es de 10%, la
verificación se hace como Media ± 10%. Se presenta un
indicador cuando el Duplicado está fuera de Rango.
Selección de la Relación: selecciona el modo para el Cálculo
de la Relación, ya sea contra la AR (Siglas en idioma inglés
de Referencia Analítica) en cada charola de muestras
individual, o contra el Valor de Referencia. EL Valor de
Referencia representa a la Media del Rango Normal de la
Población de Pacientes Normales Locales y cada laboratorio
debe establecer su propio Valor de Referencia.
Puede utilizarse el teclado o el teclado numérico para
teclear el valor apropiado.
Cuando se activan el cálculo con respecto al Valor de
Referencia, se calcularán todos los Resultados en la Relación
e INR con el uso del Valor de Referencia como denominador.
RELACIÓN = Resultado de la Muestra/Valor de Referencia
Para la Selección de la Relación (R), son posibles 3
selecciones
- Ninguna: no se efectúa ningún cálculo.
190
- R=S/Valor de Referencia: La Relación es igual al
resultado de la muestra dividido entre el Valor de
Referencia.
4.106
- R=S/Estándar X: La Relación es igual al resultado de la
muestra dividido entre el valor estándar seleccionado de
la calibración.
X = se selecciona de los estándares definidos en la
calibración.
Campo de Relación Normalizada: son posibles 3 selecciones.
- Ninguna: no se efectúa ningún cálculo
- INR = RISI
- NR = R(S)/Valor de Referencia
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Al oprimir el botón de Confirmar, se muestra la pantalla de
Verificaciones.
(Ilustración)
Esta pantalla se utiliza cuando se ha fijado una Referencia
Analítica y el usuario necesita activar criterios de
indicador basados en la Referencia Analítica y el valor
Activado de la Referencia Analítica (es decir, ensayo APCR-
V).
Se efectúa la verificación en % con respecto al valor medido
de la Referencia Analítica.
Debe definirse un % de valor absoluto y el tipo de Valor.
Pueden escogerse varias posibilidades para el valor de la AR
entre los siguientes:
• Valor de Referencia (valor introducido manualmente por el
operador).
• Estándar 1 (contra el primer punto estándar de
calibración).
• Estándar 2 (contra el segundo punto estándar de
calibración).
• Estándar 3 (contra el tercer punto estándar de
calibración).
4.107
Al seleccionar el botón de ajuste de la curva de Calibración,
se muestra la pantalla de Ajuste de Calibración.
(Ilustración)
Tipo de Algoritmo: hay 7 opciones disponibles: Ninguno,
Algoritmo de Tendencia, Umbral, Umbral/Segunda Derivada,
Primera Derivada, Segunda Derivada, Delta.
Definir Parámetros: Esta opción en el Ajuste de la
Calibración tiene las mismas selecciones que para el ajuste
191
de cálculo de la prueba; consulte la sección anterior de este
capítulo (4.2.7).
Suprimir Parámetros: Se utiliza para suprimir los parámetros
definidos con un solo botón.
Tipo de respuesta: la unidad medida se muestra en este campo.
Cuadro de marcado de Verificar CV: cuando el usuario quiere
poner un indicador en el CV de las réplicas de calibración,
debe seleccionarse este cuadro de marcado.
Cuadro de marcado de Elementos Externos: Cuando se marca, el
resultado de los elementos externos se descarta
automáticamente en el cálculo de la calibración.
El instrumento calcula la media y descarta a continuación el
valor más alejado de la media; a continuación, se vuelva a
calcular la nueva media con el uso de los puntos restantes.
% de Relación de Dilución: se definirá de acuerdo con el
ajuste de la carga de calibración (pueden introducirse hasta
dos decimales).
CV: cuando se ha configurado un mínimo de tres réplicas, el
campo puede llenarse con el valor de % de CV aceptable.
Cuando el valor del % de CV obtenido es más alto que el
límite definido, se pone un indicador al punto estándar de
calibración específico.
4.108
Unidad Final: Representa a la unidad calculada de la
calibración. La unidad puede seleccionarse de una lista que
incluye a mg/dL, g/L, %, ng/mL, U/mL, µg/L, µmol/L, UI/mL,
%, mg/mL, µ/mL.
Nueva Unidad: En caso de que se configure una unidad
diferente de aquellas incluidas en la lista, el usuario puede
configurar a una unidad de acuerdo con especificaciones
particulares, tecleándola en este campo (hasta 8 caracteres).
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Ajuste de la Curva de Calibración: al oprimir este botón, se
muestra la pantalla de ajuste de la Curva de Calibración.
(Ilustración)
Esta pantalla define a la relación matemática entre X (unidad
medida) y Y (unidad calculada).
Normalización de X y Y: X y Y pueden volverse a calcular de
acuerdo con las opciones seleccionadas.
- X (tal como es).
- R=X/Estándar Z (Z = seleccionada de los estándares
definidos en la calibración).
Y para la Y:
- Y (tal como es)
192
- R=Y/Estándar Z (Z = seleccionada de los estándares
definidos en la calibración)
Cuadro de marcado de Corregir con AR (Referencia Analítica)
en el análisis: se utiliza el resultado de la AR en la
corrida para modificar la curva de calibración (representa a
una calibración de un solo punto); todos los resultados de
los pacientes se calcularán con base en la calibración
modificada, cuando se marca...
4.109
...el cuadro de marcado. Esta opción es válida solamente para
las sesiones de calibración especializadas y solamente para
la unidad de calibración.
Relación Correcta con Estándar 100%: cuando se activa el
cuadro de marcado, se calcula la Relación (e INR en
consecuencia) con el uso del nuevo 100% como denominador,
según se obtiene de la modificación de la curva.
Resultado Extrapolado
La función del Resultado Extrapolado se ejecuta
automáticamente y se incorpora al software. No es visible en
ninguna pantalla y no puede ser modificada por el operador.
Cuando un resultado está por arriba de 150% del punto de
calibración más alto o por debajo de 60% del punto de
calibración más bajo, se le pondrá un indicador.
Definir como Obligatorio: define qué punto de calibración es
obligatorio.
La curva de calibración puede utilizar múltiples funciones
para interpolar mejor los estándares de calibración.
La curva puede dividirse en tres segmentos diferentes y
pueden aplicarse funciones diferentes a cada uno de ellos.
A fin de definir los segmentos, es necesario definir los
puntos inicial y final que correspondan a los estándares
previamente definidos. Por ejemplo, los Ensayos de Factor
utilizan 3 segmentos para cubrir el rango entero.
El punto final del primer segmento corresponde al punto
inicial del segundo; el punto final del segundo segmento
corresponde al punto inicial del tercero.
F(X) y G(y): incluye a la lista de funciones que pueden
seleccionarse.
1. X Y
2. 1/X 1/Y
3. X2 Y2
4. en (X) en (Y)
5. en [en(X)] en [en(Y)]
6. log(X) log(Y)
7. log [log(X)] log [log(Y)]
8. ex ey
x
9. 10 10y
193
Cuadro de marcado q´ Cuando se marca, es posible obligar a
que la curva pase a través del estándar del punto de
calibración deseado. Cuando se han definido múltiples
segmentos, la q´ debe corresponder al punto de interconexión
entre dos segmentos (final de un segmento – comienzo del otro
segmento).
Verificaciones de la Curva de Calibración
Puede atribuirse un indicador del rango de pendiente
diferente a los diferentes segmentos de la curva de
calibración. El límite es de -99999 a +99999.
Cuando la curva no está dividida en segmentos, debe llenarse
la primera línea solamente.
4.110
Cuando la pendiente está fuera del rango dado, se presenta un
error.
Puede atribuirse un indicador de r2 diferente a segmentos
diferentes de la curva de calibración. Cuando el valor de r2
es inferior al límite presentado (el formato es x.xxxx), se
muestra un indicador.
Cuando la curva no está dividida en segmentos, debe llenarse
la primera línea solamente.
El botón de Confirmar/Cancelar hace salir de la pantalla y se
guardan o rechazan los cambios y el sistema regresa a la
pantalla Principal.
Al hacer clic en el botón de Confirmar, se guardan los
cambios; al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
de Ver Pruebas.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
Ajuste de Paralelismo
Al seleccionar el botón de ajuste de Paralelismo, permite la
definición de las verificaciones utilizadas para los ensayos
de factores con paralelismo.
(Ilustración)
Pueden efectuarse tres diluciones con cada muestra. El % de
Relación de Dilución muestra al porcentaje de dilución
utilizado en el sistema.
4.111
194
Los resultados para el Paralelismo pueden seleccionarse para
mostrar e imprimir con diferentes unidades con el uso de los
siguientes cuadros de marcado:
• % de CR: el sistema tomará los resultados en segundos
para cada dilución, convertirá estos resultados a %
de actividad leyendo en la curva de calibración y
multiplicará a continuación los resultados por el
factor de dilución.
• Ave % de CR: el promedio de los 3 resultados del % de
CR.
• CV-%CR: el CV de los resultados de % de CR.
Pendiente*: Cuando se activa, puede introducirse un valor
mínimo y máximo aceptable para la pendiente de la línea, con
base en los 3 valores de dilución. Los resultados fuera de
estos límites tendrán un indicador de “fuera del rango” y se
imprimirán con negritas.
Intercepción*: Cuando se activa, puede introducirse un valor
mínimo y máximo aceptable para la intercepción de la línea,
con base en los 3 valores de dilución. Los resultados fuera
de estos límites tendrán un indicador de “fuera del rango” y
se imprimirán con negritas.
*Para activar e introducir valores, debe encontrarse en el
nivel de Administrador del Laboratorio.
R2: Cuando se activa, puede introducirse un valor mínimo y
máximo aceptable para la R2 para la regresión lineal
(segundos con respecto a el % de recuperación sin corregir),
con base en los 3 valores de dilución. Los resultados fuera
de estos límites tendrán un indicador de “fuera del rango” y
se imprimirán con negritas.
% de Varianza Máximo: Diferencia máxima permisible entre los
resultados vueltos a calcular. Esta verificación se determina
comparando el resultado de la dilución 1 con el resultado de
la dilución 2 y comparando también el resultado de la
dilución 2 y el resultado de la dilución 3.
% de CV Máximo: % de CV máximo permisible para los resultados
vueltos a calcular.
Al oprimir el botón de Unidades, se mostrarán las unidades
disponibles para el paralelismo. Pueden seleccionarse cuatro
de las unidades para mostrar e imprimir.
(Ilustración)
4.112
Haga resaltar la unidad deseada y oprima Mostrar en la Lista
de Muestras. Se colocará una marca en la columna de mano
izquierda. Estas unidades se mostrarán en la pantalla y se
imprimirán. Pueden seleccionarse hasta 4 unidades.
Las unidades disponibles incluyen:
195
• AVECR%: Promedio de los resultados vueltos a calcular en
%.
• CV-CR%: CV de los resultados vueltos a calcular en %.
• Pendiente: Pendiente de la línea de paralelismo.
• INT: Intercepción de la línea de paralelismo.
• r2: Correlación de la línea de paralelismo con base en
los resultados con respecto al % de dilución. Se
determina utilizando el análisis de regresión lineal.
Para la Pendiente e INT, debe introducirse un rango para
reportar estas unidades y ponerles un indicador.
Los resultados para el paralelismo de factores pueden
imprimirse de 3 maneras:
1. Reporte de las Muestras – Este reporte incluirá a 4 de
los siguientes, seleccionados por el usuario:
a. Ave CR%
b. CV CR%
c. Pendiente
d. Int (Intercepción)
e. r2
2. Reporte Acumulativo – Este reporte incluirá:
a. Los resultados de la 1ª dilución, la 2ª dilución y
la 3ª dilución, expresados en segundos (s),
porcentaje (%) y el resultado corregido en % (% de
CR).
b. Ave CR%
c. CV CR%
d. Pendiente
e. Int (Intercepción)
f. r2
3. Reporte de los Detalles del Paralelismo.
Este reporte incluirá a todo lo que está incluido en el
reporte acumulativo para una muestra, junto con una lista
de los errores asociados a la muestra.

4.113
4.3 UTILIDAD
La parte del software del ACL Elite/Elite Pro que corresponde
a la Utilidad, agrupa a todas las funciones relacionadas con
el guardado de los datos y el manejo del software del ACL.
Para facilidad de uso, la Sección 4.3.1 muestra el submenú de
utilidad, y las Secciones 4.3.2 y anterior están rotuladas
como los conceptos de este submenú.
4.3.1 Submenú de UTILIDAD
Puede tenerse acceso a este grupo de funciones en la pantalla
Principal oprimiendo el botón de UTILIDAD en la barra de
menú:
ACTUALIZAR BIBLIOTECA DE IL
196
RESPALDAR/RESTAURAR
ARCHIVAR
SOFTWARE
- Identificación del Software
- Actualización del Software
- SW – Subir-Actualizar - Amo
- SW – Subir-Actualizar – Esclavo
- SW REM Subir-Actualizar
GUARDAR ÚLTIMO MAPA DEL ROTOR
GUARDAR SEGUIMIENTO
4.3.2 UTILIDAD – Actualizar Biblioteca de IL
Esta utilidad se emplea para actualizar la biblioteca de
pruebas de IL
Siga las instrucciones indicadas en la pantalla.
La pantalla indicará que se introduzca el disquete de la
Biblioteca de IL en la unidad de disco flexible (lado
superior derecho del instrumento) y que se oprima continuar.
4.114
Al terminar la Actualización de la Biblioteca de IL, se
incluyen todas las modificaciones en la pantalla.
(Ilustración)
Las modificaciones que ocurrieron pueden también imprimirse
en un reporte.
4.3.3 UTILIDAD: Respaldar/Restaurar
Se emplea esta utilidad para respaldar o restaurar la
configuración del sistema.
Respaldar guardará la siguiente información en uno o más
discos flexibles:
configuración del sistema en términos de la Computadora
Principal, la Impresora, el Código de Barras y el Teclado;
todo el ajuste de las pruebas, el ajuste del perfil, el
ajuste del grupo de pruebas, el ajuste de los líquidos, la
tabla de interferencias, las pruebas por omisión, las pruebas
reflejas, el ajuste de Control de Calidad, el ajuste de la
AR, etc.
Restaurar copiará la información de ajuste guardada en los
discos flexibles de regreso al analizador.
(Símbolo)
Nota: Los resultados de los pacientes, las curvas de
Calibración, los resultados de Control de Calidad y los
resultados de la AR no pueden respaldarse y restaurarse.
Ver la Fecha de Respaldo mostrará la fecha en que se creó el
respaldo.
El disco utilizado para crear el respaldo debe ser un disco
flexible de 3-1/2” de Doble Lado de Alta Densidad, no
protegido y preformateado.
(Símbolo)
197
Advertencia: Puede respaldarse un ACL Elite y restaurarlo en
un ACL Elite Pro; sin embargo, no puede respaldarse un ACL
Elite Pro y restaurarlo en un ACL Elite.
4.115
(Ilustración)
UTILIDAD – Archivar
Esta utilidad se emplea para copiar/transferir datos
analíticos a un disco flexible.
(Ilustración)
Cuatro cuadros de marcado permiten la selección del conjunto
de datos que se copiarán/transferirán.
- DATOS DE LOS PACIENTES (puede seleccionarse el rango de
la fecha de Introducción de las Muestras)
- DATOS DE CONTROL DE CALIDAD (puede seleccionarse el rango
de la fecha, el líquido de Control de Calidad y las
pruebas.
- DATOS DE LA AR (Referencia Analítica) (puede
seleccionarse el rango de la fecha y las pruebas)
- DATOS DE CALIBRACIÓN (pueden seleccionarse las pruebas)
4.116
*Los datos de los pacientes se archivan con base en la fecha
de introducción de la muestra y no la fecha de que se analizó
la muestra.
Al activar el cuadro de marcado de Eliminar Datos Después de
Archivar, se suprimirán los datos seleccionados de la base de
datos del ACL, para las muestras completadas.
Para comenzar el procedimiento de archivado, oprima el botón
de INICIAR.
El nombre del archivo creado por el instrumento está
compuesto por dos letras y seis caracteres numéricos: las dos
letras identifican a la clase de selección efectuada por el
operador (CD = Datos de Calibración, QC = Control de Calidad,
PD = Datos del Paciente, AR = Referencia Analítica); los
números corresponden a la fecha cuando se llevó a cabo esta
operación (ddmmaa). La extensión del archivo es .000. Estos
archivos pueden verse con el uso de programas comunes capaces
de leer datos de texto de lectura.
Los Datos archivados incluyen lo siguiente: nombre de la
prueba, nombre del paciente con los datos demográficos
relacionados, resultados, indicadores y parámetros de la
curva de calibración, dependiendo de la selección efectuada.
(Símbolo)
Advertencia: Los datos archivados no pueden restaurarse de
regreso al ACL Elite/Elite Pro. Los datos pueden verse con
el uso de una PC estándar capaz de ver datos de texto.
4.117
4.3.5 UTILIDAD – SOFTWARE – Identificación de Software
198
Al seleccionar el botón de Utilidad en la barra del menú y
seleccionar Identificación del Software, se abre la pantalla
de identificación del SW.
Puede verse la información siguiente en esta pantalla, pero
no puede editarse.
IDENTIFICACIÓN DE SW AMO (Primario)
IDENTIFICACIÓN DE SW ESCLAVO (Secundario)
IDENTIFICACIÓN DE SW REM (no disponible en el ACL Elite)
BIBLIOTECA DE PRUEBAS DE IL
(Ilustración)
El botón de Confirmar hace salir de la pantalla y el sistema
regresa a la pantalla Principal.
4.3.6 UTILIDAD – SOFTWARE – Actualizar/Subir Software
Esta opción permite actualizar y subir las áreas principales
del software cuando se hace disponible una liberación del
software.
Para comenzar los procedimientos de actualizar y subir,
seleccione el software que va a actualizarse y subirse
(Esclavo, Amo o REM), introduzca el disco y siga las
instrucciones de la pantalla.
El procedimiento para cargar una nueva revisión de software
se efectúa en dos pasos para cada una de las 3 áreas del
software (Esclavo, Amo y REM).
4.118
La operación de Subir Software copia la información entera en
el disco duro.
La operación de Actualizar Software instala el software del
disco duro a través del sistema.
Subir y Actualizar Esclavo (Secundario)*
La segunda operación es Subir Esclavo (copiar la información
en el disco duro). Introduzca el disco, seleccione Subir
Esclavo (Secundario) y continúe.
Cuando se completa el procedimiento de Subir, seleccione
Actualizar Esclavo (Secundario) (instalación del software
desde el disco duro) y continúe.
Subir y Actualizar Amo (Primario)*
La segunda operación es Subir Amo (copiar la información en
el disco duro). Introduzca el disco, seleccione Subir Amo
(Primario) y continúe.
Cuando se completa el procedimiento de Subir, seleccione
Actualizar Amo (Primario) (instalación del software desde el
disco duro) y continúe.
Subir y Actualizar REM*
La tercera operación es Subir REM (copiar la información en
el disco duro). Introduzca el disco, seleccione Subir REM y
continúe.
199
Cuando se completa el procedimiento de Subir, seleccione
Actualizar REM (instalación del software desde el disco duro)
y continúe.
Al final de cada operación, verifique que la Identificación
del Software reporte el número de revisión correcto.
(Símbolo)
*Advertencia: Cada estuche de Actualización incluirá
instrucciones detalladas que dejen sin efecto a las
instrucciones anteriores en caso de que sean diferentes.
Siga las instrucciones del paquete de Actualizar para
efectuar las operaciones de Subir y Actualizar.
4.119
4.3.7 UTILIDAD – Guardar Mapa de Rotores
Al seleccionar el botón de Utilidad en la barra del menú y
seleccionar Guardar Mapa de Rotores, se abre la pantalla de
Guardar Rotores que se muestra a continuación.
(Ilustración)
Esta utilidad se emplea para guardar los datos en bruto del
análisis en un disco flexible.
El sistema conserva los datos en bruto durante todas las
pruebas efectuadas en los 31 últimos días. El usuario puede
teclear el nombre del archivo y seleccionar el formato del
archivo haciendo clic en el cuadro de marcado apropiado.
Los archivos DAT son compatibles con el Programa de
Investigación de Windows.
(Símbolo)
Nota: el archivo DAT está solamente disponible cuando se
ejecuta una sola prueba (hasta 19 muestras como máximo) en el
rotor. En caso de que se ejecuten más pruebas en el mismo
rotor, la opción del archivo DAT.
Los archivos TXT y los archivos ASCII son compatibles con la
hoja de trabajo y los editores de texto más comunes (es
decir, Word o Excel).
Puede utilizarse un máximo de 8 caracteres para el nombre del
archivo. No introduzca la extensión del nombre del archivo
cuando introduzca un nombre de archivo. La extensión se
añadirá automáticamente dependiendo del cuadro de marcado
seleccionado (TXT o DAT).
El formato del nombre del archivo es: RMdxxhyy.
• xx = día del mes en que se efectuó la corrida
• yy = hora del día en que se efectuó la corrida
Introduzca el disco y oprima Continuar.
El botón de Cancelar hará que se salga de la pantalla
principal.
4.120
(Símbolo)
200
*Nota: Cuando se efectúan múltiples corridas dentro de la
hora seleccionada, se guardarán todas las corridas en el
disco. Un sello del tiempo de corrida separa a los diversos
datos de la corrida en el disco. El final del tiempo de
corrida se utiliza para el sello de tiempo.
4.3.8 UTILIDAD – Guardar Seguimiento
Esta utilidad se emplea para guardar todas las operaciones
efectuadas por el instrumento.
Esta utilidad se emplea para fines de localización de fallas
en caso de que pueda aparecer un defecto en el software (es
decir, error de la base de datos, trabados del sistema,
etc.).
El sistema guarda hasta 31 archivos de seguimiento, uno por
cada día durante los 31 últimos días.
(Ilustración)
Teclee el nombre del archivo utilizando el formato siguiente:
Trace_XX.txt
El uso de un nombre de archivo que ya se encuentra en el
disco, se sobreescribirá en el archivo anterior.
XX es el día del mes en que se quiere guardar el seguimiento.
Por ejemplo, para guardar el seguimiento para el día 10,
teclee: Trace_10.txt.
En caso de que se necesite reiniciar el sistema puede todavía
ejecutarse el archivo de seguimiento después de reiniciar el
analizador.
La dimensión del archivo de seguimiento es de 1.44 Mb máximo.
(Símbolo)
Nota: el archivo de seguimiento monitoreará solamente los
errores de la base de datos o el software interno. Un
archivo de seguimiento no incluye información acerca de los
resultados anormales.
4.121
4.3.9 UTILIDAD – Prueba/Material – Respaldar y Subir
Este elemento permite que las definiciones de un solo
material y prueba se copien en los discos y se suban desde el
disco.
Al seleccionar la opción de Respaldar en este menú, se
muestra la pantalla siguiente.
(Ilustración)
El cuadro desplegable descendente de Prueba/Material permite
seleccionar la Identificación de un material, la
Identificación de la Prueba o el Grupo de Pruebas para
respaldar.
La lista de Prueba/Material, debajo de la selección, mostrará
entonces las identificaciones de los materiales, las pruebas
o el grupo de pruebas con base en la selección anterior.
201
Marque el cuadro de Comentarios para incluir los comentarios
internos en el respaldo.
En el cuadro de Nombre del Archivo, introduzca el nombre del
archivo (ocho caracteres como máximo, sin que se necesite
ninguna extensión).
Oprima el botón de confirmar para iniciar el respaldo o el
botón de cancelar para salir de la pantalla.
Al seleccionar la opción de Subir del menú, se muestra la
siguiente pantalla.
4.122
(Ilustración)
Seleccione Prueba/Material en el cuadro desplegable
descendente.
Al marcar en el cuadro de Sobreescribir, se hará que la nueva
información que se sube reemplace a la información
actualmente definida en el sistema.
Introduzca el Nombre del Archivo del material o prueba que va
a subirse (ocho caracteres como máximo sin que se necesite
ninguna extensión).
Oprima el botón de confirmar para iniciar el respaldo o el
botón de cancelar para salir de la pantalla.
5.1
Diagnóstico y Mantenimiento
5.0 Introducción
La finalidad de esta Sección es familiarizar al usuario del
ACL Elite/Elite Pro con los procedimientos de diagnóstico
impulsados por el software, que se efectúan automáticamente
en el sistema a solicitud del operador. Por medio de los
programas de diagnóstico del ACL, el usuario puede tener
acceso a los libros de registro e historial de errores del
sistema, así como efectuar las verificaciones en los
elementos clave del hardware.
Además, esta Sección contiene toda la información necesaria
para efectuar los procedimientos de Mantenimiento Preventivo
para mantener así al ACL Elite/Elite Pro en condición
funcional de primera.
5.1 El Submenú de DIAGNÓSTICO
Puede tenerse acceso al submenú de diagnóstico desde la
pantalla Principal oprimiendo el botón de DIAGNÓSTICO en la
barra del menú:
CEBADO
LIMPIEZA
MANTENIMIENTO
CONTROL DE TEMPERATURA
POSICIÓN DE LAS AGUJAS
HISTORIA DE ERRORES DE LA SESIÓN
HISTORIA DE ERRORES DEL ARCHIVO
202
LIBRO DE REGISTRO
SERVICIO (atenuado). Accesible solamente al Servicio
Las secciones siguientes contienen datos acerca de cada uno
de los elementos del submenú de Diagnóstico.
5.1.1 Cebado
INSTRUCCIONES para efectuar un CICLO DE CEBADO
(desde el estado de LISTO)
• Haga clic en el botón de Diagnóstico en la barra del menú
Principal.
• Seleccione Cebado en el menú de Diagnóstico.
El ACL comienza un ciclo de cebado, lavando las agujas y los
pistones.
Duración de 50 segundos aproximadamente.
El elemento de Cebado del menú de Diagnóstico permite que el
operador efectúe un ciclo de cebado automático en el ACL a
fin de lavar los...
5.2
...pistones y las agujas del módulo de carga. Este ciclo de
cebado puede activarse solamente cuando el sistema está en el
modo de Listo.
El ciclo de cebado debe efectuarse en los momentos
siguientes:
- al principio de un día o turno de trabajo
- al final de un día o turno de trabajo
- cuando el ACL haya estado apagado por un período de
tiempo prolongado
- después del reemplazo de la botella de Emulsión de
Lavado-Referencia.
A fin de efectuar un ciclo de cebado, haga clic en el botón
de Diagnóstico en la barra del menú Principal y seleccione la
opción de Cebado en el submenú de Diagnóstico para abrir la
pantalla de Cebado.
(Ilustración)
La ventana en esta pantalla muestra una barra que se mueve
durante la activación de ciclo para mostrar el tiempo
transcurrido de aproximadamente 50 segundos.
Los diluyentes de dos pistones se moverán hacia arriba y
hacia abajo para cebar la línea de tubos con un consumo
aproximado de 6 mL de Emulsión de Lavado-R (20 carreras por
un solo diluyente de pistones – total de 40 carreras, cada
carrera individual de 0.15 mL).
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? OK confirma la opción de Parar
y Cancelar cancela la operación.
5.3
203
(Ilustración)
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar (Shutdown), seguido por una ventana de
confirmación ¿Quiere realmente parar el ACL? La
respuesta de Sí cierra la sesión y permite que el
operador salga del sistema y/o lo apague; la respuesta
de No, cancelará la operación.
(Símbolo)
NOTA: cuando el instrumento está en standby (espera), se
efectúa un ciclo de cebado automático cada 30 minutos. El
consumo de Emulsión de Lavado-R es de 0.9 mL aproximadamente
(3 carreras por un solo diluyente de pistones – total de 6
carreras; cada carrera individual es de 0.15 mL).
5.4
5.1.2 Limpieza
INSTRUCCIONES para efectuar un CICLO DE LIMPIEZA (desde el
estado de LISTO).
Antes de comenzar el ciclo de limpieza, coloque las
soluciones de limpieza deseadas en la posición R6 del
reactivo (para la línea de reactivos) y la posición R7 (para
la línea de muestras):
• Haga clic en el botón de Diagnóstico en la barra del menú
Principal.
• Seleccione Limpieza en el menú de Diagnóstico.
El ACL comienza un ciclo de limpieza para las agujas de
reactivo y muestra.
Duración: depende de la configuración del ciclo (ver los
detalles a continuación)
El elemento de Limpieza del menú de Diagnóstico permite que
el operador efectúe una limpieza automática profunda de las
agujas del ACL con el uso de soluciones de limpieza
seleccionadas, seguida por ciclos de enjuague con el uso de
la Emulsión de Lavado-Referencia. Antes de comenzar el ciclo,
las soluciones de limpieza seleccionadas deben colocarse en
la posición R6 de reactivo para la línea de reactivos y en la
posición R7 para la línea de muestras.
Para las recomendaciones con respecto a las soluciones
limpiadoras, consulte la Sección 5.2.3 y la 5.2.7.
A fin de efectuar un ciclo de limpieza, haga clic en el botón
de Diagnóstico en la barra del menú Principal y seleccione la
opción de Limpieza en el submenú de Diagnóstico para abrir la
pantalla de Limpieza que se muestra a continuación. Nota:
Este procedimiento puede iniciarse solamente cuando el ACL
está en el estado de LISTO.
EN esta pantalla, el operador puede definir la configuración
de la operación de limpieza.
204
5.5
(Ilustración)
- VOLUMEN: volumen en microlitros de las soluciones
limpiadoras (posiciones R6 y R7) que se utilizarán en
cada ciclo individual para limpiar las líneas de
reactivos y de muestras: por omisión es de 130
microlitros. Volumen mínimo = 0 y el volumen máximo es de
130 microlitros.
- No. DE CICLOS: el número de ciclos de limpieza con el uso
de las soluciones limpiadoras (igual para ambas líneas);
por omisión es de 3 ciclos. El mínimo es de 1 y el máximo
es de 5 ciclos. Al seleccionar 0, no se ejecutarán
ningunos ciclos.
- LAVADO AL COMPLETAR: número de ciclos de enjuague
(definidos para cada línea) con el uso de la Emulsión de
Lavado-Referencia; por omisión es de 5 ciclos. El mínimo
es de 1 y el máximo es de 5 ciclos. Al seleccionar 0, no
se efectuarán ningunos ciclos.
Como mínimo, la línea de muestras, de reactivos o ambas
necesitan definirse antes de oprimir “Comenzar” para que se
efectúe el ciclo de limpieza.
PROCEDIMIENTO DE LIMPIEZA
Materiales necesarios:
• 4 frasquitos de vidrio (volumen de 10 mL, diámetro de 23
mm).
• 16 mL de solución Limpiadora.
• 16 mL de Diluyente de Factor
Coloque la solución Limpiadora en las posiciones R6 y R7 con
el uso de los dos frasquitos de vidrio antes indicados
(volumen máximo de 10 mL, 23 mm de diámetro), llenados cada
uno de ellos con 8 mL de una de las soluciones siguientes:
5.6
• Solución Limpiadora IL (P/N 98317-00) para un
procedimiento de limpieza normal, o
• Agente Limpiador IL (P/N 98327-00) diluido 1:8 para un
procedimiento de Descontaminación.
Al hacer clic en el botón de Iniciar, se inicia el ciclo de
limpieza y se abre una ventana que muestra una barraque se
mueve para indicar el tiempo transcurrido del procedimiento.
(Ilustración)
Cuando no se detecta líquido en los frasquitos, se abortará
la limpieza.
Después del primer paso con el uso de la solución limpiadora
apropiada, substituya con los dos frasquitos llenos de
Diluyente de Factor en R6 y R7. Reinicie la limpieza.
205
En caso de que los líquidos no estén en las posiciones
apropiadas, se abortará automáticamente el ciclo y aparecerá
una ventana de error.
Al hacer clic en el botón de Cancelar, se sale de la
pantalla.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Detener (Stop) detiene el procedimiento de limpieza
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar (Shutdown), seguido por una ventana de
confirmación ¿Quiere realmente parar el ACL? La
respuesta de Sí cierra la sesión y permite que el
operador salga del sistema y/o lo apague; la respuesta
de No, cancela la operación.
5.7
5.1.3 Mantenimiento
La subsección de Mantenimiento del menú de Diagnóstico
permite que el usuario tenga acceso y registre la ejecución
de operaciones de mantenimiento específicas. Lo anterior
tiene como finalidad efectuar el seguimiento de la frecuencia
con la que se mantiene el instrumento y para fines de
localización de fallas.
Para información acerca de los Procedimientos de
Mantenimiento y los lineamientos de frecuencia que se
recomiendan, consulte la Sección 5.2.
Para abrir la pantalla de Mantenimiento, haga clic en el
botón de Diagnóstico en la barra del menú Principal y
seleccione la opción de Mantenimiento en el submenú de
Diagnóstico.
(Ilustración)
La ventana grande que ocupa la mayor parte de la pantalla
muestra una lista de las operaciones de mantenimiento que se
sugieren, junto con su frecuencia recomendada en días.
Operación Días (Frecuencia)
• CICLO DE LIMPIEZA 7
• RESERVORIO DE ENJUAGE-DESECHOS 7
• LIMPIAR SENSORES ÓPTICOS Y VENTANAS 14
• LIMPIAR FILTRO DE AIRE 28

5.8
Junto a la columna de Mantenimiento/Operación hay otras tres
columnas que contienen la siguiente información con relación
a cada procedimiento.
ULTIMA FECHA: La fecha no necesita teclearse después de la
ejecución de una operación específica. Al hacer clic en el
206
botón de Fecha, hace que aparezca automáticamente la fecha
del día. Los conceptos que se muestran con rojo indican que
ya se pasó la frecuencia incluida y que ha vencido. Cuando se
procesa una corrida con mantenimiento vencido, se iluminará
el botón de Historia de Errores de la Sesión para alertar al
operador y aparecerá un indicador en los resultados. El icono
de alerta se iluminará también cuando venza el mantenimiento.
El botón de Despejar suprimirá a la fecha mostrada.
DÍAS: Este número no puede editarse. Es la frecuencia que
recomienda IL en días, con la que debe efectuarse el
procedimiento.
El icono de NOTAS abre a la pantalla de Introducir Notas para
la introducción de texto libre (pueden imprimirse 26
caracteres como máximo)
Al hacer clic en el botón de Confirmar, se guardan los
cambios en la pantalla de Notas.
Al hacer clic en el botón de Cancelar, se rechazan los
cambios; en ambos casos, el sistema regresa a la
pantalla Principal.
Al hacer clic en el botón de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir?, Sí/No
imprime la lista de mantenimiento.
Al hacer clic en el botón de Confirmar, se guardan los
cambios y al hacer clic en el botón de Cancelar, se rechazan
los cambios; en ambos casos, el sistema regresa a la pantalla
Principal.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.1.4 Control de Temperatura
Por medio de la opción de Control de la Temperatura del
submenú de Diagnóstico, el operador puede verificar si las
temperaturas del sistema se encuentran dentro de sus rangos
aceptables. Ésta es la pantalla de actualización de tiempo
real y la indicación centelleará dado que las temperaturas se
están actualizando constantemente.
Al hacer clic en el botón de Diagnóstico de la barra del menú
Principal y seleccionar el Control de Temperatura, se abre la
pantalla de Control de Temperatura.
5.9
207
(Ilustración)
- DISPOSITIVO – indica las áreas que se verifican.
- RANGO NORMAL (ºC) – indica el rango aceptable para cada
dispositivo.
- Sujetador de Rotor 38 a 39ºC 100.4 a 102.2ºF
- Peltier 10 a 16ºC 50 a 60.8ºF
- Transportador* del Rotor 34 a 40ºC 93.2 a 104ºF
- Pila de Rotores 34 a 40ºC 93.2 a 104.0ºF
- TEMPERATURA (ºC o ºF, de acuerdo con las Unidades
seleccionadas en el Ajuste) – indica la temperatura real
en el área.
*Se utiliza para monitorear la Base de la Pila de Rotores
en el ACL Elite.
Al hacer clic en el botón de Confirmar, se sale de la
pantalla y el sistema regresa a la pantalla Principal.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.10
5.1.5 Posición de las Agujas
La opción de la Posición de las Agujas del submenú de
Diagnóstico se utiliza para centrar las agujas después de
cambiar o retirar el bloque de agujas.
La posición de las agujas tiene que verificarse con la
cubierta del rotor abierta; por lo tanto, oprima el botón de
Abrir/Cerrar la Cubierta para abrir la cubierta del Rotor.
Instale la herramienta de alineación.
Al hacer clic en el botón de Diagnóstico en la barra del menú
Principal y seleccionar Posición de las Agujas, se produce
una inicialización automática muy rápida. Después de un
recordatorio para abrir la cubierta, el brazo se mueve sobre
el área del sujetador del rotor.
(Ilustración)
El botón de Subir/Bajar el Brazo hace subir/bajar el brazo
sobre el área del sujetador del rotor.
El botón de Girar moverá al sujetador del rotor 90º (1/4 de
vuelta).
Cuando tenga que llevarse a cabo el procedimiento de posición
de las agujas, la herramienta de ajuste de las agujas debe
colocarse sobre el sujetador del rotor. Para los detalles
acerca de la operación, consulte la Sección 5.2.6.
208
Recuerde retirar la herramienta al terminar el procedimiento.
Al hacer clic en el botón de Detener (Stop), seguido por una
ventana de confirmación ¿Quiere realmente detener la
operación actual?, al responder OK, el sistema regresa a la
pantalla principal. Cancelar cancelará la operación.
A fin de verificar el centrado de las agujas con la cubierta
del rotor cerrada, repita la operación descrita en 5.2.6.
5.11
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.1.6 Historia de Errores de la Sesión
Cualquier error o alarma que ocurra durante una sesión
analítica se registra en el sistema.
Pueden almacenarse hasta 200 errores en el archivo de
errores. El archivo se maneja automáticamente con el uso del
planteamiento de lo que entra primero sale primero.
En caso de que el usuario quiera ver los errores y las
alarmas mientras la sesión está activa, al hacer clic en el
botón de Diagnóstico en la barra del menú Principal y
seleccionar la opción de Historia de Errores de la Sesión, se
abrirá la pantalla de Historia de Errores de la Sesión.
(Ilustración)
La ventana de esta pantalla contiene descripciones de todos
los errores y advertencias que ocurrieron durante la sesión
actual, junto con la fecha y la hora. El último error o
advertencia aparece en la parte superior de la lista.
Al hacer clic en el botón de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir? Sí/No, se
imprime la lista.
5.12
Al hacer clic en el botón de Confirmar se sale de la pantalla
y el sistema regresa a la pantalla Principal.
Tan pronto como comienza una nueva sesión, se borran
automáticamente los errores de la sesión anterior y los
errores permanentes se transfieren a la base de datos de la
Historia de Errores de Archivos.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
209
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.1.7 Historia de Errores de Archivos
El software del ACL Elite/Elite Pro registra, almacena y
muestra todos los errores y advertencias que ocurrieron desde
que el sistema se encendió primero.
Pueden almacenarse hasta 100 errores en el archivo de
errores. El archivo se maneja automáticamente con el uso del
planteamiento de lo que entra primero sale primero.
La historia de errores puede verse en la pantalla de Historia
del Archivo de Errores (que se muestra a continuación), que
se abre haciendo clic en el botón de Diagnóstico en la barra
del menú Principal y seleccionar Historia de Errores de los
Archivos en el submenú de Diagnóstico.
5.13
(Ilustración)
Esta pantalla muestra las descripciones de todos los errores
y advertencias, junto con la fecha y la hora cuando ocurren.
El último error o advertencia aparece en la parte superior de
la lista.
Al hacer clic en el botón de Impresora, seguido por una
ventana de confirmación, ¿Quiere realmente imprimir?, Sí/No,
se imprime la lista de errores.
Al hacer clic en el botón de Despejar, seguido por una
ventana de confirmación, se suprimen todos los mensajes en el
archivo. Disponible en el Nivel de Servicio solamente.
Al hacer clic en el botón de Confirmar, se sale de la
pantalla y el sistema regresa a la pantalla Principal.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.14
5.1.8 Libro de Registro
El software del ACL Elite/Elite Pro registra, almacena y
muestra la información acerca de todas las acciones
210
efectuadas en el sistema desde que se encendió por vez
primera.
Las acciones que se registran para seguimiento en el Libro de
Registro son todas las condiciones de acuerdo con las cuales
un operador toma decisiones. Por ejemplo, se registra una
introducción de Líquido, un cambio en el valor asignado, una
modificación en el ajuste y/o en la configuración.
Pueden almacenarse hasta 200 mensajes en el archivo del libro
de registro. El archivo se maneja automáticamente con el uso
del planteamiento de lo que entra primero sale primero.
El libro de registro puede verse en la pantalla del Libro de
Registro, que se abre haciendo clic primero en el botón de
Diagnóstico en la barra del menú Principal y seleccionando a
continuación Libro de Registro en el submenú de Diagnóstico.
(Ilustración)
Esta pantalla muestra descripciones de todas las acciones y
el nivel de registro, junto con la fecha y la hora en que
ocurrieron. La última acción aparece en la parte superior de
la lista.
• FECHA/HORA: la fecha y la hora en que ocurrió la acción.
• NIVEL: nivel de contraseña
• NOMBRE DEL USUARIO: usuario
• ACCIÓN: descripción de la acción efectuada
• NOTA: campo para comentarios que puede editar el usuario
Al hacer clic en el botón de Notas, se permite que el
operador entre en los comentarios para cada mensaje del libro
de registro (26 caracteres como máximo).
5.15
Al hacer clic en el botón de Impresora, seguido por una
ventana de confirmación ¿Quiere realmente imprimir?, Sí/No
imprime los registros del libro de registro.
Al hacer clic en el botón de Confirmar, se sale de la
pantalla y el sistema regresa a la pantalla Principal.
Los BOTONES ACTIVOS en la parte inferior de esta pantalla
son:
- Abrir/Cerrar abre o cierra la cubierta del sujetador
del rotor.
- Vista de la Base de Datos muestra la Vista de la Base
de Datos o la Pantalla Principal.
- Parar, seguido por una ventana de confirmación ¿Quiere
realmente parar el ACL? La respuesta de Sí cierra la
sesión y permite que el operador salga del sistema y/o
lo apague; la respuesta de No, cancelará la operación.
5.1.9 Servicio (atenuado)
Esta sección no es accesible en el nivel del usuario.
Los procedimientos incluidos en la sección de Servicio del
software deben efectuarse solamente por parte de Ingenieros
211
de Servicio de IL capacitados y, por lo tanto, no se incluyen
en el Manual del Operador.
5.16
5.2 PROCEDIMIENTOS DE MANTENIMIENTO
5.2.1 Introducción
El ACL es un instrumento de precisión. A fin de mantenerlo
en condición funcional, IL recomienda que un operador
adiestrado, con la frecuencia mínima especificada, lleve a
cabo las operaciones siguientes.
(Símbolo)
Advertencia:
El instrumento debe descontaminarse antes de efectuar
cualquier procedimiento de mantenimiento y/o servicio. Para
las instrucciones relacionadas con los Procedimientos de
Descontaminación, consulte la Sección 5.2.7 a continuación.
Mientras efectúa los procedimientos de mantenimiento, el
operador debe usar ropa y guantes protectores para evitar el
contacto directo con artículos potencialmente contaminados
con sangre. Las manos deben lavarse inmediatamente después
de quitarse los guantes y antes de salir del laboratorio.
Consulte también la NCCLS GP25-A Vol. 13 No. 22: Manejo de
Desechos de Laboratorio Clínico, diciembre de 1993.
5.2.2 Mantenimiento Preventivo Diario
Las siguientes verificaciones y procedimientos deben
efectuarse en el ACL antes de comenzar las pruebas diarias o
una vez por turno.
(Símbolo)
NOTA IMPORTANTE: el ACL se desempeñará de manera óptima si de
deja ENCENDIDO en todo momento. El circuito electrónico
complejo es sumamente confiable cuando el número de ciclos de
ENCENDIDO/APAGADO se mantiene en un mínimo. Dejar el
instrumento en el modo de Espera (Standby) garantiza el
consumo mínimo de energía y la condición de preparación
máxima para la operación en cualquier momento. Para
información adicional, consulte la Sección 1.
• Verificar la Emulsión de Lavado-Referencia
La botella de Emulsión de Lavado-Referencia está equipada con
un sensor de nivel de líquido, que reporta la cantidad de
solución que queda en la botella (mL) en tiempo real. Este
sensor produce también una advertencia para alertar al
operador cuando la solución en la botella es insuficiente
para pruebas adicionales.
Cuando se apaga el sensor en la opción de Configuración del
Ajuste, el operador debe verificar que el nivel de líquido en
la botella se encuentre por lo menos a una distancia de 1.5 a
2 cm del fondo.
5.17
212
Cuando el nivel es más bajo, debe reemplazarse la botella de
Emulsión de Lavado-Referencia por una llena y efectuar el
procedimiento de cebado antes de usar el sistema para las
pruebas (consultar la Sección 5.1.1 o el Procedimiento de
Impresión a continuación).
(Símbolo)
NOTA: en un nivel de 2 cm hay solución suficiente para
efectuar las pruebas en uno o dos rotores más (tomando en
cuenta el volumen muerto de la botella).
• Verificar el Contenedor del Líquido de Desecho
Verifique el nivel del contenedor de desechos y vacíelo en
caso necesario. Verifique también visualmente que los
desechos fluyan libremente al contenedor. Para la
instalación correcta, consulte la Sección 2.
(Símbolo)
Advertencia: Los desechos líquidos del instrumento deben
considerarse como una fuente de contaminación y, por lo
tanto, desecharse siguiendo los procedimientos del
laboratorio con respecto a los desechos, en cumplimiento con
los reglamentos locales. Consulte también la NCCLS GP25-A,
Vol. 13, No. 22: Manejo de Desechos de Laboratorio, diciembre
de 1993.
• Efectúe el Procedimiento de Cebado
El procedimiento de cebado se utiliza para lavar la
trayectoria del líquido del sistema, asegurando así la
eliminación de los residuos de muestras o reactivos que
pueden acumularse durante el análisis de las muestras. El
procedimiento de cebado es una forma efectiva de mantener al
conjunto de agujas del ACL y el reservorio de enjuague en
buenas condiciones de funcionamiento.
Debe efectuarse el procedimiento de cebado automático del ACL
al principio y al final de cada día de trabajo.
A fin de efectuar el ciclo del cebado, haga clic en el botón
de Diagnóstico en la barra del Menú Principal y seleccione la
opción de Cebado en el submenú de Diagnóstico. Se abre la
pantalla de Cebado con un mensaje “Cebado en proceso” y el
cebado comienza inmediatamente. Cuando el sistema surtidor
termina de lavar las agujas de muestras y reactivos, el
instrumento regresa automáticamente al menú Principal.
Para detalles adicionales, consulte la Sección 5.1.1.
Importante: Mientras el ciclo de cebado está en proceso, el
operador debe inspeccionar visualmente tres aspectos:
- Que el número de burbujas en la cámara del diluyente se
reduzca a un mínimo. En caso de que haya burbujas
todavía presentes, pellizque los tubos de salida de la
cámara mientras desciende el pistón y suéltelos antes de
que el pistón llegue al centro muerto en el fondo.
213
Repita el ciclo de cebado según sea necesario, hasta que
desaparezcan todas las burbujas.
- Que no haya ningunos bloqueos ni fugas en la trayectoria
del flujo del líquido y que el líquido fluya suavemente
desde el reservorio a los diluyentes y de los diluyentes
a las agujas.
- Que haya flujo libre de los desechos líquidos de la
cámara de lavado al tubo de salida del instrumento y
luego al contenedor de desechos.
5.18
• Vacíe los Desechos de Rotores
Para tener acceso al contenedor con los rotores usados, abra
la puerta pequeña al frente del cuerpo del analizador, a la
derecha del área de reactivos. Sujete el asa del contenedor
y jálelo hacia fuera para retirarlo.
Descarte de manera apropiada los rotores usados que se
encuentran en el contenedor de desechos de rotores.
Ubicación de los desechos de rotores y contenedor de desechos
de rotores
(Ilustración)
Advertencia: Los rotores contienen materiales potencialmente
contaminados; deseche e incinere los rotores usados de
acuerdo con los reglamentos locales apropiados.
(Símbolo)
Nota: Puede dejarse un rotor parcialmente usado en el
alojamiento de rotores. Se ajusta un cronómetro de 24 horas
cuando se introduce un nuevo rotor. Después de 24 horas, se
indicará al usuario que introduzca las posiciones de cuvetas
abiertas para corridas posteriores en el rotor. A fin de
retirar un rotor del sujetador del rotor, oprima el icono de
Abrir/Cerrar para abrir la cubierta del sujetador del rotor y
recupere manualmente el rotor, asegurándose de no derramar su
contenido mientras lo transporta al contenedor de desechos.
Cierre la cubierta del sujetador del rotor oprimiendo el
icono de Abrir/Cerrar en la pantalla. Un rotor parcialmente
usado puede colocarse de regreso en el alojamiento del rotor
para uso de las cuvetas restantes. Antes de colocar un rotor
de regreso en el analizador, la última cuveta utilizada en el
rotor debe llenarse con 200 µl de Lavado-R.
Advertencia: No regrese un rotor parcialmente usado al
precalentador de rotores.
5.19
5.2.3 Mantenimiento Preventivo Semanal
El mantenimiento preventivo semanal del ACL consiste en
limpiar todas las áreas clave del instrumento que entran
normalmente en contacto con la muestra y los reactivos y que,
por lo tanto, acumulan residuos que, en caso de que se
214
permita que se acumulen, afectarán la funcionalidad del
instrumento y afectarán a los resultados de la prueba.
Las partes/áreas que se limpiarán son:
- El cuerpo del instrumento, con inclusión del
automuestreador y el área del sujetador del rotor.
- El conjunto de agujas.
- El reservorio de enjuague.
• Procedimiento de Limpieza General del Instrumento
Frote todas las superficies expuestas del cuerpo del
analizador, el interior del compartimiento del
automuestreador y el compartimiento del rotor (con exclusión
del sujetador del rotor) con el uso de un trapo empapado en
una solución de 0.1 N Ácido Clorhídrico (HCl) (Solución de
Limpieza de IL P/N 98317-00). Enjuague utilizando un trapo
empapado con agua desionizada. Frote para secar.
• Limpieza de Derrames de la Muestra
En caso de derrame de la muestra en el automuestreador o en
el compartimiento del rotor, puede requerirse la limpieza de
la sensor del tubo/copa y las dos trayectorias ópticas en el
área de análisis.
El sensor del tubo/copa en el interior del área de la charola
de muestras: frote las dos caras verticales del sensor con el
uso de un trapo limpio o aplicador de punta de algodón
empapado en una solución de 0.1 Nm HCl. Los derrames en el
compartimiento del rotor deben limpiarse con el uso del
agente limpiador P/N 98327-00 diluido (1:8). Siga con agua
desionizada y seque con un trapo limpio o aplicador de punta
de algodón.
Trayectorias ópticas en el área del análisis: consulte la
Sección 5.2.4 a continuación.
• Procedimiento de Limpieza de las Agujas
Aunque el procedimiento de cebado diario ayuda a mantener a
las agujas de muestreo/surtido en buenas condiciones de
funcionamiento, se acumula proteína y otros depósitos en el
interior y el exterior de las agujas de muestreo/surtido
después de cierto tiempo. Debe efectuarse el siguiente
procedimiento de limpieza semanalmente a fin de eliminar esos
depósitos.
El procedimiento requiere la interacción del operador y el
software del ACL. Para detalles adicionales, consulte la
Sección 5.1.2 Limpieza.
5.20
Ajuste del ACL:
Coloque 8 mL de una solución de 0.1 N HCl en 2 frasquitos.
Coloque los frasquitos llenos en las posiciones R6 y R7 de
los reactivos.
Para información más detallada, consulte 5.1.2 Limpieza.
215
Ciclo de limpieza
Haga clic en el botón de Diagnóstico en la barra del menú
principal y seleccione la opción de Limpieza del submenú de
Diagnóstico para mostrar la pantalla de Limpieza.
En esta pantalla, el operador define la configuración de la
operación de limpieza de acuerdo con las necesidades del
instrumento (consultar la Sección 5.1.2).
Al hacer clic en el botón de Iniciar, comienza el ciclo de
limpieza y se abre una ventana que muestra a una barra que se
mueve para mostrar el tiempo transcurrido del procedimiento.
(Símbolo)
ADVERTENCIA: Cuando se hayan sometido a prueba muestras en el
sistema, que se sospecha que son infecciosas, consulte la
Sección 5.2.7 para proceder con el Procedimiento de
Descontaminación apropiado.
• Procedimiento de Limpieza del Reservorio de Enjuague
Siga los pasos a continuación para limpiar el reservorio de
enjuague.
Haga clic en el botón de Diagnóstico en la barra del menú
Principal y seleccione Posición de Agujas.
Lo anterior hará que el brazo de las agujas se mueva hacia la
parte superior del sujetador del rotor.
Quite el reservorio de enjuague, lávelo perfectamente con una
solución de 0.1 N HCl y enjuáguelo con agua desionizada.
Regrese el reservorio de enjuague a su posición.
Oprima el icono de PARAR y confirme con OK. El brazo de las
agujas regresa a la posición de base en el reservorio de
enjuague de desechos. El instrumento regresa al Estado de
Listo.
5.2.4 Mantenimiento Preventivo Quincenal
El sujetador del rotor y los componentes de la trayectoria
óptica que se encuentran en el área de análisis deben
limpiarse cada dos semanas bajo el uso normal del
instrumento.
Procedimiento de Limpieza del Sujetador del Rotor y la
Trayectoria Óptica.
Oprima el icono de Abrir/Cerrar Rotor para abrir la cubierta
del sujetador del rotor.
Proceda como sigue, utilizando la figura a continuación como
referencia.
5.21
Limpieza de la Trayectoria Óptica
(Ilustración)
- Con el uso de un aplicador de punta de algodón, humedecido
con agua desionizada, limpie todos los 20 orificios en el
sujetador del rotor y la superficie del sensor del canal.
Utilice un aplicador de punta de algodón, limpio y seco, para
216
eliminar toda la humedad de estas áreas. El hisopo de
algodón no debe empujarse hacia abajo más allá del conjunto
del sujetador del rotor.
- Limpie la superficie del sensor del LED (debajo del
sujetador del rotor) y la superficie de fibra óptica del LED
con el uso de un aplicador de punta de algodón humedecido con
agua desionizada. Utilice un aplicador de punta de algodón
limpio y seco para secar bien estas áreas.
- Con el uso de un aplicador de punta de algodón humedecido
con agua desionizada, limpie la toma de fibra de la lámpara
de halógeno por debajo del sujetador del rotor y la
superficie del filtro del sensor del canal cromogénico
montado en la cubierta del sujetador del rotor, como se ve en
la figura de arriba.
Utilice un aplicador de punta de algodón limpio y seco para
secar las áreas después de la limpieza.
Oprima el icono de Abrir/Cerrar Rotor para cerrar la cubierta
del sujetador del rotor.
5.2.5 Mantenimiento Preventivo Mensual
• Verificación y Limpieza del Filtro de Aire
A fin de limpiar el filtro de aire del analizador, debe
retirarse primero de su ubicación en el lado derecho del
instrumento. Introduzca un dedo en la hendidura del
sujetador, jale hacia arriba y deslice el filtro hacia afuera
(ver la figura a continuación).
5.22
Retiro del Filtro del Ventilador
(Ilustración)
Verifique el filtro. En caso de que esté sucio, límpielo con
aire comprimido o lavándolo con agua y sopleteándolo para
secarlo.
En caso de que el filtro se vea dañado, debe reemplazase.
No coloque un filtro mojado de regreso en la posición en el
analizador.
Introduzca el filtro limpio o nuevo de regreso en su
sujetador.
5.2.6 Mantenimiento según se Necesite
• Procedimiento de Limpieza de la Línea de Desechos
Este procedimiento se efectúa para evitar la formación de
coágulos o para limpiar cualesquiera bloqueos posibles
(debidos a la coagulación) en la línea de desechos. La
frecuencia con la que debe efectuarse este procedimiento
depende de la carga de trabajo diaria; una vez al día puede
ser necesario para cargas de muestras pesadas y con menos
frecuencia para cargas ligeras.
(Símbolo)
217
NOTA: Este procedimiento puede tener que efectuarse con más
frecuencia que según se necesite, dependiendo del uso del
instrumento.
5.23
Materiales requeridos
- Una jeringa de plástico de 20 mL
- Un tubo de PVC de 20 cm, 4 mm de diámetro interno, 6 mm
de diámetro externo (las dimensiones de este tubo deben
ser tales que se ajuste sobre la jeringa en uno de los
extremos y en la línea de desechos en el otro extremo).
- 20 mL de agua desionizada
- Un contenedor para el agua desionizada.
Preparación
Quite la aguja de la jeringa de plástico (en caso necesario)
y ajuste el tubo de PVC en el extremo de la jeringa. Llene
la jeringa con agua desionizada.
218
Procedimiento
Haga clic en el botón de Diagnóstico en la barra del menú
Principal y seleccione Posición de Agujas para el submenú de
Diagnóstico. Lo anterior hará que el brazo se mueva hacia la
parte superior del sujetador del rotor.
Retire el reservorio de enjuague y límpielo en caso necesario
(consulte la Sección 5.2.3).
Introduzca el extremo libre del tubo de PVC en la línea de
desechos (orificio en el área de reservorio de enjuague).
Inyecte cuidadosamente el agua desionizada en la línea de
desechos y verifique que el líquido fluya de la línea de
desechos exterior del instrumento al contenedor de desechos.
Repita el procedimiento varias veces para asegurar la
eliminación de cualquier bloqueo potencial.
Reemplace el reservorio de enjuague. Haga clic en el icono
de Parar y confírmelo con OK; el brazo regresa a la posición
de desechos y el ACL regresa al Estado de Listo.
• Reemplazo de la Aguja
- Oprima el icono de Abrir/Cerrar Cubierta de Rotor para
abrir la cubierta del rotor.
- Haga clic en el botón de Diagnóstico en la barra del menú
Principal y seleccione Posición de Agujas en el submenú
de Diagnóstico. El brazo de las agujas se mueve sobre el
sujetador del rotor.
- Rotule los dos tubos que conectan con el conjunto de
agujas (es decir, superior e inferior).
- Afloje la perilla blanca en la parte posterior de la
aguja, desconecte la tubería, desconecte el cable del
sensor y retire el bloque de agujas.
- Introduzca el nuevo bloque de agujas, conecte el cable
del sensor, conecte los dos tubos y conecte el bloque de
manera más alta que la superficie superior del brazo.
Siga el procedimiento de posicionamiento de la aguja como se
describe en la siguiente sección.
5.24
• Procedimiento de Posicionamiento de las Agujas
El procedimiento para el reposicionamiento o el ajuste de las
agujas de muestreo/surtido del ACL es necesario en las
situaciones siguientes:
- después de haber desarmado el bloque de agujas para
limpieza, o descontaminación de las agujas
- después de haber cambiado el bloque de agujas
Procedimiento
- A fin de verificar el centrado de las agujas con la
cubierta abierta, oprima el icono de Abrir/Cerrar la
Cubierta del Rotor para abrir la cubierta del rotor.
219
- Introduzca la “herramienta de alineación de las agujas”
(una herramienta especial en el estuche de embarque) en
el sujetador de rotor con el lado A hacia arriba
(consulte las figuras en las páginas siguientes).
- Haga clic en el botón de Diagnóstico en la barra del menú
Principal y seleccione Posición de Agujas en el submenú
de Diagnóstico. Una pantalla de ¿Abrir Cubierta? Sí/No
mostrará si no se abrió la cubierta con anterioridad.
Haga clic en Sí para abrir la cubierta. El brazo de las
agujas se mueve sobre el sujetador del rotor.
- Afloje la perilla blanca en la parte posterior del brazo
de las agujas y mueva el bloque de agujas (o introduzca
uno nuevo), de manera de que su superficie superior quede
más alta que la superficie superior del brazo.
(Ilustración)
- Haga clic en el botón de Subir/Bajar Brazo para bajar el
brazo al sujetador del rotor sobre la herramienta.
5.25
- Ajuste la altura del bloque de agujas de manera de que
las agujas toquen la superficie superior de la
herramienta y confirme que las dos agujas coincidan con
los dos puntos blancos de referencia sobre la superficie
de la herramienta.
- Apriete las agujas utilizando la perilla de brazo blanca,
asegurándose de que la posición no haya cambiado después
de apretar.
- Haga clic en el botón de Subir/Bajar Brazo para hacer que
suba el brazo.
- Quite la herramienta e introduzca un rotor de ACL; empuje
manualmente el centro del resorte de presión del rotor
para ajustar el rotor de manera apropiada.
- Haga clic en el botón de Subir/Bajar Brazo para bajar el
brazo y verifique que las agujas entren en los orificios
del rotor (posición de cuveta 1) sin tocar los bordes de
los orificios.
- Haga clic en el botón de Subir/Bajar Brazo para hacer que
suba el brazo.
- Haga clic en el botón de Girar para mover el rotor a la
siguiente posición (cuveta 6 del rotor) y repita el mismo
procedimiento (como para la posición de cuveta 1).
- Repita como antes para las posiciones de cuvetas números
11, 16 y 1.
- Cuando el centrado de las agujas sea correcto, como se
muestra en los ejemplos A y B de la figura de Alineación
de las Agujas, proceda al siguiente paso. En caso de que
las agujas no estén centradas, corrija la posición.
- Retira el rotor manualmente.
220
- Haga clic en el icono de Parar y confírmelo con OK.
- El brazo regresa a la posición del reservorio de enjuague
de desechos.
- A fin de verificar el centrado de las agujas con la
cubierta cerrada, haga clic en el botón de Diagnóstico y
seleccione nuevamente Posición de Agujas.
- El brazo de las agujas se mueve sobre el sujetador del
rotor.
- Verifique que las agujas estén contenidas en los
orificios de la cubierta del rotor.
- Oprima PARAR y confirme con (símbolo) y el brazo regresa
a la posición del reservorio de desechos.
- Efectúe un ciclo de Cebado (ver la Sección 5.1.1).
(Símbolo)
NOTA: La alineación de las agujas puede no ser idéntica para
las cuatro cuvetas del rotor sometidas a prueba. En caso de
que una aguja/agujas no entren en el orificio/orificios del
rotor, o en caso de que la aguja para muestras esté ubicada a
la derecha del centro en cualquier cuveta dada (como en el
ejemplo C de la figura a continuación), deben reajustarse las
agujas en la cuveta en donde esté más alejada a la derecha y
debe repetirse el procedimiento entero.
5.26
Herramienta de Posicionamiento de las Agujas: Vista Superior
Puntos de Referencia
(Ilustración)

Herramienta de Posicionamiento de las Agujas: Vista Lateral


Puntos de Referencia
(Ilustración)
5.27
Alineación de las Agujas
(Ilustración)
Sonda de muestras centrada o desviada hacia la izquierda
• Reemplazo de la Lámpara de Halógeno
Esta operación debe ser efectuada por un Ingeniero de
Servicio Representativo de IL.
5.28
5.2.7 Procedimiento de Descontaminación
Introducción
Esta sección describe el procedimiento que se utilizará para
descontaminar el ACL Elite/Elite Pro, ya sea como una
precaución general para evitar y eliminar la contaminación
bacteriana potencial, o después de utilizar el sistema para
someter a prueba una muestra sumamente infecciosa (es decir,
sujetos positivos para Antígeno de Australia y/o positivos
para VIH, etc.).
(Símbolo)
221
Advertencia: En caso de que ocurriera el derrame de una
muestra no infectada durante el curso del uso normal del
sistema, limpie las áreas afectadas siguiendo el
procedimiento que se indica en la Sección 5.2.3.
El uso del sistema ACL para el análisis de muestras
infecciosas conocidas o de las que se tiene sospecha, debe
incluir la desinfección cuidadosa posterior de las
superficies y partes del instrumento que han estado en
contacto con las muestras. El agente de desinfección
utilizado para efectuar el procedimiento indicado a
continuación es una dilución de 1:8 de Agente Limpiador IL
P/N 98327-00, que es una solución de hipoclorito de sodio con
una concentración menor de 0.625% de cloro disponible. La
solución diluida a 1:8 se prepara mezclando 1 parte de Agente
Limpiador con 7 partes de agua destilada.
(Símbolo)
ADVERTENCIA: Utilice solamente el Agente Limpiador IL (P/N
98327-00) diluido 1:8 con agua destilada.
PRECAUCIÓN: El uso de Agente Limpiador IL sin diluir puede
ocasionar la corrosión de partes metálicas.
Procedimiento de Descontaminación
Materiales requeridos
- 2 frasquitos de vidrio (23 mm de diámetro, 10 mL de
volumen máximo).
- Prepare aproximadamente 16 mL de solución de Agente
Limpiador Diluido (mezcle 1 parte de Agente Limpiador IL
y 7 partes de agua destilada; por ejemplo, 2 mL de Agente
Limpiador y 14 mL de agua destilada).
Cargue las posiciones R6 y R7 de reactivos en el ACL:
- Posición de reactivo R6 – Coloque el frasquito de vidrio
lleno con 8 mL de solución de Agente Limpiador diluido.
- Posición de reactivo R7 – Coloque el frasquito de vidrio
lleno con 8 mL de solución de Agente Limpiador diluido.
- Seleccione Diagnóstico; seleccione Limpieza a
continuación.
- Oprima Iniciar.
5.29
Al terminar el ciclo de limpieza, el ACL regresa a la
pantalla de limpieza.
Reemplace la solución Limpiadora con Diluyente de Factor y
repita el procedimiento.
Oprima el botón de cancelar para regresar a la pantalla
principal.
Consulte la sección 5.1.2 para mayores detalles sobre el
ciclo de limpieza.
Retire los frasquitos de las posiciones R6 y R7.
Efectúe un ciclo de Cebado.
222
Reemplace el tubo de desechos exterior y el contenedor de
desechos.
NOTAS:
Los artículos desechados deben colocarse en un contenedor
apropiado para incineración ulterior, de acuerdo con los
reglamentos locales apropiados.
En caso de que se tenga sospecha de una contaminación severa,
reemplace la tubería y deseche la antigua en un contenedor
apropiado para incineración ulterior de acuerdo con los
reglamentos locales apropiados.
5.30
5.3 Tabla de Mantenimiento
Procedimiento de Mantenimiento
Diario - Vacíe, en caso necesario, el contenedor de desechos
líquidos.
- Al principio y al final de cada día de trabajo o una vez por
turno, lleve a cabo un ciclo de cebado.
- Quite y deseche los rotores usados del sujetador de rotor
al final de la operación.
Semanal - Efectúe un procedimiento de limpieza del instrumento
limpiando todas las superficies expuestas y el interior del
automuestreador y los compartimientos de rotores, con
excepción del sujetador del rotor, con un trapo empapado
en una solución diluida de Solución Limpiadora IL (P/N
98317-00) y enjuague con agua desionizada (limpie el
sujetador del rotor con Agente Limpiador IL diluido (P/N
98327-00).
- Efectúe un procedimiento de limpieza para las agujas
llevando a cabo un ciclo de limpieza especializado.
- Efectúe un procedimiento de limpieza del reservorio de
desechos de enjuague.
Quincenal - Limpie con un aplicador de punta de algodón:
- La superficie de fibra óptica de la lámpara de halógeno
- El sensor LED
- La superficie de fibra óptica del LED
- Los 20 orificios del sujetador del rotor
4 Semanas - Verifique el filtro de aire
Anual - Reemplace el filtro de aire
- Reemplace los tubos de muestras y reactivos
- Reemplace el tubo de desechos
- Reemplace el bloque de agujas
- Reemplace el reservorio de desechos
Según sea necesario - Efectúe un procedimiento de limpieza de la línea de
desechos al final de cada día de trabajo o con más
frecuencia cuando el número de muestras lo haga
necesario.
- Efectúe un procedimiento de posicionamiento de agujas.
223
224

ACL ELITE
ACL ELITE PRO Número de Serie: Mes:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Diariamente
Efectúe el Cebado del
Sistema
Vacíe Desechos
Líquidos y de Rotores

Semanal
Efectúe el Ciclo de
Limpieza
Limpie el Reservorio
de Enjuague

Quincenal
Limpie los Sensores
Ópticos

Mensual
Limpie el Filtro de Aire
225
6.1
Localización de Fallas
6.0 Introducción
Seguir los lineamientos de Mantenimiento que se describen
en la Sección 5 de este Manual, es de primordial
importancia para mantener el sistema ACL Elite/Elite Pro en
buenas condiciones de trabajo y para reducir a un mínimo
las fallas del instrumento.
En el caso de un mal funcionamiento, el ACL notifica
automáticamente al usuario acerca de la situación por medio
de un sistema de advertencias y alarmas. Con la ayuda de
verificaciones incorporadas al sistema y los lineamientos
que proporciona esta Sección, el usuario podría resolver la
mayoría de los problemas que pudieran surgir.
6.1 Fallas, Alarmas y Advertencias
Las siguientes definiciones generales se aplican a los
tipos de mensajes que muestra el ACL Elite/Elite Pro en
caso de problemas del sistema.
• Una ADVERTENCIA, que se muestra en forma de un ICONO
amarillo en la parte inferior de la pantalla, anuncia
un problema al usuario. Al hacer clic en el icono,
permite ver el texto que describe al problema. Como
regla general, puede continuar usándose el instrumento
con algunas limitaciones, dependiendo del problema.
• Una ALARMA advierte al usuario acerca de un problema
que necesita atención inmediata. Algunas subfunciones
y operaciones del sistema estarán todavía disponibles.
En caso de que persista la falla después de que el
operador apague al instrumento y lo vuelva a encender
(en caso de que se sugiera esto), debe turnarse el
problema a un Ingeniero de Servicio.
• Un mensaje de FALLA indica un problema lo
suficientemente grave que impide el uso ulterior del
instrumento y requiere la intervención de un Ingeniero
de Servicio.
Todas las Advertencias, Alarmas y Fallas están agrupadas en
las 10 categorías siguientes, dependiendo de su origen.
Cada grupo se aborda en las Secciones que se indican a
continuación:
- Anomalías del sistema Sección 6.1.1
- Anomalías del REM (Módulo Intercambiador de Calor) Sección 6.1.2
- Anomalías de temperatura Sección 6.1.3
- Anomalías mecánicas Sección 6.1.4
- Anomalías de la estación de adquisición Sección 6.1.5
- Anomalías de los líquidos Sección 6.1.6
- Anomalías ópticas Sección 6.1.7
- Anomalías operarivas Sección 6.1.8
- Anomalías de análisis sintáctico y carga Sección 6.1.9
- Anomalías de la base de datos Sección 6.1.10
226
6.2
6.1.1 Anomalías del Sistema

FALLAS
Mensaje de Error Posible Explicación Acción para Remediar
Paro térmico del ACL La temperatura en el interior del Ponerse en contacto con el Servicio
analizador es más elevada de 75ºC.
El instrumento se para
automáticamente.
Paro del ACL La corriente de salida del suministro Ponerse en contacto con el Servicio
de +5V es más elevada de 11 A. El
instrumento se para
automáticamente.
Falla del disco duro Problema con el controlador o disco Ponerse en contacto con el Servicio
duro dañado
Falla del disco flexible Problema con el controlador o disco Ponerse en contacto con el Servicio
flexible dañado
Falla de la memoria RAM Bios halla un problema con RAM Ponerse en contacto con el Servicio
Disco duro lleno El disco duro está lleno Ponerse en contacto con el Servicio
Archivo de Abertura Archivo de abertura crítico faltante Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
Alarma de longitud de archivo Longitud errónea de un archivo Volver a cargar el software principal;
crítico en caso de que la falla persista,
póngase en contacto con el Servicio
Alarma de lectura de archivo Lectura faltante de un archivo crítico Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
Alarma de escritura de archivo Escritura faltante de un archivo Volver a cargar el software principal;
crítico en caso de que la falla persista,
póngase en contacto con el Servicio
Alarma de cierre de archivo Cierre faltante de un archivo crítico Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
Memoria agotada Memoria principal agotada Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio

6.3
Error al abrir una ventana Error mientras se abrió una ventana Volver a cargar el software principal;
en principal en caso de que la falla persista,
póngase en contacto con el Servicio
Error del administrador maestro Error en el administrador de errores Volver a cargar el software principal;
principal en caso de que la falla persista,
póngase en contacto con el Servicio
Mensaje interno inesperado Mensaje interno inesperado en Volver a cargar el software principal;
principal en caso de que la falla persista,
póngase en contacto con el Servicio
Falla en el envío interno El envío interno falló en principal Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
Error en la creación de la Error mientras se crea una fila o Volver a cargar el software principal;
fila/semáforo semáforo en principal en caso de que la falla persista,
póngase en contacto con el Servicio
Error en la instalación de excitador Error mientras se instala Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
227
Error de asignación de cronómetro Error mientras se asigna cronómetro Volver a cargar el software principal;
en principal en caso de que la falla persista,
póngase en contacto con el Servicio
Error de biblioteca interno Error interno en la biblioteca en Volver a cargar el software principal;
principal en caso de que la falla persista,
póngase en contacto con el Servicio
Error de análisis sintáctico de Error en la longitud del mensaje de Volver a cargar el software principal;
longitud principal a subordinado en caso de que la falla persista,
póngase en contacto con el Servicio
Error de análisis sintáctico de Error en la clave del mensaje Volver a cargar el software principal;
subtipo (subtipo) de principal a subordinado en caso de que la falla persista,
póngase en contacto con el Servicio
Error de análisis sintáctico de tipo Error en la clave del mensaje Volver a cargar el software principal;
(subtipo) de principal a subordinado en caso de que la falla persista,
póngase en contacto con el Servicio
Parámetro inválido Error en el mensaje de parámetro Volver a cargar el software principal;
de principal a subordinado en caso de que la falla persista,
póngase en contacto con el Servicio

6.4
Falla de la base de datos Error importante en el manejo de la Volver a cargar el software principal;
base de datos en caso de que la falla persista,
póngase en contacto con el Servicio
Falla de SW Codificada Error importante en el manejo de la Volver a cargar el software principal;
clave en caso de que la falla persista,
póngase en contacto con el Servicio
ALARMAS
Mensaje de Error Posible Explicación Acción para Remediar
Falla de comunicación con Principal y subordinado no se Volver a cargar el software principal;
subordinado comunican en caso de que la falla persista,
póngase en contacto con el Servicio
Falla de convertidor A/D Error periódico mientras se maneja Volver a cargar el software principal;
ADC en caso de que la falla persista,
póngase en contacto con el Servicio
Clave faltante de subordinado Clave de subordinado faltante Volver a cargar el software principal;
en caso de que la falla persista,
póngase en contacto con el Servicio
Error al bajar subordinado Falla al cargar la clave de Volver a cargar el software principal;
subordinado en caso de que la falla persista,
póngase en contacto con el Servicio
Error DB de verificación Error de uniformidad en la base de Volver a cargar el software principal;
datos en caso de que la falla persista,
póngase en contacto con el Servicio
Error de parámetros de verificación Error en la uniformidad de los Volver a cargar el software principal;
parámetros en caso de que la falla persista,
póngase en contacto con el Servicio
ADVERTENCIAS
Advertencia térmica del analizador* La temperatura en el interior del Apague el sistema, espere unos
analizador es más elevada de 60ºC cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Error de comunicación con REM Comunicación faltante con REM. Apague el sistema, espere unos
Falta el software o REM no está cuantos segundos y vuélvalo a
funcionando encender. En caso de que el error
persista, póngase en contacto con
el Servicio
228
Error de comando de REM (N/A en El comando no se ejecutó Apague el sistema, espere unos
el ACL Elite correctamente cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Error al bajar REM (N/A en el ACL No se ejecutó la bajada Apague el sistema, espere unos
Elite) correctamente cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Error de restauración de DB (Base Falla al restaurar la base de datos Apague el sistema, espere unos
de Datos) cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Error de respaldo de DB Falla al respaldar la base de datos Apague el sistema, espere unos
cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Advertencia de abertura de archivo Abertura faltante de un archivo no Apague el sistema, espere unos
crítico cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Advertencia de longitud de archivo Longitud incorrecta de un archivo no Apague el sistema, espere unos
crítico cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Advertencia de lectura de archivo Lectura faltante de un archivo no Apague el sistema, espere unos
crítico cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Advertencia de escritura de un Escritura faltante de un archivo no Apague el sistema, espere unos
archivo crítico cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio

6.6
Advertencia de cierre de archivo Cierre faltante de un archivo no Apague el sistema, espere unos
crítico cuantos segundos y vuélvalo a
encender. En caso de que el error
persista, póngase en contacto con
el Servicio
Disco flexible lleno El disco flexible actual está lleno Reemplácelo con un nuevo disco
flexible o unidad de Disco
Disco flexible faltante* Falta el disco flexible actual Verifique el disco flexible en la
unidad de disco.
Escritura de disco flexible protegida* Escritura protegida del disco flexible Reemplácelo con un nuevo disco
actual flexible
Falla de la impresora** La impresora no está conectada o Verifique la impresora y la conexión
no está funcionado
Fin del papel No hay más papel en la impresora Vuelva a cargar papel de impresora
229

Falla de BCR (Lector de Código de El lector de código de barras interno Apague el sistema, espere unos
Barras Interno) no está funcionando cuantos segundos y vuélvalo a
encender. Vuelva a cargar el
software principal. En caso de que
el error persista, póngase en
contacto con el Servicio

*Falla Térmica
Esta advertencia indica que el instrumento se está
sobrecalentando internamente, lo que puede tener un efecto
sobre la temperatura de la cámara de medición. La razón
puede ser un filtro de aire obstruido que obstruye al flujo
de aire que entra y sale del analizador. Verifique el
filtro de aire en el lado derecho del analizador, límpielo
o reemplácelo según sea necesario, siguiendo las
instrucciones de la Sección 5 (Mantenimiento). Asegúrese de
que haya flujo de aire libre y que la temperatura ambiente
del aire sea menor de 35ºC.
NOTA: El ACL Elite/Elite Pro trabaja de manera óptima
cuando la temperatura ambiente está en el rango de 15 a
32ºC y no falla en el rango de 10 a 40ºC.
En caso de que la limpieza del filtro de aire no resuelva
la advertencia y la temperatura ambiente esté dentro de los
límites, póngase en contacto con el Servicio.
**Falla de la Impresora
En caso de que la impresora no produzca una impresión
debido a una falla de la impresora, pueden obtenerse los
resultados del video. Los resultados transmitidos por medio
del vínculo de datos RS232 C (cuando esté conectado y
activado) son también correctos.
A fin de efectuar la localización de fallas de la
impresora, verifique que el papel esté cargado
correctamente. Verifique también que se haya seleccionado
el protocolo de transmisión apropiado en el Ajuste del ACL
Elite/Elite Pro (ESCP2 o PCL) y que la impresora soporte al
protocolo de emulación seleccionado.
*El error real mostrado variará dependiendo del submenú en
donde se hizo la solicitud. En caso de que la falla
persista, póngase en contacto con el Servicio.

6.7
6.1.2 Anomalías de REM (Módulo de Intercambio de Rotores)
*(N/A en el ACL Elite)
FALLAS
Mensaje de Error Posible Explicación Acción para Remediar
Falla eléctrica de REM Falla eléctrica de REM Salga de la sesión.
Apague el sistema, espere unos
cuantos segundos y vuélvalo a
encender. En caso de que persista
el error, póngase en contacto con el
Servicio
230
Voltaje de REM fuera de rango Voltaje de REM fuera de rango Salga de la sesión.
Apague el sistema, espere unos
cuantos segundos y vuélvalo a
encender. En caso de que persista
el error, póngase en contacto con el
Servicio
Alarma vertical de REM Falla del motor del brazo vertical de Verifique que no haya ninguna
REM obstrucción que interfiera con el
movimiento. En caso de que no
haya ninguna obstrucción, pero el
error persiste, puede utilizarse el
sistema en el modo manual
desactivando al REM. En caso de
que persista el error, póngase en
contacto con el Servicio.
Alarma horizontal de REM Falla del motor del brazo horizontal Verifique que no haya ninguna
de REM obstrucción que interfiera con el
movimiento. En caso de que no
haya ninguna obstrucción, pero el
error persiste, puede utilizarse el
sistema en el modo manual
desactivando al REM. En caso de
que persista el error, póngase en
contacto con el Servicio.
Alarma de transportador de REM Falla del motor del transportador Verifique que no haya ninguna
obstrucción que interfiera con el
movimiento. En caso de que no
haya ninguna obstrucción, pero el
error persiste, puede utilizarse el
sistema en el modo manual
desactivando al REM. En caso de
que persista el error, póngase en
contacto con el Servicio.

6.8
Falla de CPU de REM Falla de CPU de REM Verifique que no haya ninguna
obstrucción que interfiera con el
movimiento. En caso de que no
haya ninguna obstrucción, pero el
error persiste, puede utilizarse el
sistema en el modo manual
desactivando al REM. En caso de
que persista el error, póngase en
contacto con el Servicio.
Falla del EM (Módulo de Falla de EM del Brazo El sistema puede utilizarse en el
Intercambio) del brazo de REM modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio
Falla del Controlador de EM del Falla del circuito del brazo El sistema puede utilizarse en el
brazo de REM modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio
Falla de EM del transportador de Falla de EM del Transportador El sistema puede utilizarse en el
REM modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio
Falla del controlador de EM del Falla del circuito del transportador El sistema puede utilizarse en el
transportador de REM modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio
231

Falla de EM de Apilamiento de REM Falla de EM de Apilamiento El sistema puede utilizarse en el


modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio
Falla del controlador de EM de Falla del circuito de apilamiento El sistema puede utilizarse en el
apilamiento de REM modo manual desactivando al REM.
En caso de que persista el error,
póngase en contacto con el Servicio

Los errores de REM pueden generarse cuando se abre la


puerta de Desechos de Rotores mientras el analizador está
ejecutando un intercambio de rotor.
6.9
6.1.3 Anomalías de Temperatura
ALARMAS (ver también las notas al final de esta tabla)
Mensaje de Error Posible Explicación Acción para Remediar
Apagado Térmico El circuito de energía está apagado Salga de la sesión. Apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
La temperatura de incubación está La temperatura de incubación está Permita que transcurran 30 minutos
fuera del rango al iniciar. fuera del rango después de después de encender para permitir
encender la estabilización de la temperatura.
En caso de que persista el error,
póngase en contacto con el Servicio
La temperatura de incubación está La temperatura de incubación está Puede aparecer un mensaje por
fuera del rango fuera del rango durante la operación unos cuantos segundos en caso de
normal que la cubierta del rotor se haya
dejado abierta. En caso de que
persista la advertencia después de
que la cubierta del rotor se haya
cerrado por varios minutos, póngase
en contacto con el Servicio
Peltier fuera de rango al iniciar La temperatura de Peltier está fuera Espere 30 minutos después de
de rango después de encender encender. En caso de que persista
Ver la Nota 1 la advertencia, póngase en contacto
con el Servicio. Aunque la
refrigeración del reactivo no esté
funcionando correctamente, puede
continuar utilizándose el sistema
siempre y cuando se dejen los
reactivos en el analizador solamente
por el tiempo requerido para las
pruebas.
Peltier fuera de rango La temperatura de peltier está fuera En caso de que persista la
de rango durante la operación advertencia, póngase en contacto
normal. con el Servicio. Aunque la
Ver la Nota 1 refrigeración del reactivo no esté
funcionando correctamente, puede
continuar utilizándose el sistema en
tanto que queden reactivos en el
analizador, solamente por el tiempo
requerido para las pruebas.
232
6.10
Transportador fuera de rango al La temperatura del transportador Espere 30 minutos después de
iniciar está fuera de rango al iniciar. encender. En caso de que persista
(N/A en el ACL Elite) Ver la Nota 2. la advertencia, póngase en contacto
con el Servicio. Entre tanto, aunque
la regulación térmica del
transportador del rotor no esté
funcionando correctamente, puede
utilizarse el sistema
Transportador fuera de rango La temperatura del transportador En caso de que persista la
(N/A en el ACL Elite) está fuera de rango advertencia, póngase en contacto
Ver la Nota 2 con el Servicio. Entre tanto, aunque
la regulación térmica del
transportador del rotor no esté
funcionando correctamente, puede
utilizarse el sistema
Apilamiento fuera de rango al iniciar La temperatura del apilamiento de En caso de que persista la
rotores está fuera de rango al iniciar advertencia, póngase en contacto
Ver la Nota 2 con el Servicio. Entre tanto, aunque
la regulación térmica del apilamiento
de rotores no esté funcionando
correctamente, puede utilizarse el
sistema
Apilamiento fuera de rango La temperatura del apilamiento de En caso de que la temperatura esté
rotores está fuera de rango fuera de rango, puede utilizarse el
Ver la Nota 2 sistema siempre y cuando se
procese el Control de Calidad
durante la sesión y que los
resultados estén dentro de los
límites establecidos. En caso de que
persista el error, póngase en
contacto con el Servicio
NOTAS:
1. Mensaje de Error:¨ Temperatura de Peltier fuera de
Rango
Explicación: La temperatura está fuera del
rango
Acción para Remediar: Seleccione DIAGNÓSTICO en el Menú
Principal y seleccione CONTROL
DE TEMPERATURA a continuación.
- En caso de que el video muestre---o ****para el
Peltier, la temperatura puede ser muy alta o muy baja.
Puede continuar utilizándose el instrumento siempre y
cuando...
6.11
...dejen los reactivos a bordo solamente por la
duración de las pruebas y que se refrigeren
posteriormente. Póngase en contacto con el Servicio.
- En caso de que el video muestre un valor de temperatura
de 4 a 12ºC para el Peltier, el sistema es totalmente
operativo y necesitan tomarse precauciones.
Sin embargo, debe llamarse al Ingeniero de Servicio
para que rectifique la situación.
- En caso de que el video muestra un valor de temperatura
baja (de 20 a 36ºC), verifique que la temperatura
ambiente no sea más elevada de 32ºC. En caso de que no
233
se corrija el problema, póngase en contacto con el
Servicio.
NOTA: Como se hizo notar arriba, una temperatura elevada
puede ser ocasionada por filtros sucios o una temperatura
ambiente fuera del rango de operación óptimo.
2. Mensaje de Error: La Temperatura del Transportador
o del Apilamiento está fuera de
rango.
Explicación: La temperatura está fuera del
rango de 36-39ºC.
Acción para Remediar: Seleccione DIAGNÓSTICO en el
Menú Principal y seleccione
CONTROL DE TEMPERATURA a
continuación.
- En caso de que el video muestre --- o ****para las
temperaturas del transportador o el apilamiento y que
el instrumento se haya calentado debidamente, póngase
en contacto con el Servicio.
- En caso de que el video muestre un valor de temperatura
elevado (de 36 a 50ºC), verifique el filtro de aire y
las condiciones ambientales, según se indica en el
punto 6.1.1 (página 6.7). en caso de que persista el
problema, póngase en contacto con el Servicio.
- En caso de que el video muestre un valor de temperatura
bajo (de 20 a 36ºC), verifique que el instrumento se
haya calentado de manera apropiada y que la temperatura
ambiente sea mayor de 15ºC. En caso de que no se
corrija el problema, póngase en contacto con el
Servicio.
NOTA: El sistema es completamente operativo aunque la
temperatura del precalentador esté fuera de rango, a menos
de que aparezca “TEMPERATURA DE INCUBACIÓN FUERA DE RANGO”
al principio del análisis.
6.12
6.1.4 Anomalías Mecánicas
ALARMAS
Mensaje de Error Posible Explicación Acción para Remediar
Alarma del automuestreador Problema con el automuestreador Salga de la sesión. Apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Alarma del rotor Problema con el sujetador del rotor Salga de la sesión. Apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Alarma del motor horizontal Problema con el brazo del motor Salga de la sesión. Apague el
horizontal sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
234

Alarma de motor vertical Problema con el brazo del motor Salga de la sesión. Apague el
vertical sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Alarma de diluyente de reactivo Problema con el diluyente de Salga de la sesión. Apague el
Reactivos sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Alarma del diluyente de muestras Problema con el diluyente de Salga de la sesión. Apague el
muestras sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Alarma de la cubierta Problema con la cubierta del rotor Salga de la sesión. Apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio

6.13
ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Advertencia del automuestreador Problema intermitente con el Salga de la sesión. Apague el
automuestreador sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Advertencia del rotor Problema intermitente con el Verifique que no haya ninguna
sujetador del rotor obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
Advertencia del motor horizontal Problema intermitente con el brazo Verifique que no haya ninguna
del motor horizontal obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
Advertencia del motor vertical Problema intermitente con el brazo Verifique que no haya ninguna
del motor vertical obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
Advertencia del diluyente de Problema intermitente con el Verifique que no haya ninguna
reactivos diluyente de reactivos obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
Advertencia del diluyente de Problema intermitente con el Verifique que no haya ninguna
muestras diluyente de muestras obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
235

Advertencia de la cubierta Problema intermitente con la Verifique que no haya ninguna


cubierta del rotor obstrucción que interfiera con el
movimiento. En caso de que
persista el error, póngase en
contacto con el Servicio
Falla del agitador El agitador magnético no está Puede utilizarse el sistema sin
funcionando agitación del reactivo. En este caso,
el reactivo debe mezclarse bien
antes de cada corrida. En caso de
que persista el error, póngase en
contacto con el Servicio.

6.14
6.1.5 Anomalías de la Estación de Adquisición
FALLAS
Mensaje de Error Posible Explicación Acción para Remediar
Alarma de terminación del tiempo La adquisición ha corrido por más Apague el sistema, espere unos
de adquisición de 30 minutos. cuantos segundos y enciéndalo
nuevamente. En caso de que
persista el error, póngase en
contacto con el Servicio

ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Error al iniciar adquisición No se encuentró la posición de base Verifique que no haya ninguna
al comenzar obstrucción que interfiera con el
movimiento. En caso de que
persista el error, apague el sistema,
espere unos cuantos segundos y
vuélvalo a encender. En caso de
que persista el error, póngase en
contacto con el Servicio
Error de sincronización de No se encuentró la posición de base Verifique que no haya ninguna
adquisición al comenzar obstrucción que interfiera con el
movimiento. En caso de que
persista el error, apague el sistema,
espere unos cuantos segundos y
vuélvalo a encender. En caso de
que persista el error, póngase en
contacto con el Servicio
Error de interrupción de adc Interrupción inesperada de ADC Salga de la sesión, apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de interrupción de cuveta Interrupción inesperada de cuveta Salga de la sesión, apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de centrífuga de adquisición Sujetador de rotor bloqueado Verifique que no haya ninguna
obstrucción. Salga del sistema,
apague el sistema, espere unos
cuantos segundos y vuélvalo a
encender.. En caso de que
persista el error, póngase en
contacto con el Servicio
236

6.15
Error tx de adquisición Incapaz de Transmitir datos Salga de la sesión, apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de falla del rotor de Falla del rotor Salga de la sesión, apague el
adquisición sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de referencia óptica de Falla de la referencia óptica Salga de la sesión, apague el
adquisición sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de referencia de adquisición Falla de la emulsión de referencia Salga de la sesión, apague el
sistema, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error de abertura de cubierta de Cubierta abierta durante la Verifique que la cubierta del rotor
adquisición adquisición esté cerrada. En caso de que la
cubierta esté cerrada, pero persista
el error, salga de la sesión, espere
unos cuantos segundos y vuélvalo a
encender. En caso de que persista
el error, póngase en contacto con el
Servicio

6.1.6 Anomalías de Líquidos


ALARMAS
Mensaje de Error Posible Explicación Acción para Remediar
Lavado corto La Emulsión de Referencia no está Verifique si el nivel del líquido de la
presente. botella de Lavado-R está bajo,
reemplácela con una nueva botella.
En caso de que esté presente
líquido suficiente, el usuario puede
desactivar temporalmente al sensor
de Lavado-R. Por lo tanto, es la
responsabilidad del operador
verificar el nivel de Lavado-R. en
caso de que persista el error con el
sensor activado, póngase en
contacto con el Servicio.
237
6.16
ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Advertencia de lavado La Emulsión de Referencia está por Verifique el nivel del líquido de la
debajo del nivel de 100 mL botella de Lavado-R. en caso de
que el nivel del líquido sea bajo,
reemplácela con una nueva botella.
En caso de que esté presente
líquido suficiente, el usuario puede
desactivar temporalmente al sensor
de Lavado-R. Por lo tanto, es la
responsabilidad del operador
verificar el nivel de Lavado-R. en
caso de que persista el error con el
sensor activado, póngase en
contacto con el Servicio.
Sensor de líquido de muestras El sensor de la aguja externa En caso de que el sensor esté
Apagado (muestra) está apagado desactivado, es la responsabilidad
del operador verificar los niveles
apropiados de líquido. En caso de
que persista el error con el sensor
activado, póngase en contacto con
el Servicio
Sensor de líquido de reactivos El sensor de la aguja interna En caso de que el sensor esté
apagado (reactivo) está apagado desactivado, es la responsabilidad
del operador verificar los niveles
apropiados de líquido. En caso de
que persista el error con el sensor
activado, póngase en contacto con
el Servicio
Falla del sensor de líquido de Error del sensor del circuito de la En caso de que el sensor esté
muestras aguja externa (muestra) desactivado, es la responsabilidad
del operador verificar los niveles
apropiados de líquido. En caso de
que persista el error con el sensor
activado, póngase en contacto con
el Servicio
Falla del sensor de líquido de Error del sensor del circuito de la En caso de que el sensor esté
reactivos aguja interna (reactivo) desactivado, es la responsabilidad
del operador verificar los niveles
apropiados de líquido. En caso de
que persista el error con el sensor
activado, póngase en contacto con
el Servicio

6.17
Muestra escasa en posición xxx Muestra insuficiente en posición xxx Se detectó un nivel de muestra
insuficiente. Cuando se utilice un
tubo, transfiera la muestra restante
a una copa de muestras y repita la
prueba. En caso de que haya
muestra suficiente presente, pero
persista el error, póngase en
contacto con el Servicio.
238

No se efectuó la limpieza No se efectuó la limpieza debido a En caso de que aparezca el error


la insuficiencia de solución durante un análisis, verifique el nivel
limpiadora o a que no hay presente del material de limpieza y efectúe un
ninguna ciclo de limpieza. En caso de que
haya material suficiente presente,
pero persista el error, póngase en
contacto con el Servicio
La estabilidad del material a bordo Ha expirado el intervalo del Reemplace el material y reajuste el
expiró en la posición “XX” cronómetro para un material a cronómetro a bordo.
bordo. Este material se mostrará en
color anaranjado en el mapa de
materiales
“ID” de Líquido Insuficiente Una Identificación de Líquido de Se detectó un nivel de material
carácter específico y no obligatorio, insuficiente. Asegúrese de que el
está ausente o en cantidad nivel del material sea suficiente. En
insuficiente. caso de que haya presente material
suficiente, pero persista el error,
póngase en contacto con el
Servicio.
“ID” de Líquido de Carácter Una identificación de líquido de Se detectó un nivel de material
Obligatorio no es suficiente carácter específico y obligatorio, insuficiente. Asegúrese de que el
está ausente o en cantidad nivel del material sea suficiente. En
insuficiente caso de que haya presente material
suficiente, pero persista el error,
póngase en contacto con el
Servicio.

Mensaje de Error: Error de Lavado/Canal Óptico


Explicación: Problema con el surtido de la
Emulsión de Referencia.
Acción para Remediar:
- Verifique el nivel de la Emulsión de Referencia en la
botella. En caso de que el nivel sea menor de 1 cm,
reemplace la botella por una nueva. Mezcle mediante
inversión antes de colocar en el instrumento.
- Verifique que la Emulsión de Referencia se haya surtido
correctamente en las cuvetas del rotor en el ciclo de
análisis. Las posiciones de la Emulsión de Referencia
dependen de la prueba (mayores detalles en la Sección
7).
6.18
- En caso de que la botella de la Emulsión de Referencia
esté en su sitio y que haya líquido suficiente,
verifique que la trayectoria del fluido esté libre de
obstrucciones.
NOTA: Una manera rápida de verificar la trayectoria del
fluido es retirar el conjunto de las agujas del brazo
de muestreo. Con el uso de un vaso de laboratorio para
recolectar el líquido, efectúe un ciclo de CEBADO
automático y verifique que el líquido salga de ambas
agujas. Recuerde efectuar un AJUSTE DE LA POSICIÓN DE
LAS AGUJAS después de esta verificación (consulte la
Sección 5).
- Verifique que el LED esté ENCENDIDO.
239
- En caso de que el LED esté ENCENDIDO, efectúe la
limpieza de la trayectoria óptica como se describe en
la Sección 5 de Mantenimiento.
- En caso de que nada de lo anterior resuelva el
problema, póngase en contacto con el Servicio.
6.1.7 Anomalías Ópticas
ADVERTENCIA
Mensaje de Error Posible Explicación Acción para Remediar
Falla de la lámpara de halógeno La lámpara de halógeno no está Salga del sistema. Apague el
funcionando sistema, espere unos cuantos
segundos y vuélvalo a encender.
Puede utilizarse el sistema sin la
lámpara de halógeno para las
pruebas basadas en la cogulación
solamente. En caso de que persista
el error, póngase en contacto con el
Servicio.

6.1.8 Anomalías Operativas


ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Desechos llenos Los desechos de rotores están Vacíe el contenedor de desechos de
llenos rotores. En caso de que persista el
error después de vaciar el
contenedor, póngase en contacto
con el Servicio.
Desechos abiertos La cubierta de desechos de rotores Cierre la puerta del contenedor de
está abierta desechos de rotores. En caso de
que persista el error después de
esta acción, póngase en contacto
con el Servicio.
Ningunos rotores (REM activa) No hay más rotores en la pila de Vuelva a llenar la pila de rotores. En
rotores caso de que persista el error
después de esta acción, póngase
en contacto con el Servicio
Ningunos rotores (REM no activa) No hay más rotores en la pila de Vuelva a llenar la pila de rotores. En
rotores caso de que persista el error
después de esta acción, póngase
en contacto con el Servicio
Estación de rotores vacía No hay más rotores en la pila de Vuelva a llenar la pila de rotores. En
rotores caso de que persista el error
después de esta acción, póngase
en contacto con el Servicio

6.19

Volver a llenar con rotores Quedan solamente uno o dos Vuelva a llenar la pila de rotores. En
rotores en la pila de rotores caso de que persista el error
después de esta acción, póngase
en contacto con el Servicio
Cubierta abierta durante la La cubierta del rotor se abrió Cierre la cubierta del rotor. En caso
carga/incubación durante la operación de carga o de que persista el error después de
incubación esta acción, póngase en contacto
con el Servicio
240
El final del tiempo expiró durante la No se cumplió con el fin del tiempo Salga del sistema, apague el
carga durante la carga instrumento, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el
Servicio.
No hay ninguna prueba a efectuar No hay ninguna prueba programada Verifique que las pruebas
a efectuar en la base de datos y programadas en la base de datos
después de la pregunta a la coincidan con las pruebas de la
computadora principal sesión de múltiples pruebas.
Verifique que la conexión con la
computadora principal esté
funcionando de manera apropiada.
y que ambos estén bien, póngase
en contacto con el Servicio.
? No se efectúan ningunas pruebas Verifique la presencia de líquidos
debido a líquidos faltantes necesarios. En caso de que estén a
bordo, póngase en contacto con el
Servicio.

6.1.9 Anomalías de Análisis Sintáctico y Carga


ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Error de análisis sintáctico xxx Error hallado en los parámetros Verifique que el ajuste de la
durante la carga definición de la prueba sea exacto y
completo. Apague el instrumento,
espere unos cuantos segundos y
vuélvalo a encender. En caso de
que persista el error, póngase en
contacto con el Servicio
Error en la corrida xxx Error hallado durante la corrida Salga del sistema, apague el
instrumento, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio
Error en la sesión xxx Error hallado durante la sesión Salga del sistema, apague el
instrumento, espere unos cuantos
segundos y vuélvalo a encender. En
caso de que persista el error,
póngase en contacto con el Servicio

6.20
6.1.10 Anomalías de la Base de Datos
ADVERTENCIAS
Mensaje de Error Posible Explicación Acción para Remediar
Advertencia de la base de datos Base de Datos de Paciente a 95% o Retire datos de la base de datos
más
Base de datos llena Base de Datos de Paciente al 100% Retire datos de la base de datos

6.2 Falla en la Transmisión de Datos


El error de Transmisión de Datos se muestra cuando ha
habido un error en la transmisión de los datos en la
interfaz RS232 C,
Intente retransmitir los datos como sigue:
241
- Seleccione AJUSTE en el Menú Principal, seleccione
ESTADO DE INTERFAZ para ver las características de la
Transmisión de Datos a la Computadora Principal.
- Seleccione la conexión para la Transmisión de Datos
(ACL-computadora).
- Repita la transmisión desde la Base de Datos.
En caso de que persista la falla, póngase en contacto con
el Servicio. Para información adicional, consulte el
Apéndice (Protocolo de Comunicación con la Computadora
Principal).
6.3 Claves de Errores de la Reducción de Datos
Cualquier error que ocurra durante el proceso de reducción
de los datos se reportará como un número clave. Las
subsecciones siguientes describen todos los números de
claves de errores y sus significados. Las fuentes posibles
de los errores, identificadas mediante claves con letras,
se muestran como indicadores de acuerdo con la lista
siguiente:
Clave del Error Abreviatura Prioridad
Errores de reducción de datos R 1 (másalta)
Errores de Temperatura T 2
Errores del instrumento (es decir, error de Sensor) E 3
Errores de calibración C 4
Errores de Referencia Analítica A 5
Errores de Control de Calidad Q 6
Errores de Paralelismo P 7
Errores en Algoritmos, relación, Rangos… W 8
Errores de Materiales (es decir, caducidad) M 9 (más baja)
Las Claves de Errores, que no generarán un resultado
válido, se representan por un Número de Error. El Número de
Error se presenta en lugar de un resultado válido.
6.21
Las claves de errores que generan un resultado, más un
indicador adicional, se indican con un mensaje que explica
el error.
Los resultados con más de un error muestran el error con la
prioridad más alta.
6.3.1 Claves de Errores de la Sesión
Error 1 – Error de ningún lavado/óptico
Significado Error de ningún lavado/óptico
Causa El canal de referencia óptica neofelométrica está fuera de rango
Indicadores Ciclo abortado
Resultados Ningunos resultados en la base de datos
Acción para Remediar Reemplace la botella de Emulsión de Referencia y limpie el sistema óptico

Error 2– Error óptico


Significado Error óptico
Causa El canal de referencia óptica de absorbencia está fuera de rango (por arriba de
9.5 V o por debajo de 5.0 V)
Indicadores Ciclo abortado
Resultados Ningunos resultados en la base de datos
Acción para Remediar Limpie el sistema óptico
242
Error 3 – Ningún lavado
Significado Ningún lavado
Causa El canal de absorbencia – Emulsión de Referencia está fuera de rango (por
arriba de 3.5 V o por debajo de 0.0 V)
Indicadores Ciclo abortado
Resultados Ningunos resultados en la base de datos
Acción para Remediar Reemplace la botella de Emulsión de Referencia y limpie el sistema óptico

Error 4 – Falla óptica


Significado Falla óptica
Causa Verificación de datos de adquisición
Indicadores Ciclo abortado
Resultados Ningunos resultados en la base de datos
Acción para Remediar Reemplace la botella de Emulsión de Referencia y limpie el sistema óptico

6.22
6.3.2 Claves de Errores de la Curva de Reacción
(Símbolo)
Advertencia: Para cualquier muestra, en caso de que no se
tenga la seguridad con respecto al resultado después de
revisar la clave de error y la curva de coagulación, se
recomienda volver a correr la muestra con el uso de un
método alterno.
Clave de error – 5
Significado Falla óptica
Causa Saturación de ADC (señal por arriba de 9.5 V al final de la curva de
coagulación)
Indicadores R
Resultados Error 5 en lugar del resultado
Acción para Remediar Posible concentración elevada de Fibrinógeno. Diluya la muestra 1:1 con
Diluyente de Factor y repita la prueba.

Clave de error – 6*
Significado Ninguna coagulación
Causa No se pasó el primer umbral
Indicadores R
Resultados Error 6 en lugar del resultado
Acción para Remediar La muestra no se coaguló dentro del tiempo de adquisición. Repita la prueba
en el tiempo de adquisición extendido.

Clave de error – 7*
Significado Error de coagulación
Causa No se pasó el segundo umbral
Indicadores R
Resultados Error 7 en lugar del resultado
Acción para Remediar La curva de coagulación de la muestra tiene ruido y no proporciona una señal
de coagulación normal dentro del tiempo de adquisición. Repita la prueba en el
tiempo de adquisición extendido.

Clave de error – 8
Significado Error de coagulación
Causa El tiempo delta entre los dos umbrales es más elevado que el valor
seleccionado
Indicadores R
Resultados Error 8 en lugar del resultado
243
Acción para Remediar Posible curva de coagulación no fásica. Revise la curva de coagulación.
Posible interferencia de la muestra con la reacción de coagulación.

* = Ver más detalles en la sección 6.4.


Clave de error – 9
Significado Error de coagulación
Causa La pendiente inicial de la curva de coagulación es más elevada que el valor
seleccionado
Indicadores R
Resultados Error 9 en lugar del resultado
Acción para Remediar Posible curva de coagulación bifásica. Revise la curva de coagulación. Posible
interferencia de la muestra con la reacción de coagulación.

Clave de error – 10
Significado Error de coagulación
Causa La pendiente final de la curva de reacción es más elevada que el valor
seleccionado
Indicadores R
Resultados Error 10 en lugar del resultado
Acción para Remediar Punto final inestable de la curva de coagulación. Revise la curva de
coagulación. Posible interferencia de la muestra con la reacción de
coagulación. Repita la prueba en el tiempo de adquisición extendido.

Clave de error – 11
Significado El error delta final es una verificación de que la curva no está cayendo
demasiado después de alcanzar su lectura máxima
Causa La delta final de la curva de reacción (lectura abs máxima – lectura abs final )
es más elevada que el valor seleccionado.
Indicadores R
Resultados Error 11 en lugar del resultado
Acción para Remediar En caso de que sea una reacción nefelométrica, puede ser una indicación de
un punto final inestable en la curva de coagulación. Revise la curva de
coagulación. Posible interferencia de la muestra con la reacción de
coagulación. Repita la prueba en el tiempo de adquisición extendido
En caso de que sea una prueba de absorbencia, puede ser una indicación de
un valor de absorbencia fuera del límite especificado.

Clave de error – 12
Significado Error de coagulación
Causa El pico máximo de la primera derivada está por debajo del valor límite
seleccionado
Indicadores R
Resultados Error 12 en lugar del resultado
Acción para Remediar El pico de la primera derivada no es suficientemente significativo para indicar
un punto de reacción de coagulación real. Revise la curva de coagulación.
Repita la prueba en el tiempo de adquisición extendido.

6.24
Clave de error – 13
Significado Error de coagulación
Causa El pico máximo de la segunda derivada está por debajo del valor límite
seleccionado
Indicadores R
Resultados Error 13 en lugar del resultado
Acción para Remediar El pico de la segunda derivada no es suficientemente significativo para indicar
un punto de reacción de coagulación real. Revise la curva de coagulación.
Repita la prueba en el tiempo de adquisición extendido.
244

Clave de error – 14
Significado Error de compensación (algoritmo delta)
Causa El valor de compensación es mayor que el valor de la “Primera Parte” definido
en la sección de ajuste del cálculo de la definición de la prueba o menor que el
límite bajo del rango de la escala.
Indicadores R
Resultados Error 14 en lugar del resultado
Acción para Remediar Revise la escala del eje de las “Y” de la curva de reacción de coagulación para
determinar si el valor es alto o bajo (turbio). Vuelva a correr la Muestra.

Clave de error – 30
Significado Error de compensación (algoritmo delta)
Causa La compensación de la parte inicial de la curva está por debajo del valor límite
seleccionado
Indicadores R
Resultados Error 30 en lugar del resultado
Acción para Remediar La turbiedad de la reacción inicial es relativamente baja. Revise la curva de
reacción de coagulación. Verifique la integridad de los reactivos y asegúrese de
que no haya burbujas presentes.

Clave de error – 31
Significado No se cumple con Delta de Curva Mínima
Causa La delta total de la curva de reacción es menor que el límite especificado en el
ajuste de la prueba. (La curva de reacción es plana y la formación de
coagulación puede no haber ocurrido.
Indicadores R
Resultados Error 31 en lugar del resultado
Acción para Remediar Revise la curva y vuelva a correr la muestra. La muestra puede tener un tiempo
de coagulación extendido.

6.25
Curva de Reacción/Línea Base con Ruido (Error 32/33)
Significado Las lecturas de la línea base de la curva de reacción son erráticas
Causa Interferencia en las lecturas de la reacción
Indicadores Q – se muestra “Curva de Reacción/Línea Base con Ruido” en el cuadro de la
Lista de Advertencias cuando se muestra la curva de coagulación.
Resultados Se muestra Resultado Numérico
Acción para Remediar Revise la Curva y repita la prueba.

6.3.3 Claves de Errores de Calibración


Clave de error – 15
Significado Ninguna calibració
n – datos insuficientes (curva con un solo segmento)
Causa Menos de 2 estándares de calibración dioresultados válidos en el segmento
específico de la curva
Indicadores en las muestras C – Ninguna calibración – datos insuficientes
Resultados de la Calibración Error 15 en lugar del resultado
Acción para Remediar Resultado inválido. Revise la curva de reacción. Repita la calibración con
materiales recién preparados.
245
Clave de error – 16
Significado Curva inválida – Datos insuficientes (curva con más de un segmento)
Causa Menos de 2 estándares de calibración dio resultados válidos
Indicadores en las muestras C – Curva inválida – datos insuficientes
Resultados de la Calibración Error 16 en lugar del resultado
Acción para Remediar Resultado inválido. Revise la curva de reacción. Repita la calibración con
materiales recién preparados.

Clave de error – 17
Significado No. inferior de estándares
Causa Un número de puntos estándar es menor que los definidos en el ajuste
Indicadores en las muestras C – n-1 Puntos estándar
Resultados de la Calibración Error 17 en lugar del resultado
Acción para Remediar Resultados inválidos. Revise la curva de reacción. Repita la calibración con
materiales recién preparados.

6.26
Clave de error – 18
Significado Ninguna calibración – Ningún(os) estándar(es) obligatorio(s)
Causa Un estándar de calibración obligatorio no proporciona un resultado válido (un
solo segmento de la curva)
Indicadores C – ninguna calibración ningún Estándar
Resultados Error 18 en lugar del resultado
Acción para Remediar Curva inválida. Revise la curva de reacción. Repita la calibración con
materiales recién preparados
Clave de error – 19
Significado Segmento de curva inválido – Ningunos estándares obligatorios
Causa Un estándar de calibración obligatorio no proporciona un resultado válido
(curva con más de un segmento)
Indicadores en las muestras C – ninguna calibración ningún Estándar
Resultados de la Calibración Error 19 en lugar del resultado
Acción para Remediar Curva inválida. Revise la curva de reacción. Repita la calibración con
materiales recién preparados

Clave de error – 20
Significado Réplicas de estándares inválidas
Causa Una o más de las réplicas para un estándar de calibración definido no
proporciona un resultado valido
Indicadores en las muestras C-Estándar n inválido
Resultados de la Calibración Error 20. La media tiene indicador. CV se muestra con indicador (en rojo)
Acción para Remediar Curva inválida. Revise la curva de reacción. Repita la calibración con
materiales recién preparados

Clave de error – 21
Significado No se muestra CV – Réplicas insuficientes
Causa Una o más de las réplicas para un estándar de calibración definido no
proporcionan un resultado válido. No puede calcularse el CV (réplicas inferiores
o = 2)
Indicadores en las muestras C – Réplicas insuficientes
Resultados de la Calibración Error 21. No se muestra CV
Acción para Remediar Estándar inválido. Revise la curva de reacción. Repita la calibración con
materiales recién preparados
246
6.27
Clave de error – 22
Significado Réplica inválida
Causa Una réplica para un estándar de calibración definido no proporciona un
resultado válido.
Indicadores C – Réplicas inválidas
Resultados Error 22 La media del valor tiene indicador
Acción para Remediar Réplica inválida. Revise la curva de reacción. Repita la calibración con
materiales recién preparados

Clave de error – 23
Significado CV fuera de rango
Causa CV de las réplicas es más elevado que el límite seleccionado
Indicadores en las muestras C – CV fuera de rango
Resultados de la Calibración Error 23 El CV tiene indicador
Acción para Remediar Resultado fuera de rango. Revise la curva de reacción. Repita la calibración
con materiales recién preparados.

Clave de error – 24
Significado Ninguna calibración – pendiente fuera de rango
Causa La pendiente de la curva (curva compuesta por una sola ecuación) está fuera
del rango definido (un solo segmento)
Indicadores en las muestras C – Ninguna Calibración – pendiente fuera de rango
Resultados de la Calibración Error 24 No se muestra la curva de calibración
Acción para Remediar Revise la curva de reacción. Repita la calibración con materiales recién
preparados.

Clave de error – 25
Significado Curva inválida – pendiente fuera de rango
Causa Una de las pendientes de la curva (curva compuesta por varios segmentos)
está fuera del rango definido.
Indicadores en las muestras C – Segmento inválido – pendiente fuera de rango
Resultados de la Calibración Error 25 Se muestra la curva de calibración
Acción para Remediar Revise la curva de reacción. Repita la calibración con materiales recién
preparados

6.28
Clave de error – 26
Significado R2 fuera de rango
Causa La R2 de la calibración está fuera del límite seleccionado.
Indicadores en las muestras C – R2 fuera de rango
Resultados de la Calibración Error 26 Se muestra la curva de calibración. El valor de R2 tiene indicador
Acción para Remediar Revise la curva de reacción. Repita la calibración con materiales recién
preparados

Clave de error – 27
Significado Ninguna calibración – Ninguna curva válida
Causa La curva de calibración no tiene ningún segmento válido
Indicadores en las muestras C – R2 fuera de rango
Resultados de la Calibración Error 26 No se presenta la curva de calibración.
Acción para Remediar Revise la curva de reacción. Repita la calibración con materiales recién
preparados
247
Clave de error – 28
Significado La curva no es monotónica
Causa Calibración inválida debido a un resultado que no está en secuencia en
comparación con los otros puntos de calibración.
Indicadores en las muestras C – segmento inválido
Resultados de la Calibración Error 28 La curva no es monotónica
Acción para Remediar Repita la calibración

Error – Datos extrapolados


Significado Datos extrapolados
Causa El resultado de la prueba está por arriba de 150% en comparación con el
estándar de calibración más elevado o por debajo de 60% en comparación con
el estándar de calibración más bajo.
Indicadores C – Resultado extrapolado
Resultados de la Calibración Ningunos
Acción para Remediar Ninguna

6.29
Error – Segmento Adyacente Inválido (Ensayos de Factores)
Significado Uno de los segmentos de la Curva de Calibración contiene un error
Indicadores en las muestras C – Segmento Adyacente Inválido
Acción para Remediar Revise los resultados antes de reportar. Repita cualesquiera muestras en caso
de que los resultados sean sospechosos.

6.3.4 Claves de Errores de Referencia Analítica


Error – AR inválida
Significado AR inválida (con el uso del Valor de Referencia para el cálculo de la Relación /
INR9
Causa La AR no da un resultado válido
Indicadores en las muestras A – AR inválida
Resultados de la AR La AR tiene indicador con una R que indica el número de clave de Error
específico.
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR fuera de rango


Significado AR fuera de rango (con el uso del Valor de Referencia para el cálculo de la
Relación / INR9
Causa La AR da un resultado fuera de rango
Indicadores en las muestras A – AR fuera de rango
Resultados de la AR La AR tiene indicador con color azul
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR inválida
Significado AR inválida (AR utilizada como referencia para el cálculo de la Relación / INR)
Causa La AR no da un resultado calculado válido
Indicadores en las muestras A – AR inválida. No se presenta la Relación/INR en las muestras
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
248

6.30
Error – AR fuera de rango
Significado AR fuera de rango (AR se utiliza como referencia para el cálculo de la Relación
/ INR
Causa La AR da un resultado fuera de rango
Indicadores en las muestras A – AR fuera de rango. No se presenta la Relación/INR en las muestras
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR fuera de rango


Significado AR fuera de rango (en comparación con un estándar de Calibración)
Causa La AR no tiene un resultado de Relación válido
Indicadores en las muestras A – AR fuera de rango. No se presenta la Relación/INR en las muestras
Resultados de la AR La AR no tiene una relación calculada
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR no verificada
Significado AR no verificada (en comparación con un estándar de Calibración no definido)
Causa AR no verificada
Indicadores en las muestras A – AR no verificada. Se proporciona la Relación/INR en las muestras
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR fuera de rango


Significado AR fuera de rango (ninguna verificación de la AR seleccionada)
Causa La AR da un resultado inválido
Indicadores en las muestras Ninguno
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.31
Error – ARa inválida
Significado ARa inválida (verificación en ARa seleccionada)
Causa La ARa es inválida
Indicadores en las muestras A – ARa inválida
Resultados de la ARa La AR tiene indicador
Acción para Remediar Repita la prueba con materiales recién preparados

Error – ARa fuera de rango


Significado ARa fuera de rango (verificación en ARa seleccionada)
Causa La ARa está fuera de rango
Indicadores en las muestras A – ARa está fuera de rango.
Resultados de la ARa La ARa se presenta en azul
Acción para Remediar Repita la prueba con materiales recién preparados

Error – ARa inválida


Significado AR inválida (verificación en ARa no seleccionada)
Causa ARa inválida
Indicadores en las muestras Ninguno
Resultados de la AR ARa con indicador
Acción para Remediar Repita la prueba con materiales recién preparados
249

Error – AR inválida
Significado AR inválida (se define la Relación con respecto a un Estándar de Calibración)
Causa La AR proporciona una unidad calculada inválida
Indicadores en las muestras A-AR inválida. La Relación/INR se presenta en las muestras
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.32
Error – AR fuera de rango
Significado AR fuera de rango (Relación definida con respecto al Estándar de Calibración)
Causa La AR da un resultado calculado fuera de rango
Indicadores en las muestras A – AR fuera de rango. La Relación/INR se presenta en las muestras
Resultados de la AR Se calcula la AR y se presenta en azul
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR inválida
Significado AR inválida (No se selecciona ninguna verificación en la AR)
Causa La AR proporciona un resultado inválido
Indicadores en las muestras Ninguno
Resultados de la AR La AR tiene indicador
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR fuera de rango


Significado AR fuera de rango (se selecciona verificación en la AR)
Causa La AR da un resultado fuera de rango
Indicadores en las muestras A – AR fuera de rango. No se proporciona la Relación/INR cuando se define la
AR para el cálculo de la Relación/INR
Resultados de la AR La AR tiene indicador en azul
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – AR fuera de rango


Significado AR fuera de rango (se selecciona la AR en el estándar de Calibración)
La AR da un resultado fuera de rango
Indicadores en las muestras A – AR fuera de rango. Se proporciona la Relación/INR, pero tiene indicador
Resultados de la AR La AR tiene indicador en azul
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.33
6.3.5 Claves de Errores de Control de Calidad
Error – Control de Calidad inválido
Significado Control de Calidad no válido (Verificación de Control de Calidad – No
seleccionada)
Causa El Control de Calidad proporciona un resultado no válido
Indicadores en las muestras Ningún indicador en las muestras
Resultados del Control de El resultado del Control de Calidad no se muestra y se presenta el número de
Calidad clave específico
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
250
Error – Control de Calidad inválido
Significado Control de Calidad no válido (Verificación de Control de Calidad –
seleccionada, muestras con indicador – no seleccionadas)
Causa El Control de Calidad proporciona un resultado no válido
Indicadores en las muestras Ningún indicador en las muestras
Resultados del Control de El resultado del Control de Calidad no se muestra y se presenta el número de
Calidad clave específico
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – Control de Calidad fuera de rango


Significado Control de Calidad fuera de rango (Verificación de Control de Calidad –
seleccionada, muestras con indicador no seleccionadas)
Causa El Control de Calidad proporciona un resultado fuera de rango
Indicadores en las muestras Ningún indicador en las muestras
Resultados del Control de Indicador con Control de Calidad inválido y aparecerá en violeta o rojo
Calidad
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – Control de Calidad inválido


Significado Control de Calidad inválido (Verificación de Control de Calidad – seleccionada,
muestras con indicador – seleccionadas)
Causa El Control de Calidad proporciona un resultado no válido
Indicadores en las muestras Q – Control de Calidad inválido, indicador en las muestras está presente
Resultados del Control de El resultado del Control de Calidad no se muestra y se presenta el número de
Calidad clave específico
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.34
Error – Control de Calidad fuera de rango
Significado Control de Calidad fuera de rango (Verificación de Control de Calidad –
seleccionada, muestras con indicador seleccionadas)
Causa El Control de Calidad proporciona un resultado fuera de rango
Indicadores Q – está presente el indicador de fuera de rango en las muestras
Resultados El resultado del Control de Calidad tiene indicador en violeta o rojo
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.3.6 Claves de Errores de Pruebas Dobles


Clave de error – 45
Significado No se calcula la media (Ninguna verificación seleccionada en la media)
Causa Una de las dos pruebas no es válida (resultado no numérico)
Indicadores en las muestras Ningún indicador en las muestras
Resultados Error 45. No se muestra la media
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
251
Clave de error – 46
Significado No se calcula la media (Verificación seleccionada en la media)
Causa Uno de los dos resultados no es válido
Indicadores en las muestras W- No se calcula la media. Indicador en las muestras
Resultados Error 46. No se muestra la media
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Error – Media fuera de rango


Significado Media fuera de rango (Verificación seleccionada en la media)
Causa Uno de los dos resultados está fuera del rango normal o el rango de linealidad
Indicadores en las muestras W-La media tiene indicador en las muestras
Resultados Se presenta la media con relación a el rango de resultados violado
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.35
Error – Media fuera de rango
Significado Duplicada fuera de rango (Verificación seleccionada en la media)
Causa La diferencia entre las Réplicas excede el límite
Indicadores en las muestras W-La media tiene indicador en las muestras
Resultados La media tiene indicador en violeta
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

6.3.7 Claves de Errores de Relación e INR


Clave de error – 52/53/54/55/56/59/60/62/63/65
Significado Error de cálculo de relación (es decir, Relación para PT, APTT, TT, etc.)
Causa Uno de los resultados necesarios para el cálculo no es válido
Indicadores en las muestras W-La media tiene indicador en las muestras
Resultados Error 52 = muestra
Error 53 = Estándar
Error 54 = AR
Error 55 = Sa
Error 56 = ARa
Error 59 = AR inválida
Error 60 = Estándar inváido
Error 62 = muestra inválida
Error 63 = Referencia inválida*
Error 65 = ARa inválida
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
*El valor de referencia se ajuste en 0
Clave de error – 50
Significado Relación: S o Sa fuera de rango (es decir, Relación para APCR-V)
Causa S o Sa fuera del rango normal
Indicadores en las muestras W-Relación: S, Sa fuera de rango
Resultados Error 50: No se calcula la relación
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
252
6.36
Clave de error – 58
Significado NR, AR o ARa fuera de rango (es decir, NR para APCR-V)
Causa AR o ARa fuera de rango
Indicadores en las muestras W-R: AR, ARa fuera de rango
Resultados Error 58: No se calcula la relación
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados

Clave de error – 57/64/66


Significado Error NR
Causa La Relación no está disponible para calcular NR
Indicadores en las muestras W-Error NR
Resultados Error 57: No se halló la relación*
Error 64. Relación AR inválida
Error 66: Delta AR inválida
Acción para Remediar Revise las curvas de reacción. Repita la prueba con materiales recién
preparados
*El Valor de Referencia se ajusta en 0.

6.3.8 Errores de DMS


Mensaje de error Posible Explicación
Base de Datos llena Más de 1000 identificaciones de muestras en DMS. Las identificaciones de las
muestras deben suprimirse para permitir espacio para programación
Más de 30 pruebas Intentar programar la prueba # 31 para una muestra. Las pruebas deben
programadas por muestra suprimirse para permitir espacio para programación
Identificación de muestra Se ha introducido una identificación de muestra por duplicado cuando se edita
duplicada una lista de carga. La identificación de la muestra por duplicado debe
suprimirse.
Identificación de control ya La identificación ya utilizada para otra muestra de paciente. La identificación de
utilizada para el paciente la muestra debe cambiarse.
Selección de rango inválida Una de las dos identificaciones en el rango seleccionado no existe
No se halló la identificación de la La identificación solicitada no existe en la base de datos.
muestra

6.37
6.3.9 Otros Errores Diversos
Mensaje de error Posible Explicación
Muestra no identificada en la La muestra no tiene una identificación asociada en la base de datos
posición X
Verificar la charola de muestras Falta el material en la charola de muestras
Bajo Se halló que faltaba la muestra durante la aspiración o verificación de
detección del nivel de líquido
La Prueba X no está calibrada La prueba no tiene una calibración asociada a ella
Muestra añadida en la posición Una muestra que no estaba en la lista de carga anterior se encontró durante la
X verificación de la charola de muestras
Rotor usado El rotor está parcialmente usado. Introduzca las posiciones de cuvetas sin
usar.(abra la cubierta del rotor para verificar el primer número de cuveta vacía
disponible)
Cargar rotores El rotor es insuficiente para efectuar el análisis solicitado. Añada más rotores a
la pila de rotores.
AR fuera de rango NP fuera de rango (± 9% para PT, ± 15% para APTT o ± 20% para FIB
basado en PT
Control de Calidad fuera de Material de Control de Calidad fuera de rango de acuerdo con el límite de DE
rango seleccionado en el ajuste del Control de Calidad
253
6.4 “Error Clásico de Reducción de Datos”
El “Error” aparece cuando hay anomalías en los datos
generados durante la coagulación de la muestra. El número
que acompaña al error -6, 7 ó 13, se refiere al algoritmo
de criterios que detectó al problema.
Para detalles adicionales, consulte el diagrama de la
Sección 6.6 que describe gráficamente el proceso de
reducción de datos.
Error 6
Criterios de falla: La curva de coagulación no pasa el
primer umbral antes del final del tiempo de adquisición.
Causas posibles: La muestra puede no haberse coagulado
durante el tiempo de adquisición o la variación en la
turbiedad es insuficiente para ocasionar la lectura del
punto de coagulación. Córrala en el tiempo de adquisición
extendido.
6.38
Error de Coagulación 7
Criterios de falla: La curva de coagulación pasa el primer
umbral, pero no el segundo umbral antes del final del
tiempo de adquisición.
Causas posibles: La muestra puede no haberse coagulado
durante el tiempo de adquisición o la variación en la
turbiedad es insuficiente para ocasionar la lectura del
punto de coagulación. Córrala en el tiempo de adquisición
extendido.
Error 13
Criterios de falla: Cuando la pendiente inicial de la curva
de reacción es demasiado elevada, los criterios empleados
para decidir el punto de coagulación es el Máximo de la
Segunda Derivada. Cuando no se pasa el límite del Máximo de
la Segunda Derivada, significa que la aceleración de la
reacción no lo suficientemente significativa.
Causas posibles: La curva de reacción puede no ser una
curva de coagulación real, lo que indica probablemente una
curva que muestra una forma bifásica fuera de lo usual.
6.5 Errores de Identificación de Muestras (con el uso
del lector de código de barras interno)
Cuando se utilizan muestras con código de barras, se hace
la identificación con el lector de código de barras interno
del ACL; pueden generarse los errores siguientes.
- No_R = Identificación de Muestra faltante
- Dpl = Identificación de muestra duplicada
- No_C = Identificación de Muestra truncada
- Inv = Identificación de Muestra inválida
En caso de que ocurra cualquiera de estos errores, el
operador puede introducir la identificación de la muestra
manualmente en el sistema.
254
6.39
6.6 Diagrama de Reducción de Datos para PT, APTT y TT

CURVAS DE
COAGULACIÓN
(después de afinar)

Entre el
1er y 2do
Por debajo del 1er Alogaritmo de Umbral
Umbrales
umbral
(parte 1)
ERROR 6 ERROR 7
Por arriba del 2do umbral
(Arriba de ∆ del
tiempo) ∆ tiempo en segundos

Por debajo ∆ del


tiempo
Control de verificación de
la pendiente
Por arriba del Por debajo del límite
límite
Alogaritmo de Alogaritmo de Umbral
2da derivada (parte 2)

Por debajo del límite  ERROR 13 Por arriba del 2do umbral

Por arriba del límite D2  Resultado (#)


Resultado (*)
(#)El tiempo se calcula en la correspondencia de la Segunda
Derivada Máxima de la curva de coagulación.
(*) El tiempo se calcula en la intersección entre la curva
de coagulación y el primer umbral.
255
7.1
Especificaciones de Ensayos e Instrumento
7.0 Introducción
Esta Sección incluye a las especificaciones relacionadas
con muchos ensayos efectuados en el sistema ACL Elite/Elite
Pro, así como las especificaciones relacionadas con el
instrumento y sus artículos accesorios.
Las abreviaturas siguientes se emplean en toda esta
Sección:
• APCR-V Proteína Activada • D-D h Dímero D Alto
Resistencia C – Prueba de Factor V • FPS Proteína S Libre
• AT Antitrombina • LAC LAC – Pantalla y
Confirmar
• PLG Plasminógeno • SCT Tiempo Coagulación
Sílice
• PCX Complejo Pro IL* • VWF Factor von Willebrand
• HPX Hepatocomplejo* • F8 chr H/L Factor VIII
cromogénico Alto/Bajo
• PCL ProClot • DP Plasma Deficiente
• PC Proteína C • AR Referencia Analítica
• PS Proteína S
• FIB-C Fibrinógeno Clauss
• FIC-C h Fibrinógeno Clauss
Alto
• FIB-C l Fibrinógeno Clauss
Bajo
• HEP Heparina
• Pl Inhibidor de Plasmina
*No disponibles actualmente en los E.U.A
(Símbolo9

Nota: El ACL Elite/Elite Pro y el AD.8, 9 y 10000 utilizan


sistemas analíticos idénticos. Los Reactivos, Calibradores,
Controles y sus valores asignados son intercambiables entre
los dos sistemas.
La información provista en esta Sección se organiza como
sigue:
Parámetros Medidos Sección 7.1
Cálculo de Resultados Sección 7.2
Pruebas Coagulométricas 7.2.1
Pruebas Cromogénicas 7.2.2
Configuración y Especificaciones de Muestras/Reactivos Sección 7.3
Requisitos y Posiciones de las Muestras 7.3.1
Posiciones de las Muestras en el Rotor 7.3.2
Volúmenes de las Pruebas Coagulométricas 7.3.3
Volúmenes de las Pruebas Cromogénicas 7.3.4
Volúmenes de Pruebas Especiales 7.3.5
256

Procedimientos de Procesamiento de Datos, Parámetros y


Especificaciones Analíticas Sección 7.4
Límites de Indicadores 7.4.1
Formato de Resultados VDU e Impresora 7.4.2
Manejo con los Mensajes de Resultados 7.4.3

7.2

Pendiente de la Curva de Calibración (m) 7.4.4


Intercepción de la Curva de Calibración (q) 7.4.5
Rangos para los Valores de Calibración del Plasma 7.4.6
Tiempos de Reacción 7.4.7
Pruebas Coagulométricas y Especiales
Pruebas Cromogénicas
Algoritmos de las Pruebas 7.4.8
Características de Desempeño de los Ensayos Sección 7.5
Desempeño de Precisión de Ensayos, Linealidad y Estudios de Comparación de Métodos
7.5.1
Estabilidad de la Calibración del Ensayo 7.5.2
Limitaciones Analíticas Sección 7.6
Traspaso 7.6.1
Ensayo de una muestra contaminante
Ensayo de una muestra contaminada
Cefalina: autoacondicionamiento de las agujas 7.6.2
Muestras Lipémicas 7.6.3
Especificaciones del Contenedor Sección 7.7
Tubos Primarios 7.7.1
Contenedores de Reactivos y Copas 7.7.2
Especificaciones del Instrumento Sección 7.8
Especificaciones del Hardware y Operativas 7.8.1
Dimensiones 7.8.2
Especificaciones de las Bases de Datos 7.8.3
Especificaciones Ambientales Sección 7.9
Especificaciones Eléctricas Sección 7.10
Riesgos Sección 7.11
Advertencia General 7.11.1
Riesgos de Descarga 7.11.2
Riesgos Eléctricos 7.11.3
Riesgos Biológicos 7.11.4
Riesgos Mecánicos 7.11.5
Anexo: Estudios de Comparación de Métodos

(Símbolo)
Nota: Consulte las definiciones de las pruebas individuales
en el menú de Ajuste en el analizador para los últimos
ajustes de la biblioteca de pruebas para cada ensayo.
257
7.3
7.1 Parámetros Medidos
Esta sección describe los parámetros que miden los ensayos
del ACL Elite/Elite Pro para determinar los resultados de
las pruebas. Las pruebas se agrupan de acuerdo con su
metodología común. Se proporciona una breve explicación
(texto y gráficas) de los métodos.
Algunos de estos parámetros pueden ser también una de las
unidades de reportes que utiliza el ACL, tal como
“segundos” para las pruebas coagulométricas. Todas las
mediciones se utilizan en el cálculo interno de los
resultados de las pruebas, ya sea con relación a las curvas
de calibración o procesadas de diversas maneras para
reportar otros parámetros útiles, según se describe en la
Sección 7.2.
Todos los parámetros se miden en el ACL Elite/Elite Pro a
37ºC ± 1ºC, siempre y cuando la temperatura ambiente se
mantenga dentro del rango de 15ºC a 32ºC.
PRUEBAS COAGULOMÉTRICAS: PT, APTT, TT, Factores, Pro-IL-
Complex*, Hepatocomplex* (Hepatocomplejo), SCT, ProClot y
Proteína S.
El ACL monitorea la formación de coágulos mediante la
difusión de luz (LS por sus siglas en idioma inglés),
midiendo el tiempo (t) expresado en segundos (s) que se
requiere para alcanzar un punto seleccionado en la curva de
formación de coágulos.
(Gráfica)
*No disponible actualmente en los Estados Unidos.
7.4
FIBRINÓGENO (Basado en PT)
La prueba de Fibrinógeno se basa en las mediciones de
monitoreo de la coagulación al registrar la luz difusa
antes y después de la formación del coágulo y calcula la
diferencia entre las dos lecturas (delta de la difusión de
luz = ∆LS).
(Gráfica)
PRUEBAS CROMOGÉNICAS Y DE LÁTEX: Antitrombina, Heparina,
Inhibidor de Plasmina, Plasminógeno, Proteína C
(Cromogénica), Dímero D, vWF y Proteína S libre.
El ACL monitorea fotométricamente el desarrollo de color de
la reacción y calcula la diferencia entre la luz absorbida
al principio de la reacción y la luz absorbida en un punto
definido durante la reacción (∆OD).
(Gráfica)
7.5
FIBRINÓGENO C
La prueba de Fibrinógeno se mide mediante fotometría,
midiendo el tiempo en segundos que toma cambiar en una
cantidad predeterminada; este tiempo se relaciona
adicionalmente con la concentración de Fibrinógeno.
258
En caso de resultados de pacientes mayores de 600 mg/dL (6
g/L), puede ejecutarse la prueba con el uso del Fib-C h.
en el caso de resultados de pacientes menores de 100 mg/dL
(1 g/L), puede ejecutarse la prueba con el uso de FIB-C l.
la prueba de Fib C h diluirá automáticamente la muestra 2
veces y la prueba de Fib C l concentrará la prueba a la
mitad con el uso de un volumen reducido.
7.2 Cálculo de Resultados
Esta Sección describe las opciones del ACL para el cálculo
de los resultados con base en los parámetros medidos para
cada prueba. Algunos parámetros se reportan directamente,
tales como los “segundos” para las pruebas coagulométricas.
Para otras pruebas, tales como las cromogénicas, los
resultados se calculan con base en el ajuste de las
mediciones ópticas con las curvas de calibración,
estructurada mediante la ejecución de mediciones o
calibradores similares. El ACL ofrece opciones de
resultados en unidades para muchas de las pruebas, dado que
es capaz de utilizar mediciones básicas para una sola
muestra y procesarlas de diferentes maneras para derivar
varios otros valores que son clínicamente significativos
(es decir, relaciones).
La tabla a continuación resume las pruebas, los parámetros
medidos por el ACL y los formatos de resultados que puede
reportar el ACL. La opción de los resultados reportados
depende de las condiciones del instrumento y analíticas (es
decir, calibración previa, presencia de la AR en la
corrida, la selección de las unidades), como se ve en la
tabla a continuación.

Pruebas Parámetros medidos Resultados Reportados


PT Segundos s, %, R o INR
FIB (basado en PT) Delta Luz Dfusa mg/ dL o g/L
APTT Segundos s, R
Tiempo de Coagulación de Sílice Segundos S, compensación, final
TT Segundos S, R
Un Solo Factor Segundos s, %
Antitrmbina ∆ O.D. %
Heparina ∆ O.D. U/mL
Plasminógeno ∆ O.D. %
Inhibidor de plasmina ∆ O.D. %
Complejo* Pro-IL Segundos s, %, R o INR
Hepatocomplejo* Segundos s, %, R o INR
ProClot Segundos s, %, R
FIB-C Segundos mg/dL o g/L
Proteína C (Cromogénica) ∆ O.D. %
*No disponible actualmente en los E.U.A.
259
7.6
Pruebas Parámetros medidos Resultados Reportados
Proteína S Segundos s,%
Proteína S libre ∆ O.D. %
LAC – Pantalla y Confirmar Segundos S, R
VWF ∆ O.D. Compensación# , Máx, %

FB Cromogénico Alto/Bajo ∆ O.D. %


Dímero D ∆ O.D. ng/mL, Compensación#
APCR-V Segundos (S y Sa) s, %, R o INR
*Lectura de absorbencia promedio inicial para la reacción
Prueba Plasma Normal Calibración almacenada No calibrada
(AR) en la corrida
PT (Corregir ENCENDIDO) con AR s, %, R, INR* s, R/INR*
sin AR segundos segundos
PT (Corregir APAGADO) con AR s, %, R, INR* segundos
sin AR segundos, %** segundos
Fibrinógeno con AR mg/dL, g/L La prueba debe calibrarse
sin AR
Prueba Plasma Normal Calibración almacenada No calibrada
(AR) en la corrida
APTT con AR Esta prueba no requiere segundos, Relación
sin AR calibración segundos**
TT con AR Esta prueba no requiere segundos, Relación
sin AR calibración segundos**
Tiempo de Coagulación de Esta prueba no requiere segundos
Sílice calibración
LAC – Pantalla/Confirmar Esta prueba no requiere segundos, Relación
calibración
Antitrombina %, ∆ O.D. ∆ O.D.
Heparina Xa U/mL, ∆ O.D. ∆ O.D.
Inhibidor de Plasmina %, ∆ O.D. ∆ O.D.
Plasminógeno %, ∆ O.D. ∆ O.D.
Proteína C Cromogénica %, ∆ O.D. ∆ O.D.
Dímero D ng/mL, ∆ O.D. ∆ O.D.
FB Cromogénico H/L %, ∆ O.D. Esta prueba no requiere
calibración
Proteína Libre S ∆ O.D. ∆ O.D.
Factores s, % segundos
ProClot s, %, R segundos
Fib-C s, mg/dL o g/L segundos
Proteína S s, % Esta prueba DEBE
calibrarse cada corrida
Pro-IL-Complex*** s, %; INR segundos
Hepatocomplejo*** s, %, INR segundos
APCR-V* Esta prueba no requiere Segundos (s y sa)
calibración R, NR

* Tromboplastina valor ISI se introduce en el Ajuste de Líquidos


** Solamente en caso de R = S/AR
*** No disponible actualmente en los E.U.A.
# Se requiere la AR para el cálculo de NR.
260
7.7
7.2.1 Pruebas Coagulométricas
PT (Tiempo de Protrombina)
El PT se mide en segundos. Cuando se corre el Plasma Normal
(AR) o una curva de calibración, el ACL puede efectuar
diferentes cálculos a fin de reportar los resultados en
otros formatos: % de actividad, R (relación con uso de la
AR) o INR (Relación Normalizada Internacional).
En el ejemplo a continuación, se mide (100% del calibrador)
a los 11 segundos (R=1), la dilución al 50% del Plasma de
Calibración se mide a los 15 segundos (R=1.36) y la
dilución al 25% se mide a los 21 segundos (R=1.9).
Se utiliza el valor del Plasma de Calibración (100% del
calibrador) – en segundos – como denominador para calcular
la Relación (R).
100% NP: 11 s  11 ÷ 11 = 1(R)
50% NP: 15 s  15 ÷ 11 = 1.36(R)
25% NP: 21 s  21 ÷ 11 = 1.9(R)
(Gráfica)
(Símbolo)
NOTA: Cuando se corre la prueba de PT con “Corregir con AR
en el Análisis” marcado (símbolo), se utiliza el valor de
Referencia Analítica en segundos para modificar la curva de
calibración. Se utiliza la curva modificada para el cálculo
del valor de la muestra.
Cuando se corre la prueba de PT sin marcar “Corregir con AR
en el Análisis”, se utiliza el valor del Plasma de
Calibración en la curva de calibración original (punto de
100%) para el cálculo del valor de la muestra.
Recalibre la prueba de PT cuando cambie el lote de Lavado-R
o el lote del rotor (caracter alfa).
Para más detalles, consulte la Sección 4 – Ajuste de la
Prueba.
7.8
• Resultado como % de actividad: La actividad de
protrombina de la muestra se expresa como % calculado
de la curva de calibración con base en el valor de R.
• Resultado como R: R es la relación entre el valor de la
muestra en segundos y el valor en segundos para la AR,
el Valor de Referencia o uno de los estándares de
calibración (ver la NOTA anterior).
R(relación)= PT de la Muestra (en segundos)
AR, o Valor de Referencia o Estándar de Calibración (en segundos)
• Resultado en INR: es el valor de R normalizado de
acuerdo con el ISI (Índice de Sensibilidad). Para
obtener este valor, debe introducirse el ISI en el
software del ACL.
INR = RISI
APTT, TT
261
APTT y TT se miden en segundos. Estas pruebas no requieren
calibración. Puede colocarse el Plasma Normal, junto con
las muestras, en cada corrida de análisis, o puede
almacenarse un valor de referencia en el software. Para
información adicional, consulte la Sección 4 (Ajuste de la
Prueba).
• Resultado como R: R es la relación entre el valor de la
muestra en segundos y el valor en segundos para AR o un
Valor de Referencia.
R(relación)= APTT/TT de la muestra en segundos
AR o Valor de Referencia (en segundos)
APCR-V
Esta prueba se mide en segundos. Sa es el “tiempo
activado” y S es el “tiempo base”.
• Resultado como R: R es la relación entre el valor en
segundos para Sa y el valor en segundos para S.
R(relación)= Sa en segundos
S en segundos
• Resultado como NR: NR es la relación normalizada, el
valor de la relación de la muestra dividido entre el
valor de la relación (AR) del Plasma Normal.
NR= Valor de la Relación de la Muestra
Valor de la Relación AR
7.9
FACTORES
Los factores se miden en segundos; el ACL calcula el % de
actividad con base en una curva de calibración.
Las curvas de calibración para los ensayos de Factores
están compuestas de tres segmentos: un segmento de Curva
Alta con calibradores de más alta concentración, un
segmento de Curva Baja con calibradores de concentración
baja y un segmento Medio que conecta al punto de
calibración de 25% de la Curva Alta con el punto de
calibración de 6.25% de la Curva Baja.
El valor del Plasma de Calibración (calibrador de 100%) se
utiliza como denominador para calcular la Relación (R).
- Para el segmento de la Curva de Calibración Alta
100% NP: 40s  40 + 40 = 1(R)
50% NP: 50s  50 + 40 = 1.25(R)
25% NP: 60s  60 + 40 = 1.50(R)
La curva se construye con Relaciones (con base en segundos)
en el eje de las x y % de Actividad en el eje de las y,
utilizando una escala log-log.
(Gráfica)
SEGMENTO DE LA CURVA ALTA
7.10
- Para el segmento de la Curva de Calibración Alta
6.25% NP (log = 0.80): 70s  70 + 40 = 1.75(R)
3.12% NP (log = 0.50): 80s  80 + 40 = 2.00(R)
1.56% NP (log = 0.20): 90s  90 + 40 = 2.25(R)
262
(Gráfica)
SEGMENTO DE LA CURVA BAJA
El SEGMENTO MEDIO conecta a los puntos de 25% y 6.25%.
• Resultado como % de actividad: para el rango entero de
Curva de Calibración Multilineal, la relación entre el
valor de la muestra en segundos y el valor de 100% del
Plasma de Calibración en segundos, se calcula y se
utiliza a continuación para leer el valor de la
Actividad con base en la curva de calibración.
Consulte la sección 3.4 para la preparación de la dilución
de 6.25% que se utiliza para calibrar la curva baja.
(Símbolo)
Nota: Todas las muestras que se corren para el análisis de
los factores son diluidas automáticamente (x5) por el
sistema ACL durante el análisis.
7.11
Pro-IL-Complex*
El Pro-IL-Complex se mide en segundos; el ACL calcula
también el % de Actividad con base en la curva de
calibración.
A continuación se incluyen algunos datos de calibración
típicos y un ejemplo gráfico de una curva de calibración
del Pro-IL-Complex – segmento de 25% - 6.25.
(Gráfica)
PCX
Los valores de las relaciones se calculan utilizando el
Estándar de 100% como denominador. Por lo tanto, el plasma
de Calibración debe colocarse en la charola de muestras
cuando se corre la calibración del Pro-IL-Complex.
100% NP : 40s  40 + 40 = 1
25% NP(log = 1.40): 65s  65 + 40 = 1.63 (log = 0.21)
12.5% NP(log = 1.10): 95s  95 + 40 = 2.4 (log = 0.38)
6.25% NP(log = 0.80): 150s  150 + 40 = 3.75 (log = 0.57)
El segmento de 100% - 25% se construye con Relaciones (con
base en segundos) en el eje de las x y 1/% de Actividad en
el eje de las y, con el uso de una escala lineal.
El segmento de 25% - 6.25% se construye con Relaciones (con
base en segundos) en el eje de las x y el % de Actividad en
el eje de las y, utilizando una escala de log – log.
La actividad de la muestra se obtiene calculando la
relación entre el valor de la muestra en segundos y el 100%
del Plasma de Calibración en segundos. Este valor se lee a
continuación de la curva de calibración para obtener el
valor del % de Actividad.
* No está disponible actualmente en los E.U.A.
263
7.12
HEPATOCOMPLEX* (HEPATOCOMPLEJO)
El Hepatocomplex se mide en segundos; el ACL calcula
también el % de Actividad con base en una curva de
calibración.
Se incluyen a continuación algunos datos de calibración
típicos y un ejemplo gráfico de una curva de calibración de
Hepatocomplex.
100% NP: 18s  18 + 18 = 1(R)
50% NP: 27s  27 + 18 = 1.5(R)
25% NP: 36s  36 + 18 = 2(R)
La curva de Calibración se construye con la Relación en el
eje de las x y 1/Actividad en el eje de las y, en una
escala lineal.
(Gráfica)
HPX
La actividad de la muestra se obtiene calculando la
relación entre el valor de la muestra en segundos y el 100%
del Plasma de Calibración en segundos. Este valor se lee a
continuación de la curva de calibración para obtener el
valor del % de Actividad.
* No está disponible actualmente en los E.U.A.
7.13
Tiempo de Coagulación de Sílice – Pantalla y Confirmar
Se mide el SCT en segundos. Estas pruebas no requieren
calibración. El Plasma Normal puede colocarse junto con
las muestras en cada corrida de análisis o puede
almacenarse un valor de referencia en el software. Para
información adicional, consulte la Sección 4 (Ajuste de la
Prueba).
• Resultado como R: R es la relación entre el valor de la
muestra en segundos y el valor en segundos para un
Valor de Referencia.
R(relación) Pantalla = Resultado de muestra en pantalla en segundos
Media del Rango Normal en Pantalla en segundos
R(relación) Confirmación = Resultado de muestra de confirmación en segundos
Media del Rango Normal de confirmación en segundos
SCT(relación) Normalizado = Relación de muestra en pantalla
Relación de confirmación de muestra

ProClot
Se mide ProClot en segundos; el ACL calcula también el % de
Actividad con base en una curva de calibración.
Se incluyen a continuación algunos datos de calibración
típicos y un ejemplo gráfico de la curva de calibración de
ProClot.
100% NP: 165s  165 + 60 = 2.75(R)
50% NP: 120s  120 + 60 = 2.0(R)
0% NP: 60s  60 + 60 = 1.0(R)
264
La curva de calibración se construye con una Relación al
cuadrado en el eje de las x y la Actividad en el eje de las
y, en una escala lineal.
(Gráfica)
PCL
La actividad de la muestra se obtiene con el uso de la
Relación al cuadrado (que se calcula utilizando el valor de
la muestra en segundos y el valor del calibrador de 0% en
segundos) para leer el % de Actividad en la curva de
calibración.
265
7.14
FIBRINÓGENO (Basado en PT)
El ACL registra la luz difusa antes y después de la formación
de un coágulo y calcula la diferencia (∆LS) entre las dos
lecturas.
El ACL calcula el valor del fibrinógeno de la muestra en
mg/dL con el uso de una curva de calibración. La curva
correlaciona la concentración de fibrinógeno de 3
calibradores con sus Relaciones de ∆LS.
Se incluyen a continuación algunos datos de calibración de
fibrinógeno típicos y la curva de calibración construida con
ellos.
Conc. Cal. (mg/dL) Delta LS Relación (R)
300 60 60 + 60 = 1
150 30 30 + 60 = 0.5
75 15 15 + 60 = 0.25

La curva de Calibración se construye con una Relación en el


eje de las x y la concentración de Fibrinógeno en el eje de
las y, en una escala lineal.
(Gráfica)
C(mg/dL)
El ACL calcula la relación entre los valores de la muestra de
fibrinógeno (en delta LS) y el primer punto del Plasma de
Calibración (en delta LS) para obtener el valor
correspondiente en mg/dL de la curva de calibración.
7.2.2 Pruebas Cromogénicas
Antitrombina, Inhibidor de Plasmina, Plasminógeno, Proteína C
(Cromogénica)
Para estas pruebas cromogénicas, el ACL mide la diferencia
entre la luz absorbida al principio y en un punto definido
durante la reacción (∆OD). El % de actividad de la muestra se
calcula con base en una curva de calibración construida con 3
calibradores de actividad conocida y ∆OD medida. Se incluyen
a continuación...
7.15
...ejemplos de curvas de calibración para Antitrombina,
Inhibidor de Plasmina, Plasminógeno y Proteína C.

(Gráfica) (Gráfica)
AT/Inhibidor de Plasmina Plasminógeno/Proteína C
7.16
Heparina
Para la Heparina, el ACL calcula la concentración de las
muestras en U/mL con base en una curva de calibración. La
curva de calibración se construye con 3 calibradores de
concentración conocida y ∆OD medida.
266
Un ejemplo de una Curva de Calibración de Heparina se muestra
a continuación.
(Gráfica)
Curva Alta de Heparina
(Símbolo)
NOTA: Para la Antitrombina y la Heparina, se mide delta OD
durante todo el tiempo de adquisición de la reacción de 30
segundos. Para el Inhibidor de Plasmita, Plasminógeno y
Proteína C (Cromogénica), el tiempo de adquisición es de 60
segundos.
Dímero D
Para la prueba de Dímero D, el ACL mide la diferencia entre
la luz absorbida al principio y en un punto definido durante
la reacción (∆OD). La concentración de Dímero-D en la
muestra, en ng/mL, se calcula con base en una curva de
calibración construida correlacionando los valores de delta
OD y sus concentraciones respectivas en ng/mL.
En caso de que los resultados del paciente sean más altos de
1050 ng/mL, la prueba puede volverse a correr con el uso de
la prueba de Dímero D alto, que tiene una linealidad de 1000
a 5250 ng/mL.
(Símbolo)
Nota: La prueba de D-Dh (alto) debe correrse solamente con
pacientes con una concentración de muestra de Dímero D mayor
de 1000 ng/mL.
7.17
Un ejemplo de curva de Calibración de Dímero D se muestra a
continuación.
(Gráfica)
Dímero D (ng/mL)
Proteína S Libre
Para la prueba de Proteína S Libre, el ACL mide la diferencia
entre la luz absorbida al principio y un punto definido
durante la reacción (∆OD). La concentración de la Proteína S
Libre en la muestra, en %, se calcula con base en una curva
de calibración construida correlacionando los valores de
delta OD del calibrador y sus concentraciones respectivas en
%. La curva de calibración para la Proteína S Libre se
construye con 3 segmentos.
Segmento 1 100% a 50%
Segmento 2 50% a 25%
Segmento 3 25% a 12.5%
Un ejemplo de la curva de Calibración de la Proteína S se
muestra a continuación:
(Gráfica)
7.18
267
7.3 Configuración y Especificaciones de Muestras/
Reactivos
7.3.1 Requerimientos y Posiciones de las Muestras
las tablas siguientes indican los materiales que deben
colocarse en la charola de muestras del ACL Elite/Elite Pro a
fin de efectuar cada prueba, junto con sus posiciones
respectivas. Las tablas agrupan a los diferentes tipos de
pruebas.
En las Tablas, Ax indica las posiciones del mapa de
materiales en la charola de muestras para las posiciones A1 a
A10 que se utilizarán para los Calibradores, Diluyentes,
Tampón, Plasma Deficiente, etc. Las posiciones por omisión se
definen en el submenú de Ajuste del software del ACL
Elite/Elite Pro.
Para detalles, consulte la Sección 4 y el Apéndice C de este
Manual.
PRUEBAS COAGULOMÉTRICAS
Prueba POSICIONES
Ax Ax Ax Ax 1-40
CAL PT-FIB Combinación Diluyente de -- -- --
Normal Factor
PT-FIB Combinación -- -- -- Muestras
Normal
APTT Combinación -- -- -- Muestras
Normal
TT Combinación -- -- -- Muestras
Normal
PT-FIB/APTT Combinación -- -- -- Muestras
Normal
SCT Combinación -- -- -- Muestras
Normal
FACTORES Combinación Diluyente de Combinación Plasma Muestras
(Calibración + Normal Factor Normal Deficiente
Análisis) (100%) Diluida*
(6.25%)

PRUEBAS DOBLES
Prueba POSICIONES
Ax Ax Ax Ax 1-40
PRUEBA DOBLE Combinación -- -- --
(PT-FIB, APTT, Normal Muestras
TT)

Combinación Normal = Plasma de Calibración


* La Combinación Normal Diluida se prepara colocando 300 ul
de Diluyente de Factor + 20ul de Plasma de Calibración en una
copa de 0.5 mL. Mezcle bien la copa antes de usarse.
268
7.19
PRUEBAS CROMOGÉNICAS y ESPECIALES
Prueba POSICIONES
Ax Ax Ax Ax Muestras
Calibración de AT Combinación Diluyente de Copa Copa Copas vacías
Normal Factor Vacía Vacía en las
posiciones
1-12

Análisis de AT -- Diluyente de -- -- 1 – 20;


Factor Copas vacías
en las
posiciones
21-40
Calibración de AT* Combinación Diluyente de Copa Copa --
Normal Factor Vacía Vacía
Análisis de AT* -- Diluyente del -- -- 1 – 40
Factor
Calibración de Copa Calibrador Calibrador Diluyente de
Heparina Vacía Trabajo
Análisis de -- -- -- Diluyente de 1 – 40
Heparina Trabajo
PI Combinación Tampón -- -- 1 – 40
Normal Diluido
PLG Combinación Diluyente de Substrato -- 1 – 40
Normal Factor
Calibración PCX** Combinación Diluyente de DP # Copas --
Normal Factor Vacías
Análisis. PCX** -- -- DP # -- 1 – 40
Calibración. HPX** Combinación Diluyente de Copas vacías DP # --
Normal Factor
Análisis. HPX** -- -- DP # 1 – 40
PCL Combinación Diluyente de Proteína C Copa 1 – 40
Normal Trabajo DP # Vacía
Calibración. FIB-C Combinación Diluyente de -- -- --
Normal Factor
Análisis. FIB-C -- Diluyente de -- -- 1 – 40
Factor
PS Combinación PS PS Activado 50% 1 – 40
Normal DP # DP # Estándar
PC Combinación Diluyente de Substrato -- 1 – 40
Normal Factor
Calibración FPS Combinación Diluyente de Copas -- --
Normal Factor Vacías
Análisis. FPS -- Diluyente de -- -- 1 – 40
Factor
269

Prueba POSICIONES
Cal/Análisis F8 chr H Combinación Copa Vacía Copa Vacía Tampón 1 – 20;
Normal F8 Chr Copas vacías
en las
posiciones
21-40
Cal/Análisis F8 chr L Copa Copa Vacía Combinación Tampón 1 – 20;
Vacía Normal F8 Chr Copas vacías
Diluída en las
posiciones
21-40

LAC - Pantalla y Combinación 1 – 40


Confirmar Normal
Calibración vWF Combinación Diluyente de Copas Vacías Tampón --
Normal Factor vWF
Análisis. vWF -- Diluyente de Tampón
Factor vWF

7.20

Calibración de Combinación Tampón Diluyente de -- --


Dímero D del Calibrador factor
Análisis de -- Tampón -- -- 1 – 40
Dímero D
APCR-V Combinación Factor V -- -- 1 – 40
Normal DP #

* Antitrombina Líquida
** No disponible actualmente en los Estados Unidos
# = Plasma Deficiente
La Combinación Normal puede ser de Plasma de Calibración IL o
un plasma combinado en el laboratorio.
7.3.2 Posición de las Muestras en el Rotor
La tabla siguiente indica, para cada prueba diferente (o
combinación de pruebas en el caso de las pruebas dobles), las
posiciones ocupadas en el rotor por los materiales necesarios
para efectuar el ensayo. Se utiliza un máximo de 19 muestras.

PRUEBA Curva de Cal. NP Muestras Emulsión de Referencia


Referencia Óptica
Cal. PT-FIB 100% 1-6 -- -- 19 --
50% 7-12
25% 13-18
PT / APTT -- 1 2 – 19 20 --
270
SCT -- -- 1 – 19 20 --
TT -- 1 2 – 19 20 --
FACTOR 100% 1 7 – 19 20 --
(Cal + Análisis) 50% 2
25% 3
6.25% 4
3.12% 5
1.56% 6
Análisis de -- -- 1 – 19 20
FACTOR
PRUEBA -- 1 2 – 19 20 --
DOBLE
(PT-FIB,
APTT, TT)
Cal. de AT 100% 2-5 -- -- 14 1
Líquido 50% 6-9
25% 10-13

Análisis de AT -- -- 2–9 20 1
Líquido
Cal. de AT 100% 2-5 -- 14 1
50% 6-9
25% 10-13
Análisis de AT -- -- 2 – 19 20 1
Calibración de 0.8 2-5 -- -- 14 1
Heparina 0.4 6-9
0.0 10-13
Análisis de -- -- 2 – 19 20 1
Heparina
PI / PLG 100% 2 -- 5 – 19 20 1
50% 3
0% 4

7.21
PRUEBA Curva de Cal. NP Muestras Emulsión de Referencia
Referencia Óptica
Calibración de 25% 5-8 -- -- 17 --
PCX* 12.5% 9-12
6.25% 13-16
100% 1-4
Análisis de -- -- 1 – 19 20 --
PCX*
PRUEBA Curva de Cal. NP Muestras Emulsión de Referencia
Referencia Óptica
Calibración de 100% 1-4 -- -- 13 --
HPX* 50% 5-8
25% 9-12
Análisis. De -- -- 1 – 19 20 --
HPX*
271
PCL 100% 1 -- 4 – 19 20 --
50% 2
0% 3
Cal. de FIB-C 150% 2-5 -- -- 14 1
100% 6-9
50% 10-13
Análisis. de -- -- 2 – 19 20 1
FIB-C
PROTEÍNA S 100% 1 -- 4 – 19 20 --
50% 2
0% 3
PROTEÍNA C 100% 2 -- 5 – 19 20 1
50% 3
0% 4
Cal. de FPS 100% 2-4 -- -- 14 1
50% 5-7
25% 8-10
12.5% 11-13
Análisis de -- -- 2 – 19 20 1
FPS

Cal./Anal. de 100% 2 -- 5 – 19 20 1
F8 Chr H/L 50% 3
25% 4
LAC - Pantalla -- 1 2 – 19 20 --
/ Confirmar
Cal. de vWF 100% 2-5 -- -- 18 1
50% 6-9
25% 10-13
12.5% 14-17
Análisis. de -- -- 2 – 19 20 1
vWF
Cal. de Dímero 1000 2-5 -- -- 14 1
D ng/mL 500 6-9
250 10-13
Análisis. de -- -- 2 – 19 20 1
Dímero D
APCR-V -- 1y2 3 – 10 (s) 19 --
11 – 18 (Sa)

En los ciclos cromogénicos, la Emulsión de Referencia sirve


como comprobación para verificar el lavado completo entre
muestras y de un rotor a otro.
*No disponible actualmente en los Estados Unidos.
7.22
7.3.3 Volúmenes de las Pruebas Coagulométricas
272
La tabla siguiente resume los volúmenes de la muestra y del
reactivo aspirados y surtidos para cada prueba
coagulométrica, con inclusión de los volúmenes de “carga”.
Cal. PT-FIB
100% Análisis de APTT y SCT TT
50% PT-FIB
25%
Altura de Carga 10 µL/muestra 10 µL/muestra 10 µL/muestra 10 µL/muestra
de la Muestra 0
0
Muestra Surtida 50 µL 50 µL 53 µL 75 µL
25 µL
12.5 µL
Carga de -- -- -- --
Diluyente 10 µL/muestra
10 µL/muestra
Diluyente Surtido -- -- -- --
25 µL
37.5 µL
Carga de 10 µL 10 µL/muestra 10 µL de reactivo 50 µL
Reactivo 10 µL por muestra por rotor
10 µL 50 µL CaCl2/rotor
Reactivo Surtido 100 µL 100 µL 53 µL de reactivo 75 µL
100 µL 50 µL de CaCl2
100 µL

7.23
NOTA: Acondicionamiento de la aguja para cefalina (APTT)
Cuando se procesa la prueba basada en APTT mediante un ciclo
con el uso de tromboplastina – PT, Factores de Trayectoria
Extrínseca, Pro-Il-Complex*, Hepatocomplex* (Hepatocomplejo)
y Proteína S, la aguja interna aspira 90 µL de cefalina o
Limpiador A, seguido por una burbuja de aire de 80 µL. La
cefalina o el Limpiador A se surte a continuación en el
reservorio de desechos. Este paso se repite tres veces.

FACTORES DE TRAYECTORIA FACTORES DE TRAYECTORIA


EXTRÍNSECA INTRÍNSECA
Carga de Est. NP 1-6 10 µL Est. NP 1-6 10 µL
Muestra Muestras 10 µL Muestras 10 µL
Muestra Surtida Est. NP 1, 4** 8 µL Est. NP 1, 4** 8 µL
Est. NP 2, 5 4 µL Est. NP 2, 5 4 µL
Est. NP 3, 6 2 µL Est. NP 3, 6 2 µL
Muestras 8 µL Muestras 8 µL
273
Carga de Est. NP 1-6 10 µL Est. NP 1-6 10 µL
Diluyente
Diluyente Surtido Est. NP 1, 4 32 µL Est. NP 1, 4 32 µL
Est. NP 2, 5 36 µL Est. NP 2, 5 36 µL
Est. NP 3, 6 38 µL Est. NP 3, 6 38 µL
Carga de 10 µL 50 µL de 10 µL 50 µL de 50 µL de
Reactivo Estándares y DP Estándares CaCl2 DP
muestras Por cada y muestras Por rotor Por cada factor
factor
Reactivo Surtido 80 µL 40 µL de 40 µL de 40 µL 40 µL de
Trombopl. DP Cefalina de DP
Por muestra CaCl2 Por muestra

• NP es la abreviatura de Plasma Normal.


• Est. Es la abreviatura de Estándar.
* No disponible actualmente en los Estados Unidos.
** El Estándar 4 se preparará manualmente (20 ul de plasma de
Calibración + 300 ul de diluyente de factor)
Estándares para ensayos de un Solo Factor
Para los ensayos de un Solo Factor de las Trayectorias
Extrínseca e Intrínseca, los Estándares son como se indica a
continuación.
Segmento de CURVA ALTA Segmento de CURVA BAJA
1er Estándar 100% 6.25%
2do Estándar 50% 3.12%
3er Estándar 25% 1.56%

El SEGMENTO MEDIO conecta los puntos de 25% y 1.56%.


7.24
7.3.4 Volúmenes de las Pruebas Cromogénicas/filtro de 405
La tabla siguiente incluye a las pruebas que utilizan el
filtro de 405 nm en el ACL Elite/Elite Pro. Los detalles
correspondientes a cada prueba pueden verse en la pantalla o
imprimirse. La información acerca de la prueba puede
obtenerse en el menú de Ajuste, Pruebas, Ver/Definir. Una vez
que se hace resaltar la prueba, puede imprimirse la
información oprimiendo el icono de imprimir o puede oprimirse
el icono de detalles para ver la prueba.
Los volúmenes de las pruebas pueden hallarse en las secciones
de Ajuste de Calibración y Ajuste de Análisis para cada
prueba. El volumen incluido, definido para cada prueba, no
incluye a ningunos volúmenes de carga. Los volúmenes de carga
son como sigue:
Carga de la Muestra 10uL/Muestra
Carga del Reactivo 10ul/cuveta cuando se pipetea junto con la
muestra (es decir, APTT Cefalina)
274
Carga del Reactivo 50uL/rotor cuando se pipetea solo en el
rotor (es decir, APTT/Ca/Cl)
Pruebas de Canal
de filtro 405/Cromogénicas
Abreviatura de la Prueba Nombre de la Prueba Número de Clave de la Prueba
PLG Plasminógeno 212
PI Inhibidor de Plasmina 213
PC Proteína C 214
F8 Chr H Cromogénica VIII Alta 220
D-D- Dímero D 250
AT Antitrombina 200
AT* Antitrombina Líquida 199
HepXa Heparina-UHF 210
Fib-C Fibrinógeno Clauss 202
vWF Factor de von Willebrand 400
PS Libre Proteína S Libre 160

(Símbolo)
Nota: La “Referencia Óptica” es la referencia para las
pruebas cromogénicas. Consiste en 80 µL de tampón diluido +
80 µL de enzima.
7.25
7.3.5 Volúmenes de Pruebas Especiales
La tabla siguiente incluye a las pruebas Especiales en el ACL
Elite/Elite Pro. Los detalles correspondientes a cada prueba
pueden verse en la pantalla o imprimirse. La información
acerca de la prueba puede obtenerse en el menú de Ajuste,
Pruebas, Ver/Definir. Una vez que se hace resaltar la prueba,
puede imprimirse la información oprimiendo el icono de
imprimir o puede oprimirse el icono de detalles para ver la
prueba.
Los volúmenes de las pruebas pueden hallarse en las secciones
de Ajuste de Calibración y Ajuste de Análisis para cada
prueba. El volumen incluido, definido para cada prueba, no
incluye a ningunos volúmenes de carga. Los volúmenes de carga
son como sigue:
Carga de la Muestra 10uL/Muestra
Carga del Reactivo 10ul/cuveta cuando se pipetea junto con la
muestra (es decir, APTT Cefalina)
Carga del Reactivo 50uL/rotor cuando se pipetea solo en el
rotor (es decir, APTT/Ca/Cl)
Pruebas Especiales
Abreviatura de la Prueba Nombre de la Prueba Número de Clave de la Prueba
APCR-V Resistencia de Proteína C Activada 225
LAC-S, LAC-C LAC – Pantalla/Confirmar 410/411
SCT-S, SCT-C STC – Pantalla/Confirmar 155/156
PCX* Pro-IL-Complex 150
HPX* Hepatocomplex (Hepatocomplejo) 151
P-ClotSP Proclot SP 153
PS Proteína S 159
* No disponible actualmente en los Estados Unidos
275
7.26
7.4 Características del Procesamiento de Datos, Parámetros y Especificaciones
Analíticas
7.4.1 Límites de Indicadores
Cuando los resultados están fuera de los límites aceptables,
Bajo o Alto, el ACL les pone indicadores mostrándolos como --
-/***, respectivamente o con un color diferente. Hay tres
tipos de resultados a los que se les proporcionan indicadores
de esta manera:
1. Resultados de pruebas fuera de las capacidades de la
escala de lectura numérica del instrumento.
2. Linealidad de las curvas de calibración fuera de los
límites aceptables.
3. El porcentaje de CV (% CV) para los ciclos de calibración
está fuera de los límites relativos aceptables.
1. Resultados de Pruebas Fuera de las Capacidades de la
Escala de Lectura Numérica del Instrumento.
Estos límites son impuestos por las capacidades
electromecánicas del instrumento; no son necesariamente los
mismos que los límites del rango del ensayo.
(Símbolo)
NOTA: Verifique los ajustes del instrumento y el inserto del
paquete que se incluye con los reactivos del ensayo para
obtener información acerca del rango y las limitaciones del
ensayo, y el procedimiento a seguir cuando los resultados del
ensayo se encuentran fuera del rango lineal.
La tabla a continuación indica, para cada prueba, cuáles
resultados se muestran en Negro y cuáles resultados están
fuera de los límites y, por lo tanto, se muestran en Rojo.

7.27
PRUEBA Rojo Negro Rojo ---/***
PT < 15% 15-150% > 150% <0- >500%
Fibrinógeno < 0.40 mg/dL 40-800 mg/dL > 800 mg/dL <0- > 3000 mg/dL
< 0.4 g/L 0.4-8.0 g/L > 8.0 g/L <0- > 30 g/L
Factores < 15% 15-150% > 150% <0 - >900%
Antitrombina Liofilizada < 15% 15-150% > 150% <0 - >900%
PI < 10% 15-150% > 150% <0- >500%
PLG < 10% 15-150% > 150% <0 - >500%
PC < 15% 15-150% > 150% <0 - >500%
Heparina < 0.1 U/mL 0.1-1 U/mL > 1 U/mL <0 - >90 U/mL
Pro-IL-Complex* > 4% 4-150% >150% <0 - >900%
Hepatocomplex* > 8% 8-120% > 120% <0 - >500%
ProClot < 10% 10-150% > 150% <0 - >500%
Proteína S < 10% 10-150% > 150% <0 - >500%
276
FIB C < 60 mg/dL 60-550 mg/dL >550 mg/dL <0 - >900 mg/dL
< 0.6 g/L 0.6-5.5 g/L -5.5 g/L <0 - >9.0 g/L
Proteína S Libre < 10% 10-140% > 140% <0 - >999%
F8 Chr. H < 10% 10-120% >120% <0 - >500%
F8 Chr. L < 0% 0-10% > 10% <0 - >500%
LAC S/C < 12 s 12.0-165.0 s > 165 s 10-999 s
< 0.5R 0.5-5.0 R > 5.0 R <0 ->99.0 R
SCT S/C < 6.640 s 24-35 s > 247.5 <0 ->300
vWF < 10% 10-150% > 150% <0 ->999%
Dímero D < 200 ng/mL 200-1050 ng/mL > 1050 ng/mL <0 ->9999 ng/mL
* No está disponible actualmente en los Estados Unidos
***Representa el límite de operación del sistema (rango de la
escala)
2. Linealidad de las curvas de calibración fuera de los
límites aceptables.
Los resultados más confiables se obtienen cuando el
coeficiente de linealidad r2 de una curva de calibración se
aproxima a 1.000. El ACL ofrece ayuda “visual” útil al dotar
de marcador a r2 fuera de los límites aceptables relativos.
Por ejemplo, en caso de que una prueba tuviera el límite
aceptable establecido como > 0.980, los resultados fuera del
límite se mostrarán como:
• r2 < 0.980 – mostrado en Rojo
• 0.980 < r2 < 1.000 – mostrado en Negro
Consulte los parámetros de ajuste del Cálculo para los
límites específicos en cada prueba.
7.28
3. El porcentaje de CV (% CV) para los ciclos de
calibración está fuera de los límites relativos
aceptables.
Cuando los valores del % de CV de las réplicas de calibración
son mayores que los límites aceptables programados, se les
pone un indicador en rojo. La tabla a continuación incluye a
los límites aceptables para cada prueba.
NOTA: para PT y Fibrinógeno, las calibraciones se consideran
aceptables por parte del sistema cuando el % de CV no es más
de 1% superior al límite y r2 se encuentra dentro de los
límites aceptables.
PRUEBA Calibrador Límite de % de CV
PT NP (100%) 1.5
NP (50%) 2.0
NP (25%) 2.0
FIB NP (100%) 8.0
NP (50%) 12.0
NP (25%) 12.0
AT liofilizado NP (100%) 8.0
NP (50%) 6.0
NP (25%) 4.0
AT líquido NP (100%) 8.0
NP (50%) 6.0
277
NP (25%) 4.0
Heparina NP (100%) 8.0
NP (50%) 6.0
NP (25%) 4.0
HPX* NP (100%) 1.5
NP (50%) 2.0
NP (25%) 6.0
PCX* NP (100%) 2.0
NP (25%) 3.0
NP (12.5%) 4.0
NP (6.25%) 6.0
FIB-C NP (150%) 1.5
NP (100%) 2.0
NP (50%) 2.5
FPS NP (100%) 8
NP (50%) 8
NP (25%) 8
NP (12.5%) 20
vWF NP (100%) 5
NP (50%) 5
NP (25%) 7
NP (12.5%) 10

7.29
Dímero-D NP (1000 ng/mL) 4.0
NP (500 ng/mL) 6.0
NP (250 ng/mL) 10.0
*No está disponible actualmente en los Estados Unidos
7.4.2 Formato de Resultados: VDU e Impresora
El formato utilizado para mostrar e imprimir campos numéricos
depende del valor obtenido. El formato no puede cambiarse. Se
utilizan las reglas siguientes:
Rango de Valor Formato Ejemplo
X<1 x.yyy (3 lugares decimales) Concentración (U/mL)
1 < X < 10 x.yy (2 lugares decimales) Tiempo
10 < X < 100 xx.y (1 lugar decimal) Actividad
X > 100 XXX (o mayor) dependiendo del Concentración (mg/dL)
tamaño del campo)

7.4.3 Manejo de los Mensajes de Resultados


Se presenta a continuación una tabla que está relacionada con
los mensajes de resultados que aparecen en la VDU o la
impresora.
• Esta tabla contiene una lista de los mensajes más comunes
que pudieran aparecer en el ACL en el lugar de los
resultados, ordenados por prueba, junto con la
explicación y sugerencias para obtener un resultado
numérico.

7.30
Tabla de Mensajes Generales
PRUEBA MENSAJE Posible Explicación
278
PT Error 6 La muestra no se coagula dentro del
tiempo de adquisición programado.
Lea la muestra en el Tiempo
Extendido
Error 7 Fibrinógeno <60 mg/dL
Muestra coagulada analizada
El valor del plasma normal se Plasma Normal fuera de rango con
muestra en violeta respecto a los datos de referencia
(rango ± 9% del valor de
referencia). Los resultados tienen
indicador, dependiendo del ajuste
del cálculo.
FIB ***en la muestra El valor de FIB excede del límite de
rango de escala alta.
Diluya la muestra 1:2 con Diluyente
de Factor para muestras altas y
repita.
Valor > 800 mg/dL en la muestra, en Diluya la muestra 1:2 para ajustar
rojo en el rango de operación del
instrumento
El valor del Plasma Normal se Plasma Normal fuera de rango
muestra en violeta (Rango ± 20% del valor de
referencia)
Error 10 El coágulo puede no estar
completamente estabilizado. Lea la
muestra en el Tiempo de
Adquisición Extendido
No se proporciona ningún FIB para La difusión de la luz excede del
la muestra límite máximo legible del
amplificador.
1. La mezcla de análisis es muy
turbia y excede inicialmente al límite
legible.
2. Durante la formación del coágulo,
la curva excede al límite legible.
Diluya la muestra 1:2 para ajustarse
en el rango de operación y
multiplique los resultados por 2.
279
7.31
PRUEBA MENSAJE Posible Explicación
APTT Error 6 La muestra no se coagula dentro del
tiempo final máximo. Lea la muestra
en el Tiempo de Adquisición
Extendido
Error 7 -Fibrinógeno < 60 mg/dL
-Muestra coagulada analizada
Se muestra el valor del Plasma Plasma Normal fuera de rango con
Normal en violeta respecto a los datos de referencia
(rango ± 15% del valor de
referencia).
Los resultados tienen indicador,
dependiendo del ajuste del cálculo
TT Error 6 La muestra no se coagula dentro del
tiempo de adquisición. Lea la
muestra en el Tiempo de
Adquisición Extendido.
Error 7 -Fibrinógeno < 60 mg/dL
-Muestra ya coagulada
El valor del Plasma Normal se Plasma Normal fuera de rango con
muestra en violeta respecto a los datos de referencia
(rango ± 20% del valor de
referencia). Los resultados tienen
indicador, dependiendo del ajuste
del cálculo.

7.32
7.4.4 Pendiente de la Curva de Calibración (m)
La tabla a continuación incluye a las pendientes esperadas
(m) para las líneas de calibración.
PRUEBA rango de la pendiente m
PT 0-0.2
FIB – mg/dL 0-1000
- g/L 0-10
Factores 100%-25% -20-0
25%-6.25% -30-0
6.25%-1.56% -30-0
Antitrombina Liofilizada -2000-0
Antitrombina Líquida -2000-0
Inhibidor de Plasmina -2000-0
Heparina -200-0
Plasminógeno 0-1000
Pro-IL-Complex* -12-0
segmento 25%-6.25%
Pro-IL-Complex* 0-0.17
segmento 100%-25%
Hepatocomplex* 0-0.35
ProClot 0-200
PRUEBA rango de la pendiente m
FIB-C -10-0
PC 0-1000
Proteína S 0-10
vWF: Ag 0-1000
280
Dímero D 0-6000
* No está disponible actualmente en los E.U.A.

7.4.5 Intercepción de la Curva de Calibración (q)


En las pruebas que requieren calibración (FIB-PT, Factores,
Pruebas Cromogénicas y Pruebas Especiales, la curva de
calibración se ajusta mejor a los puntos medidos, tal como
que el primer punto (primera dilución) queda en la línea de
calibración.
Las gráficas siguientes ilustran la situación antes y después
del ajuste al primer punto.
La ecuación para una línea es: Y = mX + q
Por lo tanto: q = Y –mX
La gráfica mostrada utiliza esta primera intercepción “q”,
como se ve a continuación.
(Gráfica)
7.33
La curva se transporta a continuación de manera de que pase a
través del primer punto y se calcula una nueva intercepción
q’: q’ = Y’-mX’
Los resultados de la muestra para estas pruebas calibradas se
calculan con base en esta nueva curva de calibración, que
tiene una pendiente idéntica a la original, pero una
intercepción diferente.
(Gráfica)
7.4.6 Rangos para los Valores del Plasma de Calibración
Antes de analizar las muestras, el ACL Elite/Elite Pro
requiere que el usuario defina el valor correspondiente del
Plasma de Calibración para cada prueba. Se efectúa lo
anterior en el área de ajuste de Líquidos del software (para
detalles, consulte la Sección 4).
Cuando se tiene acceso a esta área, se muestra un valor por
omisión; el usuario entra en el valor correspondiente para el
lote del Plasma de Calibración en uso.
7.4.7 Tiempos de Reacción
Esta sección contiene información acerca de los diferentes
tiempos dentro de las reacciones para cada prueba medida por
el ACL Elite/Elite Pro, con inclusión de los detalles del
proceso de adquisición de datos. Las pruebas se han dividido
en dos grupos, que se someten a prueba por separado: pruebas
Coagulométricas/Especiales y pruebas Cromogénicas.
PRUEBAS COAGULOMÉTRICAS y PRUEBAS ESPECIALES
El diagrama siguiente representa la reacción general para una
prueba Coagulométrica y una Especial:

INTERVALO ENTRE DATOS


281
RAMPAS TIEMPO DE ADQUISICIÓN
DEMORA HORA
RAMPA RAMPA RAMPA
0.4s 0.4s # 0.4s

7.34

La tabla a continuación muestra los tiempos de reacción


específicos para la prueba coagulométrica y especial.
Consulte las pruebas individuales en el sistema para mayores
detalles.
Notas relacionadas con la tabla a continuación:
1. TIEMPO EN BLANCO=RAMPA+INTERVALO ENTRE RAMPAS (segundos)
2. TIEMPO DE ADQUISICIÓN TOTAL=TIEMPO EN BLANCO + TIEMPO DE
ADQUISICIÓN (segundos) o TIEMPO EN BLANCO + DEMORA +
TIEMPO DE ADQUISICIÓN (segundos).
3. El tiempo EXTENDIDO está disponible para FIB-PT, APTT y
TT en modo de pruebas individuales y pruebas dobles.
PRUEBAS Tiempo en Blanco Tiempo de Tiempo de Tiempo de
COAGULOMÉTRICAS (segundos) adquisición por adquisición (seg.) adquisición total
punto (mseg.) (segundos)§
Calibración* FIB/PT 4 100 58 62
Análisis* FIB/PT
(sola, doble)
estándar 4 100 58 62
extendido 4 150 165 169
APTT (sola, doble)*
estándar 4 100 115 119
extendido 4 250 245 249

SCT S/C
4 250 245 245
TT 2mL
estándar 2 100 58 60
extendido 2 150 165 167
TT 5mL
estándar 4 100 58 62
extendido 4 150 165 169
TT 8mL
estándar 4 100 58 62
extendido 4 150 165 169
FACTORES
Trayectoria Externa
Calibración+Análisis 4 150 165 169
FACTORES
Trayectoria Interna
Calibración+Análisis 4 150 165 169
FACTORES-
Análisis Trayectoria
Externa 4 150 165 169
282
FACTORES
Análisis Trayectoria
Interna 4 150 165 169
*Verificar las definiciones de las pruebas individuales en el
sistema para los valores específicos.
283
7.35
PRUEBAS Tiempo en Blanco Tiempo de Tiempo de Tiempo de
ESPECIALES (segundos) adquisición por adquisición (seg.) adquisición total
Rampa, demora punto (mseg.) (segundos)§
Pro-IL-Complex # 4 + 20 250 275 299
Hepatocomplex # 4 200 220 224
ProClot 4 + 20 250 275 299
Proteína S 4 200 220 224
APCR-V 4 200 220 224
# Calibración y Análisis; no está disponible en los Estados
Unidos en la actualidad
PRUEBAS CROMOGÉNICAS
El diagrama siguiente representa la reacción para un ensayo
cromogénico.

TIEMPO DE ADQUISICIÓN

RAMPA RAMPA

0.4 s 0.4 s 0.4 s

La tabla a continuación resume los tiempos de reacción


PRUEBAS Tiempo en Blanco Tiempo de Tiempo de Tiempo de
CROMOGÉNICAS (segundos) adquisición por adquisición (seg.) adquisición total
Rampa, demora punto (mseg.) (segundos)§
Antitrombina 1 100 30 31
Antitrombina Líquida 1 50 20 21
Heparina 1 100 30 31
Plasminógeno 1 100 60 61
Inhibidor de Plasmina 1 100 60 61
Proteína C 0 100 90 92
(Cromogénica)
Fibrínógeno-C 2 100 90 92
Factor VIII 1 100 120 121
(cromogénico)
vWF: Antígeno 1 250 300 301
Proteína S Libre 1 250 300 301
Dímero D 2+1 250 300 303
284
7.36
7.4.8 Algoritmos de Pruebas
La tabla siguiente muestra los algoritmos que relacionan el
eje de las Y y el eje de las X para las mediciones de
parámetros efectuadas en el ACL Elite/Elite Pro.
PRUEBA CORRELACIÓN y x
PT Lineal 1/Actividad Relación
FIBRINÓGENO Lineal C(mg/dL o g/L Relación
FACTORES Log Actividad Relación
AT, PLG, PC, PI Lineal Actividad ∆OD
HEPARINA Lineal C(U/mL) ∆OD
PRO-IL-Complex* Log/Log Actividad R
(25%-12.5%-6.25%)
PRO-IL.Complex* Lineal 1/Actividad R
(100%-25%)
HEPATOCOMPLEX* Lineal 1/Actividad R
PROCLOT Cuadrática Actividad R2
FIBRINÓGENO-C Log-Log/Log C (mg/dL o g/L) segundos
PROTEÍNA S Lineal Actividad segundos
DÍMERO D Lineal 1/C (ng/mL) ∆OD
VWF Lineal Actividad ∆OD
Proteína S Libre Lineal Actividad ∆OD
*No está disponible en los Estados Unidos en la actualidad
7.37
7.5 Características del Desempeño de los Ensayos
7.5.1 Estudios de Comparación de Datos, Linealidad y
Desempeño de Precisión de los Ensayos
Esta sección contiene información acerca del desempeño de
precisión analítico de varios ensayos en el ACL Elite/Elite
Pro. Las tablas que se muestran a continuación incluyen a los
datos obtenidos durante los estudios de desempeño (con el
objeto de la evaluación del sistema) efectuados en los
laboratorios de IL en el campo.
Los datos presentados a continuación deben usarse como un
ejemplo del desempeño de precisión típico de los ensayos en
el ACL Elite/Elite Pro.
Estudios de precisión
La tabla que se incluye a continuación muestra los datos de
precisión dentro de la corrida, obtenidos para 2 ó 3 niveles
de controles, durante los estudios efectuados en IL con el
ACL Elite/Elite Pro para los reactivos IL siguientes.
Precisión Dentro de la Corrida
La precisión dentro de la corrida, evaluada en el transcurso
de múltiples corridas (10) con el uso de múltiples niveles de
plasma de control, dio los resultados siguientes:
285
7.38
Desempeño de Precisión
Reactivo Nivel de Control n Media %CV
Antitrombina (%) Normal 30 112.3 2.33
Anormal 1 30 58.3 3.23
Anormal 2 30 25.7 3.42
APCR-V Nivel 1 40 0.98 1.82
(Relación Normalizada) Nivel 2 40 0.62 1.96
APTT-SP (segundos) Normal 60 29.3 1.27
Anormal 1 60 49.2 0.98
Anormal 2 60 61.3 1.72
Dímero D (ng/mL) Nivel 1 90 263 6.54
Nivel 2 90 673 3.00
Factor VII (%) con Normal 40 78.9 3.32
Fibrinógeno PT Anormal 1 40 55.7 3.01
Anormal 2 40 24.4 4.04
Factor VIII (%) con Normal 40 77.0 8.39
APTT-SP Normal 1 40 84.0 6.67
Normal 2 40 39.2 6.67
Fibrinógeno C (mg/dL) Normal 80 269.3 3.20
Fibrinógeno Bajo 80 97.2 2.09
Heparina (U/mL) 0.85 LMW Heparina 30 0.8 2.02
Heparina Baja 30 0.3 4.33
Heparina Alta 30 0.7 2.65
Inhibidor de Plasmina (%) Normal 50 110 1.21
Anormal 1 50 68.4 2.52
Anormal 2 50 35.3 3.82
Plasminógeno (%) Normal 50 106.2 2.78
Anormal 1 50 69.2 2.94
Anormal 2 50 31.3 3.31
ProClot (%) Normal 80 83.0 3.71
APTT-SP Anormal 80 48.6 5.12
Proteína C (%) Normal 40 95.4 1.68
Anormal 1 40 51.1 1.77
Anormal 2 40 22.8 3.31
Proteína S (%) Normal 70 103.1 2.60
Anormal 2 70 50.7 4.36
PT (segundos) Normal 60 12.8 1.30
Anormal 1 60 19.2 1.75
Anormal 2 60 29.1 2.07
FIB-PT (mg/dL) Normal 90 243.0 7.06
Fibrinógeno Bajo 90 106.4 7.14
TT 8 ml (segundos) Normal 90 17.9 3.39
Muestra de heparina 90 22.8 3.57

7.39
Estudios de Linealidad
Los estudios de linealidad se efectuaron en múltiples niveles
de muestras; cada nivel se corrió por duplicado en un ACL
Elite/Elite Pro. Los resultados se muestran en la tabla a
continuación.
Reactivo No. de Pendiente Intercepción r Rango de las
niveles Muestras
Antitrombina (%) 7 0.94 5.958 0.999 14-140
286
Dímero D (ng/mL) 10 0.97 6.229 0.998 56-1192
Factor VII (%) con Fibrinógeno-PT 9 1.01 -4.036 0.997 1.9-132
Factor VIII (%) con APTT-SP 9 0.87 -0.508 1.000 2.3-127.5
Fibrinógeno-C (mg/dL) 7 1.10 -25.713 0.999 91-528

Reactivo No. de Pendiente Intercepción r Rango de las


niveles Muestras
Heparina (U/mL) 7 0.97 -0.007 0.999 0.00-1.07
Inhibidor de Plasmina (%) 7 0.94 6.677 0.997 0-115
Plasminógeno (%) 7 0.95 3.500 0.994 0-137
ProClot (%) APTT-SP 8 0.92 -0.129 1.000 0-171
Proteína C (%) 7 1.04 -0.338 1.000 0.5-173.5
Proteína S (%) 11 1.00 -0.221 1.000 0-120
PT (segundos) 6 0.96 0.565 1.000 12-35
Fibrinógeno Basado en PT (mg/dL) 9 0.95 15.621 0.997 0-567

7.40
Estudios de Comparación de Métodos
En los estudios de comparación de métodos para evaluar las
muestras de plasma citrado, los resultados del ACL
Elite/Elite Pro fueron similares a los resultados del
dispositivo del predicado (ACL 9000), según se sustenta en el
resumen de las estadísticas de regresión lineal a
continuación. Las gráficas se reportan en el Anexo al final
de este capítulo.
Reactivo No. de Pendiente Intercepción r Rango de las
niveles de Muestras
muestras
Antitrombina (%) 48 1.08 -3.031 0.995 14-125
APCR-V (Relación Normalizada) 57 0.97 0.021 0.993 0.457-1.105
APTT (segundos) 54 1.04 -1.471 0.998 27.5-96.2
Dímero D (ng/mL) 46 0.91 86.596 0.996 56-1083
Factor VII (%) con Fibrinógeno-PT 48 1.02 -2.605 0.996 2.4-170
Factor VIII (%) con APTT-SP 47 0.96 0.6184 0.990 0.96-199.2
Fibrinógeno-C (mg/dL) 54 1.10 -14.032 0.998 74-766
Heparina (U/mL) 50 1.03 -0.002 0.996 0.00-1.21
Inhibidor de Plasmina (%) 57 0.91 8.642 0.990 49.6-125.0
Plasminógeno (%) 57 0.99 3.525 0.989 18.4-150.8
ProClot (%) APTT-SP 54 0.98 1.912 0.995 10.7-199.1
Proteína C (%) 52 1.10 -5.781 0.998 22-317
Proteína S (%) 54 0.92 2.935 0.993 12-117
PT (segundos) 52 1.07 -0.838 0.999 10.4-25.1
Fibrinógeno Basado en PT (mg/dL) 51 0.93 35.038 0.990 49.7-844.7
Tiempo de Trombina-8mL 54 1.01 1.010 0.998 15.5-43.5
(segundos)
Consulte el final de este capítulo para las Gráficas de
Comparación de Métodos
7.41
7.5.2 Estabilidad de la Calibración de los Ensayos
Los estudios de estabilidad de la calibración se efectuaron
en IL con un rango completo de controles a fin de determinar
287
la cantidad mínima de tiempo en el que puede usarse una curva
de calibración para cada ensayo. Los resultados se muestran
en la tabla a continuación.

PRUEBA Estabilidad de la Calibración


Factor II 5 días
Factor V 5 días
Factor VII 5 días

PRUEBA Estabilidad de la Calibración


Factor VIII 5 días
Factor IX 5 días
Factor X 5 días
Factor XI 5 días
Factor XII 5 días
Fibrinógen-C 5 días
Antitrombina 5 días
Antitrombina Líquida 30 días
Heparina 5 días
Plasminógeno 5 días
Inhibidor de Plasmina 5 días
Estos intervalos de tiempo deben usarse como lineamiento
solamente. El uso de materiales de Control de Calidad
constituye el mejor determinante de estabilidad en cada
laboratorio en particular.
7.42
7.6 Limitaciones Analíticas
7.6.1 Traspaso
Los estudios efectuados en todos los miembros de la familia
ACL han mostrado un traspaso de muestra menor de 0.5% por
volumen.
En la mayoría de los casos, la inexactitud a la que
contribuyó el factor de traspaso se encuentra bien dentro de
la imprecisión esperada del método; por lo tanto, no es
estadística ni clínicamente significativa.
Se halló que los siguientes casos de excepción eran
estadísticamente significativos, aunque no clínicamente
significativos (la cantidad de contaminación no desplazará el
resultado de una muestra anormal al rango normal).
1. Cuando se somete a prueba una muestra de plasma (PT o
APTT) de un paciente con una severa Deficiencia de Factor
(factor < 10%) inmediatamente después de una muestra
normal.
2. Cuando se somete a prueba una muestra heparinizada alta
de una manera que sale de lo común (> 10 U/mL) o muestras
de pacientes sometidos a una terapia de reemplazo de
factor agresiva, inmediatamente después de una muestra
normal.
Ensayo de una Muestra Contaminante
288
Se recomienda el procedimiento siguiente a fin de manejar una
muestra que se sospecha contiene niveles elevados de Factores
o Heparina y evitar el traspaso a otras.
Modo de prueba para APTT o PT/FIB: coloque la muestra de la
que se tiene sospecha en la copa #1. Coloque la Emulsión de
Referencia o el Diluyente de Factor en la posición de
combinación (pool). Ponga el Ácido Clorhídrico (HCl 0.1 N)
en las posiciones de copas #2 y #4. Ponga el agua
desionizada en las posiciones #3 y #5. Utilice las copas en
las posiciones 6-9 para poner las otras muestras que van a
someterse a ensayo.
(Símbolo)
Nota: No se reportarán ningunos resultados calculados en esta
situación (es decir, Relación, INR, % de Actividad o
Fibrinógeno).
Ensayo de una Muestra Contaminada
Se recomienda el procedimiento siguiente a fin de volver a
ensayar las muestras de las que se tiene sospecha que han
sido contaminadas por la muestra que las precede en la
corrida (con Factores o Heparina elevados):
Nota: Debido a que la contaminación es ocasionada por un
traspaso, afecta en su mayor parte a la muestra aspirada y
tiene un efecto mínimo sobre la muestra que permanece en la
copa.
Modo de prueba para APTT o FIB/PT: Ponga la muestra que va a
volverse a someter a ensayo en la copa #1. Utilice las copas
en las posiciones 2-9 para colocar las otras muestras que van
a someterse a ensayo.
7.43
7.6.2 Cefalina: Autoacondicionamiento de Agujas
La aguja de aspiración/surtido de reactivos lleva a cabo su
propio “autoacondicionamiento” antes de utilizar el reactivo
de cefalina.
Cuando una prueba que utiliza cefalina es precedida por un
ciclo en que se utiliza tromboplastina (es decir, PT,
Factores Individuales de la Trayectoria Externa, Pro-IL-
Complex*, Hepatocomplex* o Proteína S), se repite el
procedimiento siguiente tres veces antes de aspirar la
cefalina:
- La aguja interna aspira 90 µL de reactivo o Limpiador A,
seguido por una burbuja de aire de 80 µL;
- Se descarta el líquido al reservorio de desechos.
* No disponible actualmente en los Estados Unidos
7.6.3 Muestras Lipémicas
Cuando se somete una muestra lipémica a prueba en el ACL
Elite/Elite Pro, la turbiedad ocasionada por la lipemia puede
289
interferir con la medición de fibrinógeno que se efectúa
mediante difusión de luz.
Las muestras lipémicas deben aclararse de preferencia antes
de someterlas a prueba en el ACL. Sin embargo, como los
estudios han mostrado que hay una relación lineal entre la
turbiedad y los valores de fibrinógeno, se ha introducido un
factor de corrección para el cálculo de los resultados del
fibrinógeno con base en la compensación inicial de la muestra
a fin de compensar la interferencia lipémica.
7.7 Especificaciones de los Contenedores
7.7.1 Tubos Primarios
La charola de muestras del ACL Elite/Elite Pro acepta varias
clases de tubos primarios de tamaños y volúmenes de llenado
diferentes, según se especifica en la tabla a continuación.

Tamaño de los Volumen de Volumen de Sangre Volumen Total


tubos de vidrio Anticoagulante (mL) Extraída (mL) (mL)
primarios (mm)
13 x 75 - Tipo a 0.50 4.5 5.0
13 x 75 - Tipo b 0.35 3.15 3.5
13 x 64 0.30 2.7 3.0
11.5 x 64 0.30 2.7 3.0
11.5 x 92 0.50 4.5 5.0
13 x 100 0.50 4.5 5.0

7.44
Especificaciones para el ACL que extrae de tubos primarios
Tipos a y b.
Tipo a
Para extraer volúmenes de sangre de 4.5 mL (valor nominal) el
ACL puede aspirar plasma con tolerancias de +10 a -20%.
Para la recolección máxima de muestras (4.5 mL +10%), el ACL
puede aspirar la cantidad correcta de muestra cuando el
hematocrito es de < 70%.
Tipo b
Para extraer volúmenes de sangre de 3.15 mL (valor nominal)
el ACL puede aspirar plasma con tolerancias de +10 a -20%.
Para la recolección máxima de muestras (3.15 mL +10%), el ACL
puede aspirar la cantidad correcta de muestra cuando el
hematocrito es de < 70%.
(Símbolo)
NOTA:
Las especificaciones anteriores pueden ser afectadas por las
variables siguientes:
290
- Variaciones en el lote y fabricante del diámetro interno
del tubo.
- Tiempo restante para la fecha de caducidad (el nivel de
vacío disminuye de manera próxima al final de la vida del
tubo)
7.7.2 Copas y Contenedores de Reactivos
Las tablas siguientes detallan las especificaciones para las
copas de muestras y los contenedores de reactivos que pueden
utilizarse en el ACL Elite/Elite Pro.

Charola de Muestras
Tipo de Volumen Utilizable Volumen Utilizable
Contenedor Volumen Diámetro Posiciones 1-40 Posiciones A1-A10
Copa de Muestra 0.5 mL 14 mm 0.4 mL dilución en copa
solamente
Copa de Muestra 2 mL 14 mm 1.8 mL 1.9 mL
Copa de Muestra 4 mL 14 mm 3.8 mL 1.9 mL
Frasquito de Reactivo 4 mL 18 mm NA 3.6 mL
Frasquito de Reactivo 10 mL 23 mm NA 9.2 mL

Área de Reactivos
Tipo de Volumen Utilizable Volumen Utilizable
Contenedor Volumen Diámetro Reactivos Agitados Reactivos no
Agitados
Frasquito de Reactivo 4 mL 18 mm NA 3.5 mL
Frasquito de Reactivo 10 mL 23 mm 8.3 mL 9.4 mL
Frasquito de Reactivo 16 mL 28 mm 13.2 mL 14.1 mL

NOTA: Los frasquitos de reactivos, parcialmente llenados con


reactivos de FIB-PT y APTT pueden llenarse en su parte
superior con reactivo fresco SOLAMENTE CUANDO el reactivo del
frasquito se encuentra todavía dentro de la estabilidad a
bordo a 15ºC y la relación entre el reactivo antiguo y el
reactivo fresco no excede de 1:2 (se sugiere utilizar una
parte del reactivo antiguo más dos partes de nuevos
reactivos.
7.45
7.8 Especificaciones del Instrumento
7.8.1 Especificaciones del Hardware y Operativas
Temperatura de los reservorios de reactivos: 10 – 16 ºC
Temperatura del área de análisis: 37 ± 1 ºC a temperatura ambiente de 15 a
32ºC
Fuente de luz de canal coagulométrico: Diodo emisor de luz, λ=660 nm
Fuente de luz de canal cromogénico: Lámpara de halógeno, λ=405 nm con filtro
Trayectoria óptica del canal cromogénico: 0.5 cm
291
Cuvetas analíticas: Las unidades de rotores contienen 20 cuvetas
cada uno
Número de rotores en apilamiento de rotores: 12 máximo
Charolas de muestras disponibles:
1. para copas y tubos primarios (13 x 75 mm – 5 mL y 13 x 64 mm – 3 mL)
2. para copas y tubos primarios (13 x 100 mm – 5 mL)
3. para copas y tubos primarios Sarstedt (11.5 x 64 mm – 5 mL y 11.5 x 92 mm – 3 mL)
Adaptadores de las charola de muestras: Para contenedores y copas de reactivos de 4
mL
Contenedores de reactivos: Frasquitos, copas de 4 mL, 10 mL y 16 mL,
Adaptadores para reservorios de reactivos: Para frasquito de 10 mL con agitador (gris)
Para frasquito de 10 mL sin agitador (rosa)
Para frasquito de 4 mL sin agitador (verde)
Reactivo R1-R4 imán agitador: Tamaño – 10 x 5 mm de diámetro
Velocidad de rotación – 250 rpm
Surtido de muestra/reactivo: Pistones de acero inoxidable contenidos en
una estructura de acrílico
Tubo de desechos: PVC, 12 mm de diámetro
Ventiladores de enfriamiento: Dos, con cinco aspas y filtro para polvo
Fusibles Dos, T6.3A (para de 100-240 VCA Nominales)
Teclado de PC: Estándar
Unidad de Pantalla de Video: LCD de 12.1” a colores, con pantalla sensible
al tacto

Interfaz para transmisión de datos la RS 232C


Computadora Principal:
Interfaces adicionales: Una para Escaner de Código de Barras
optativo
Una para Impresora Externa optativa
Estructura del instrumento: Poliuretano expandido diseñado para montaje
directo de elementos internos

7.46
7.8.2 Dimensiones
Altura total: 60 cm
Altura de la superficie de análisis: 33 cm
Ancho: 100 cm
Profundidad: 60 cm
Peso: 63 kg

7.8.3 Especificaciones de las Bases de Datos


La tabla a continuación proporciona especificaciones
relacionadas con el tamaño máximo de todas las Bases de Datos
incluidas en el software del ACL Elite/Elite Pro.
7.47
292
Descripción Tamaño Tipo de
Máximo Manejo
Nº de Identificaciones del Pacientes en la Base de Datos 1000 FIFO
Número de Pruebas por Paciente * 30 N/A
Número de Curvas de Reacción en la Base de Datos de los Pacientes 800 FIFO
Número de Resultados en Cada archivo de Control de Calidad Individual 500 FIFO
Número total de Resultados de Control de Calidad en cada archivo Estadístico 65536 FIFO
Número de Curvas de Reacción en la Base de Datos de Control de Calidad 200 FIFO
Número Total de Materiales de Control de Calidad 50 N/A
Número de Materiales de Control de Calidad de IL 30 N/A
Número de Materiales de Control de Calidad de Acuerdo con Especificaciones 20 N/A
Particulares
Número de Pruebas para cada Material de Control de Calidad Individual 20 N/A
Nº de resultados de Control de Calidad en la base de Datos de Control de Calidad 100 FIFO
Número de Resultados en la Base de Datos de AR 10-50-100- Seleccionable
500-1000
Número de Curvas de Reacción en la Base de Datos de AR 100 FIFO
Número Total de Operadores 100 N/A
Número Total de Perfiles 30 N/A
Número de Pruebas en un Solo Perfil 20 N/A
Número Total de Pruebas en la Biblioteca 300 N/A
Número de Pruebas de IL en la Biblioteca 200 N/A
Número de Pruebas de Acuerdo con Especificaciones Particulares en la Biblioteca 100 N/A
Número Total de Grupos de Pruebas 60 N/A
Número de Grupos de Pruebas de IL 30 N/A
Número de Grupos de Pruebas de Acuerdo con Especificaciones Particulares 30 N/A
Número de Pruebas en un Solo Grupo de Prueba 6 N/A
Número Total de Materiales (Líquidos) en la Base de Datos 300 N/A
Número de Materiales de IL (Líquidos) en la Base de Datos 200 N/A
Número de Materiales (Líquidos) de Acuerdo con Especificaciones Particulares en 100 N/A
la Base de Datos
Número de la Lista de Carga Definible 20 N/A
Número de Identificaciones de Muestras en la Lista de Carga 40 N/A

Descripción Tamaño Tipo de


Máximo Manejo
Número de Pasos utilizados en una Aplicación de la Prueba 30 N/A
Número de Materiales (Líquidos) utilizados en una Aplicación de la Prueba 36 N/A
Número de Reglas Reflejas 60 N/A
Número de Criterios en cada Regla Refleja Individual 3 N/A
Número de Pruebas que pueden generse por cada Regla Refleja Individual 10 N/A
Número de Calibraciones para Sesión Dedicada 1 FIFO
Número de Calibradores Dentro de la Sesión y Dentro de la Corrida 5 FIFO
Número de Mensajes en la Historia de Errores en la Sesión 200 FIFO
Número de Mensajes en la Historia de Errores del Archivo 100 FIFO
Número de Mensajes en el Libro de Registro 200 FIFO
Número de Mensajes en el archivo de Seguimiento Hasta 1.4 Automático
MB
* La prueba por duplicado cuenta para 3 resultados (primer
resultado, segundo resultado y media).
FIFO = Lo que entra primero sale primero.
7.48
7.9 Especificaciones Ambientales
293
El ACL Elite/Elite Pro pertenece a la siguiente clase de
instrumentos:
CATEGORÍA: II
GRADO DE CONTAMINACIÓN: 2
USO: bajo techo
Las condiciones ambientales siguientes se aplican al ACL
Elite/Elite Pro:
• Condiciones ambientales para transporte y almacenamiento
Temperatura: 4 – 45ºC
Humedad Relativa: máximo 95%, sin condensación
• Condiciones ambientales funcionales
Temperatura: 15 – 32ºC
Humedad Relativa: máximo 85%, sin condensación
Presión Barométrica: 500 a 1060 mbaras
Altitud: 2000 metros máximo
• Condiciones ambientales de límite de seguridad
Temperatura: 5 – 40ºC
Humedad Relativa: máximo 95%, sin condensación
Presión Barométrica: 500 a 1060 mbaras
Altitud: 2000 metros máximo
7.10 Especificaciones Eléctricas
FRECUENCIA: 50 y 60 Hz (nominal)
Rango de frecuencia: 50 – 60
VOLTAJE: 100 V a 240 V
Tolerancia de voltaje: ± 10%
Consumo de Energía: 350 VA
Fusibles: 2 x T 6.3 A
294
7.49
7.11 RIESGOS
7.11.1 Advertencias Generales
El analizador ACL Elite/Elite Pro puede utilizarse con un
voltaje principal de 90 a 240 VCA (50/60 Hz). Se proporciona
una unidad de suministro de energía automático con el
instrumento, que permite el uso del suministro de energía
local de 90-240 V.
El analizador debe enchufarse a una toma de energía conectada
a tierra.
A fin de permitir el enfriamiento apropiado alrededor del
analizador, permita por lo menos 15 cm (6 pulgadas) de
espacio libre a los lados, la parte posterior y la parte
superior de la unidad.
Se ha sometido a prueba el ACL Elite/Elite Pro y se ha
hallado que cumple con los requerimientos EMC y RFI
internacionales. Estos requerimientos están concebidos para
proveer una protección razonable contra la interferencia
nociva cuando se hace funcionar el equipo en un ambiente
comercial. Este instrumento genera, utiliza y puede radiar
energía de radiofrecuencia. En caso de que se produzca una
interferencia nociva como resultado de la instalación y uso
diferente al recomendado por el fabricante, se requerirá que
el usuario corrija la interferencia por los gastos por su
cuenta.
(Símbolo)
7.11.2 Riesgos de Descarga
Se apremia a los operadores y el personal de mantenimiento
del analizador ACL Elite/Elite Pro para que lleven a cabo
prácticas de seguridad eléctricas adecuadas cuando utilicen
el instrumento. Aunque todas las partes metálicas expuestas
del analizador se encuentran con un potencial de tierra (0
volts), no deben tocarse nunca con una mano mientras la otra
mano está tocando un accesorio de plomería, radiador,
dispositivo accionado por CA u otro objeto conectado a
tierra.
7.11.3 Riesgos Eléctricos
• Desenchufe el analizador de la toma de energía antes de
abrir el cuerpo del analizador.
• APAGUE el analizador antes de reemplazar componentes o
intentar alguna reparación.
• No haga funcionar el analizador en una atmósfera que
contenga gases explosivos, dado que los componentes del
analizador pueden generar chispas.
(Símbolo)
Tierra: Identifica a una Terminal de Tierra.
(Símbolo)
295
Tierra de Protección: Identifica a cualquier Terminal cuya
finalidad es la conexión a un conductor externo.
296
7.50
(Símbolo)
7.11.4 Riesgos Biológicos
Dado que el ACL se utiliza para trabajar con productos
derivados de la sangre humana, todas las partes del
analizador accesibles al operador deben considerarse como
biológicamente peligrosas de manera potencial. Por esta
razón, deben usarse guantes y ropa protectora durante la
operación del sistema.
Cuando se lleven charolas de muestras cargadas con muestras,
debe tenerse cuidado de evitar el derrame de las muestras.
Evite también derramar fluido sobre el analizador y limpie
inmediatamente cuando ocurra esto.
La superficie del analizador debe inspeccionarse con
frecuencia para determinar si hay derrames visibles y debe
descontaminarse en caso necesario, siguiendo las
instrucciones de la Sección 5.
Siga las recomendaciones que se proporcionan en la Sección 5
para el mantenimiento preventivo y rutinario del instrumento.
Para información adicional, consulte el documento NCCLS 117-P
No. 15: Protección de los Trabajadores de Laboratorios Contra
los Riesgos Biológicos de Instrumentos, 1991.
Instrumentation Laboratory cumple con la Directiva 2002/96/EC
del Parlamento Europeo sobre Desechos, Equipo Eléctrico
(WEEE). Para instrucciones acerca de la Disposición al Final
de la Vida, póngase en contacto con el distribuidor local
para mayores detalles.
7.11.5 Riesgos Mecánicos
El operador debe prestar atención a las partes movibles del
instrumento durante la operación normal.
En particular, debe tenerse acceso al área de la charola de
muestras únicamente en el estado de Listo o con el uso de la
función STAT (Pausa) para evitar riesgos mecánicos debidos al
movimiento de los brazos de las agujas.
Denegaciones
Instrumentation Laboratory, Inc. (IL) es responsable de la
seguridad y el desempeño eléctrico de este equipo cuando y
solamente cuando:
• Las operaciones de ensamblaje, extensiones, ajustes,
modificaciones o reparaciones sean llevados a cabo por
personas autorizadas por IL.
• La instalación eléctrica de la sala cumpla con los
requisitos locales, estatales o nacionales (con inclusión
del circuito de suministro de energía con conexión a
tierra independiente).
• Se utiliza el equipo de acuerdo con estas instrucciones
para uso.
297

Bibliografía
Para información adicional, consulte el documento NCCLS 117-P
No. 15: Protección de los Trabajadores de Laboratorio Contra
los Riesgos de Biológicos de los Instrumentos, 1991.
7.51
ANEXO: Estudios de Comparación de Métodos
Nota: El desempeño analítico del ACL 8/9/10000 y ELITE/ELITE
PRO es comparable.
Antitrombina (%):
(Gráfica)
Antitrombina: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (% de Actividad de AT)
ACL 6000 (% de Actividad de AT)
Resistencia APC V (Relación Normalizada):
(Gráfica)
APCR V: ACL 9000 EM5 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM5 (Relación Normalizada)
ACL 6000 (Relación Normalizada)
7.52
APTT-SP (Segundos):
(Gráfica)
APTT: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (segundos)
ACL 6000 (segundos)
Dímero D (ng/mL):
(Gráfica)
Dímero D: ACL 9000 EM6 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM6 (ng/mL)
ACL 6000 (ng/mL)
7.53
Factor VII (%) con Fibrinógeno-PT:
(Gráfica)
Factor VII: ACL 9000 EM5 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM5 (% de Actividad)
ACL 6000 (% de Actividad)
Factor VIII (%) con APTT-SP:
(Gráfica)
Factor VIII: ACL 9000 EM3 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM3(% de Actividad)
ACL 6000 (% de Actividad)
7.54
Fibrinógeno C (mg/dL):
(Gráfica)
Fib-C: ACL 9000 EM6 (Prueba)
298
con respecto a ACL 6000 (Referencia)
ACL 9000 EM6 (mg/dL)
ACL 6000 (mg/dL)

Heparina
(Gráfica)
Heparina: ACL 9000 EM3 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM3 (U/mL)
ACL 6000 (U/mL)
(U/mL):
7.55
Inhibidor de Plasmina (%):
(Gráfica)
Inhibidor de Plasmina: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (% de Actividad)
ACL 6000 (% de Actividad)
Plasminógeno (%):
(Gráfica)
Plasminógeno: ACL 9000 EM3 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM3 (% de Actividad)
ACL 6000 (% de Actividad)
7.56
ProClot (%) con APTT-SP:
(Gráfica)
ProClot (con APTT-SP): ACL 9000 EM5 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM5 (% de Actividad)
ACL 6000 (% de Actividad)
Proteína C (%):
(Gráfica)
Proteína C: ACL 9000 EM7 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM7 (% de Actividad)
ACL 6000 (% de Actividad)
7.57
Proteína S (%):
(Gráfica)
Proteína S: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (% de Actividad)
ACL 6000 (% de Actividad)
PT (Segundos):
(Gráfica)
PT: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (Segundos)
ACL 6000 (Segundos)
7.58
299
Fibrinógeno Basado en PT (mg/dL):
(Gráfica)
Fibrinógeno Basado en PT: ACL 9000 EM7 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 EM7 (mg/dL)
ACL 6000 (mg/dL)
300
Tiempo de Trombina – 8 mL (Segundos):
(Gráfica)
TT – 8 mL: ACL 9000 (Prueba)
con respecto a ACL 6000 (Referencia)
ACL 9000 (Segundos)
ACL 6000 (Segundos)
8.1
8 Recolección y Almacenamiento de Muestras
8.0 Introducción
Dada la importancia de las pruebas de coagulación para tomar
decisiones de diagnóstico y terapéuticas, es esencial seguir
un procedimiento detallado para la recolección y el
transporte de muestras de sangre, así como la preparación del
plasma utilizado para estas pruebas.
Muchas variables, tales como el tipo de anticoagulante, el
almacenamiento de la muestra y el tipo de contenedor
utilizado para extraer sangre, tendrán un efecto sobre los
resultados analíticos.
Los procedimientos generales que se describen a continuación
– que se refieren a la recolección de muestras de sangre
humana del paciente, su transporte del sitio de recolección
al laboratorio y su manejo y almacenamiento en el laboratorio
– se consideran estándar para cualquier prueba de
coagulación.
8.1 Recolección de Muestras
La sangre venosa debe extraerse con éstasis mínimo con el uso
de una jeringa de plástico o un tubo de prueba llenado al
vacío, según lo recomienda el Documento CLSI H21-A3.
Para todas las pruebas relacionadas con el control de la
hemostasis, con excepción de la cuenta de plaquetas, el
anticoagulante preferido es el citrato trisódico con la
concentración recomendada en el Documento CLSI H21-A3, con el
uso de una relación de 1 volumen de citrato por 9 volúmenes
de sangre.
La concentración correcta del anticoagulante es de primordial
importancia para la precisión de los resultados. Debe
hacerse referencia al Documento antes mencionado cuando se
requieran ajustes a la concentración de citrato.
8.2
8.2 Manejo del Plasma
8.2.1 Separación del Plasma
Las muestras deben centrifugarse a 2500 g durante 15 minutos,
tan pronto como sea posible después de la recolección.
Debe evitarse la hemólisis durante la recolección y la
centrifugación de la muestra, debida a la presencia de
glóbulos rojos, que tengan superficies de fosfolípidos con
actividad de tromboplastina que afecte a los tiempos de
coagulación.
301
8.2.2 Transporte del Plasma
Para las recomendaciones con respecto al transporte del
plasma, consulte el Documento CLSI H21-A3.
8.2.3 Almacenamiento del Plasma
Para las recomendaciones con respecto al transporte del
plasma, consulte el Documento CLSI H21-A3.
8.3 Plasma de Calibración
8.3.1 Descripción
Las condiciones operativas del sistema ACL Elite/Elite Pro
utilizan una combinación (pool) de plasma de referencia para
verificar el sistema como un todo (analizador más reactivos).
El IL TestTM Calibration Plasma consiste en una combinación
(pool) liofilizada de plasma normal que tiene las mismas
características de una combinación (pool) fresca de plasma
humano normal. El material liofilizado ofrece las ventajas de
un almacenamiento más fácil y estabilidad más prolongada.
El ACL Elite/Elite Pro utiliza el Plasma de Calibración como
sigue:
1. Para generar una curva de calibración según sea
necesario.
2. Para verificar y seguir las condiciones del ensayo
durante el análisis de la muestra, dentro del sistema
entero (optativo para ciertos ensayos).
Para los ensayos de PT, Fibrinógeno basado en PT y TT, el
valor del Plasma de Calibración debe estar dentro del rango
de referencia almacenado en la memoria del ACL. Cuando éste
no sea el caso, se proporcionarán indicadores de mensajes al
operador. La dotación de indicadores a los resultados es
optativa.
8.3
8.3.2 Preparación
Consulte la hoja de inserto impresa del paquete que acompaña
a cada producto.
8.3.3 Asignación de Valor
El Plasma de Calibración difiere del plasma de control normal
en que se utiliza para generar una curva de calibración y
para monitorear la precisión y la exactitud del sistema
(analizador más reactivos).
Lo anterior significa que el Plasma de Calibración tiene un
valor conocido que constituye el objetivo – o valor de
referencia – para las pruebas. El plasma de control normal
puede tener un rango de valores aceptables, no un solo valor
que constituya el objetivo, para las pruebas.
El Plasma de Calibración debe tener una actividad próxima al
100% de los valores esperados, en tanto que la actividad del
plasma de control normal debe estar solamente dentro de un
rango de referencia asignado.
302
Los plasmas de control normal y anormal pueden utilizarse de
manera aleatoria como parte de un programa de control de
calidad interno para verificar el desempeño analítico del
sistema.
El valor del Plasma de Calibración que constituye el
objetivo, indicador en la hoja del inserto del paquete, se
asigna mediante el uso de un número de determinaciones
efectuadas en diferentes instrumentos.
A fin de eliminar cualquier variación posible de un
laboratorio a otro, es aconsejable calcular los tiempos (en
segundos) de PT, APTT y TT para cada lote de Plasma de
Calibración, que pueden utilizarse como el valor de
referencia para las propias condiciones del laboratorio.
IL sugiere el procedimiento siguiente para determinar el
valor del Plasma de Calibración para cada laboratorio en
particular:
• Para APTT y PT, efectúe un mínimo de 5 y un máximo de 10
determinaciones. Calcule la media del valor para cada
ensayo e introdúzcalo en el cuadro de “verificaciones” de
Ajuste de las Pruebas el ACL.
• Para PT, el título corresponderá al valor, en segundos,
de la solución de 100%. Una vez que se acepta la
calibración, introduzca el valor obtenido para el 100%.
• Para el Fibrinógeno, cuando se efectúe una calibración de
Fibrinógeno, introduzca el valor reportado en la hoja del
inserto del paquete del Plasma de Calibración. Introduzca
este valor también en el cuadro de “verificaciones” de
Ajuste de las Pruebas.
NOTA: El procedimiento antes delineado debe efectuarse en
cualquier momento en que haya un cambio – tal como un nuevo
lote de Plasma de Calibración, nuevo reactivo, nuevo lote de
reactores, etc. – que requiera una nueva calibración del
sistema del ACL Elite/Elite Pro.
8.4
Referencias
1. CLSI Document (latest revision) Collection, Transport
and Processing of Blood Specimens for Coagulation
Testing and General Performance of Coagulation Assays.
2. ECCLS Vol. No. 1. Standard for Specimen Collection.
3. CLSI Document (latest revision) Procedure for the
Collection of Diagnostic Blood Specimens by
Venipuncture.
9.1
9 Partes y Consumibles
9.0 Introducción
Esta sección contiene información acerca de los materiales
consumibles que están disponibles para uso con el Sistema del
303
ACL Elite/Elite Pro. Estos artículos pueden ordenarse en IL o
su representante, siempre que se necesiten, con el uso de los
Números de Catálogo que se muestran en la tabla, Sección 9.2.
Uno o más de estos artículos se embarcan con el “Estuche de
Inicio” que se incluye con el sistema ACL Elite/Elite Pro,
como se indica en la Sección 9.1.

9.1 Estuche de Inicio


Los siguientes materiales consumibles están contenidos en el
Estuche de Inicio que se embarca con el Sistema ACL
Elite/Elite Pro.

Charolas de Muestras
Están disponibles tres tipos de charolas de muestras, como se
indica a continuación. El estuche de inicio incluye dos de
ellas. El usuario escoge la configuración deseada del sistema
entre la Configuración Corta y la Alta. Las charolas para los
tubos Sarsted deben ordenarse por separado.
Tipo de charolas Se utilizan para
Corta Tubo primario, 3 ó 3.5 mL, volumen total (13 x 75 mm)
Alta Tubo primario, 5 mL, volumen total (13x75 ó 13x100 mm)
S 11.5 Tubo tipo Sarsted, 3 mL (11.5x66 mm) o 5 mL (11.5x92 mm)

Adaptadores para las Charolas de Muestras


- para copas de plástico – 4 piezas
- para frasquitos de vidrio de 4 mL – 6 piezas
Adaptadores para Frasquitos de Reactivos
- para frasquitos de 10 mL, reactivos que requieren
agitación magnética (grises) – 4 piezas
- para frasquitos de 10 mL, reactivos que no requieren
agitación magnética (rosas) – 4 piezas
- para frasquitos de 4 mL, reactivos que no requieren
agitación magnética (verdes) – 4 piezas
9.2
Agitadores Magnéticos
- para agitación de reactivos – un paquete contiene 5
piezas
Copas Pequeñas para Muestras
- copas de muestras de 0.5 mL – un paquete contiene 1000
piezas
Copas Grandes para Muestras
- copas de muestras de 2.0 mL – un paquete contiene 1000
piezas
Copas para Diluyente/Tampón/Reactivos
- copas de 4.0 mL, con etiquetas – un paquete contiene 100
piezas
Frasquitos de Vidrio para Diluyente/Tampón/Reactivos
304
- frasquitos de vidrio de 10 mL – un paquete contiene 10
piezas
Conjunto de Bloque y Sondas
- un conjunto que consiste en un bloque acrílico con las
agujas de muestras y reactivos
Tubería para Muestras y Reactivos
- una pieza de 1.5 metros de tubería para cortarse y usarse
según se necesite.
305
Herramienta de Inserción para Tubería de Muestras y Reactivos
- una herramienta que se utilizará cuando se reemplace la
tubería de muestras y reactivos
Emulsión de Lavado/Referencia
- una botella de Emulsión de 1 litro
Reservorio para Desechos/Enjuague
- un reservorio para lavado y enjuague de agujas
Botella de Desechos
- botella de 5 litros para recolectar los desechos del ACL
Tubería de Desechos
- un pedazo de tubería de 1.5 metros para usarse en la
recolección de desechos líquidos
- Herramienta de Ajuste para las Agujas de
Aspiración/Surtido
- Una herramienta para usarse en el ajuste de la posición
de las agujas en el brazo
Rotores
- Rotores de 20 Cuvetas – el paquete contiene 100 piezas
9.3
Herramienta de Introducción de Rotor
- Una herramienta que se utiliza para introducir los
rotores en el sistema
Contenedor de Desechos de Rotores
- Un contenedor removible que se utiliza en el interior del
sistema para contener los rotores usados
Filtro de Aire Moldeado
- Un filtro de aire para el cuerpo del analizador
Fusibles 6.3 AT
- 2 fusibles para el sistema
Cable de Energía
- Un cable de energía para el sistema: el cable incluido
coincide con el voltaje con el que se utilizará el
sistema, ya sean 100-115V o 220-240 V.
Cable de Impresora Externa
- Un cable para conectar la impresora externa optativa.
Cable de la Computadora Principal
- Un cable para conectar la computadora principal optativa.
Estuche de Disco del Sistema de Software
- Estuche que contiene el software principal del sistema
Estuche de Disco de la Biblioteca de Pruebas
- Estuche que contiene el software de la biblioteca de
pruebas
Manual del Operador
- El Manual del Operador para el uso del sistema ACL
Elite/Elite Pro.
Dispositivo señalador de ratón de Dos Botones
Lector de Código de Barras Externo (ACL Elite Pro solamente)
306
Certificado de Cumplimiento
- Un certificado de cumplimiento específico del sistema
9.4
9.2 Información para Ordenar Consumibles
Número de Catálogo Descripción del Artículo # de Piezas en la Unidad del
Paquete
181108-90* Charola de Muestras para tubos de 13x75 mm (3-3.5 mL) 1
181108-98* Charola de Muestras para tubos de 13x75 y 13x100mm (5 mL) 1
181812-85 Charola de Muestras para tubos Sarsted de 11.5x66 mm (3 mL) 1
y 11.5x92 mm (5 mL)
190764-00 Adaptador de Charola de Muestras para copa de plástico 4
190763-00 Adaptador de Charola de Muestras para frasquitos de 4 mL 6
181812-65 Adaptador para frasquitos de reactivos de 10 mL con agitación 4
magnética (grises)
190762-00 Adaptador para frasquitos de reactivos de 10 mL sin agitación 6
magnética (rosas)
190761-00 Adaptador para frasquitos de reactivos de 10 mL sin agitación 4
magnética (verdes)
97466-06 Agitador Magnético 6
189241-00 Frasquitos de Vidrio, 10 mL 10
67992-00 Copas de Muestras, 0.5 mL 1000
55751-00 Copas de Muestras, 2 mL 1000
67994-00 Copas, 4 mL más Etiquetas 100
68000-00 Rotores-20 cuvetas 100
181812-77 Herramienta de Reabastecimiento de Rotores 1
181108-97 Contenedor de Desechos de Rotores 1
181108-43 Conjunto de Sondas - Bloque 1
181039-41 Herramienta de Ajuste de Agujas 1
73269-01 Tubería para Muestras y Reactivos, 1.5 m 1
181080-65 Herramienta Extractora de Tubería para Muestras y Reactivos 1
181812-72 Reservorio para Desechos, para lavado de agujas 1
181057-69 Botella para Desechos Líquidos 1
99095-03 Tubo de Desechos, 1.5 m 1
181812-71 Filtro de Aire moldeado 1
148821-00 Fusibles 6.3 AT 2
148821-00 Cable de Energía, 110-115 V 1
71992-00 Cable de Energía. 220-240 V 1
84862-50 Cable de Impresora Externa 1
181812-74 Cable de Computadora Principal (9 pins – 9 pins) 1
200024-00 Emulsión de Lavado/Referencia, 1 litro 1
181951-XX Estuche de Disco del Sistema de Sofware 1
181963-XX Estuche de Disco de la Biblioteca de Pruebas 1
97627-50 Certificado de Cumplimiento 1
181121-11 Manual del Operador, versión en inglés 1

*se incluyen 2 charolas de muestras en cada estuche de inicio


XX = dependiendo de la revisión del software
10.1
10 Garantía
10.0 Condiciones Generales de la Garantía
IL declara al Comprador original que cada instrumento
fabricado y/o vendido por IL, estará libre de defectos de
materiales, mano de obra y, bajo condiciones de uso normales
y apropiadas, lo garantiza por un período de un año a partir
de la instalación y no más de 13 meses de la fecha de
embarque.
La obligación de IL está limitada a reparar, reemplazar o
modificar (a juicio indisputable de IL) en la fábrica de IL o
en alguna otra parte, el material cuyos defectos hayan sido
307
verificados, con la condición de que el Comprador haya
informado a IL acerca de cualesquiera defectos hallados
dentro de 8 días de la recepción o del hallazgo, en caso de
los defectos que no puedan identificarse en la inspección
normal.
Se excluyen los daños ocasionados por el transporte o
relacionados con éste. El transporte hacia y desde la Fábrica
de IL será por cuenta y riesgo del Comprador y se pagará
también para el nuevo embarque.
Estos reemplazos, reparaciones o alteraciones no determinarán
en ningún caso la prórroga del período de garantía antes
especificado.
Esta garantía no cubre a aquellas partes que se deterioren, o
que se consideren consumibles, o aquellas partes o artículos
que, por su naturaleza, se requiera que se reemplacen
periódicamente, de manera congruente con el mantenimiento
normal (con inclusión de las lámparas y tubos, sin estar
limitados a éstos).
Aquellos instrumentos o accesorios, que sean suministrados
por IL, pero que no sean de fabricación por IL, se
beneficiarán solamente por las condiciones de garantía que
ofrece el fabricante.
Se entiende también que, después de la compra y entrega del
instrumento, se considerará al Comprador responsable de
cualesquiera pérdidas, daños o quejas con respecto a personas
o cosas, en que se incurra por el uso o el mal uso del
instrumento en nombre del Comprador, sus empleados,
operadores conjuntos u otros.
IL no asume ninguna obligación o compromiso de garantía con
respecto a la precisión y/o exactitud de las mediciones, así
como por cualquier daño al instrumento que resulte directa o
indirectamente del uso de reactivos y/o consumibles
diferentes de los producidos por IL específicamente para sus
propios instrumentos, debidamente sometidos a prueba en los
mismos.
10.2
La garantía no se aplicará a aquellos instrumentos
defectuosos o materiales que muestren defectos o daños que
surjan de las causas siguientes:
a. Cuidado insuficiente o negligente por parte del
Comprador.
b. Mantenimiento insuficiente o negligente por parte del
Comprador con relación a las instrucciones contenidas en
los Manuales preparados por IL para este fin, la
manipulación indebida, o las alteraciones de los
instrumentos o, en cualquier caso, la intervención o las
308
reparaciones efectuadas por cualquier persona no
debidamente autorizada por IL.
c. El mal uso debido a descuido, negligencia o
inexperiencia.
d. El empleo de materiales bajo condiciones más pesadas que
aquellas para las que han sido diseñados y fabricados, y
el uso de los mismos en combinación con productos
incompatibles o peligrosos.
e. La falta de observancia de los reglamentos relativos a la
instalación, suministro de energía y operación de los
instrumentos (con consideración en particular a los
reglamentos para la prevención de accidentes).
10.1 Denegación con respecto a productos que no son la marca
IL
Los reactivos, los consumibles y los suministros consumibles
marca IL (con inclusión, por ejemplo, de la emulsión de
lavado y referencia, y los rotores) se desarrollaron
específicamente para el sistema ACL de detección de coágulos
nefelométrico centrífugo. Los productos del sistema de
detección ACL de IL se someten a prueba para asegurar el
desempeño apropiado cuando se utilizan muestras de plasma de
acuerdo con el protocolo que se describe en la Sección 8.
Cada lote de reactivos del ACL, marca IL, se somete a prueba
contra estos criterios. No se efectúa la verificación de
otras marcas de reactivos o suministros para asegurar su
idoneidad para la metodología del ACL o su nivel de desempeño
en los instrumentos ACL de IL. El uso de reactivos o
suministros que no son de la marca IL para pruebas, de
acuerdo con los protocolos de IL, puede ocasionar una
degradación clínicamente significativa del desempeño y los
resultados.
IL no asume ninguna obligación ni compromiso de garantía con
respecto a la precisión y/o la exactitud de las mediciones,
ni por ningún daño al instrumento que resulte directa o
indirectamente del uso de reactivos, consumibles y
suministros consumibles diferentes de los producidos por IL.
10.3
ESTA GARANTÍA SE OTORGA EXPRESAMENTE Y EN LUGAR DE TODAS LAS
DEMÁS GARANTÍAS, EXPRESAS O IMPLÍCITAS. EL COMPRADOR ACUERDA
QUE NO HAY NINGUNA GARANTÍA DE COMERCIABILIDAD Y QUE NO HAY
NINGUNOS OTROS RECURSOS O GARANTÍAS, EXPRESOS O IMPLÍCITOS,
QUE SE EXTIENDAN MÁS ALLÁ DE ESTE CONVENIO.
Ningún mandatario o empleado de IL está autorizado para
otorgar alguna otra garantía o asumir por IL cualquier
responsabilidad, con excepción de lo antes establecido.
309
IL no somete a prueba los reactivos de otros fabricantes para
determinar su idoneidad para la metodología del ACL o su
nivel de desempeño en los instrumentos ACL.
Garantía de ACL
Los siguientes artículos se consideran como partes
consumibles.
Tubería de Fluidos_____________________________
Sonda de Muestras______________________________
11.1, 11.2, 11.3
11 Localidades Mundiales de IL
(Lista)
310
* * * * * * *
ACL Elite/Elite Pro – AVISO INR IMPORTANTE DEL BOLETÍN TÉCNICO
FÓRMULA INR
INR = (PT del Paciente / PT Normal)ISI
PT DEL PACIENTE = PT del Paciente en segundos
PT NORMAL = *Media del Rango Normal (en el ACL Elite/Elite
Pro se denomina el Valor de Referencia).
Valor ISI = Índice de Sensibilidad Internacional del # de
lote del reactivo de tromboplastina que se está
utilizando.
Para asegurar el reporte apropiado de los resultados INR,
deben seguirse estos pasos:
1. Asegúrese de que el instrumento se encuentre en el modo
de LISTO. En el MENÚ DE AJUSTE, seleccione el SUBMENÚ DE
LÍQUIDOS y seleccione a continuación el REACTIVO DE
TROMBOPLASTINA (IDENTIFICACIÓN DEL LÍQUIDO) apropiado de
la lista en la parte superior de la pantalla.
2. Seleccione la PRUEBA DE PT que utilice este reactivo de
Tromboplastina y haga clic en ASIGNAR VALOR.

3. Introduzca el VALOR ISI del Lote de Tromboplastina en


uso y seleccione Confirmar dos veces para introducir
el valor. Asegúrese de que todas las pruebas de PT que
utilizan la misma Tromboplastina importen la
asignación de ISI apropiada. Pueden estar presentes
varias PRUEBAS DE PT que utilicen la misma
Tromboplastina, tal como PT extendida, PT estándar por
duplicado y PT por duplicado de tiempo de adquisición
extendido. Estas pruebas importarán el valor de la
prueba estándar.
NOTA: El valor ISI es específico para el número de lote
del reactivo de tiempo de protrombina que se está usando.

4. En el MENÚ DE AJUSTE, seleccione VER/DEFINIR PRUEBAS.


Seleccione la prueba de PT apropiada y haga clic en los
detalles.
5. Seleccione AJUSTE DEL CÁLCULO y el instrumento mostrará,
en la parte derecha de la pantalla, la selección del
VALOR DE REFERENCIA. Esto representa a la Media del Valor
Normal de la Población en SEGUNDOS, que se utiliza como
el DENOMINADOR en el CÁLCULO de la RELACIÓN y de INR.
6. Asegúrese de que el valor introducido en el campo
represente a la MEDIA DEL RANGO NORMAL DE LA POBLACIÓN de
la población local para PT. Este valor puede editarse y
puede modificarse para reflejar la media del rango normal
establecido para el laboratorio.
311
7. Confirme que las Pruebas PT que utilizan el mismo lote de
tromboplastina para la Relación/INR se calculen con el
uso del mismo valoren segundos que el denominador (Media
del Rango Normal de la Población).
8. El instrumento utiliza la fórmula siguiente para el
CÁLCULO DE LA RELACIÓN.
CÁLCULO DE LA RELACIÓN = PLASMA DEL PACIENTE (segundos)
VALOR DE REFERENCIA (segundos)
Valor de Referencia significa la MEDIA DE LA POBLACIÓN
NORMAL (segundos)
MEDIA DEL RANGO NORMAL DE LA POBLACIÓN = Media del Tiempo
de PT Normal = Media Normal del Paciente
El rango en segundos según lo recomendado por CLSI,
Documento C28-A, Vol. 15 No. 4.
9. INR se calculará como sigue:
INR = (PT del Paciente/PT del Valor de Referencia)ISI
Con el uso del elemento del Valor de Referencia, el
denominador utilizado en el cálculo de la Relación e INR
reflejará con exactitud a la Media del Rango Normal de la
Población.
* o la media Geométrica
ADVERTENCIAS IMPORTANTES:
• Cuando los cálculos de INR no se ajustan de manera
apropiada, pueden reportarse resultados erróneos del
paciente.
• En caso de que cambie el número de lote del producto,
debe introducirse entonces el nuevo valor ISI del
inserto del paquete.
• En el ACL Elite/Elite Pro, tanto la pantalla como la
impresión muestran/reportan las unidades de INR y la
Relación por separado.
312
* * * * * * *
1
Apéndice A
ACL Elite/Elite Pro
Protocolo de Comunicación con la Computadora Principal
2
Apéndice A
Fecha de Revisión Comentarios
7 de diciembre de 2002 Adición de ejemplos de transmisión
Números de campo ASTM especificados
Adición de Notas para información
Número total de páginas
Claves de Pruebas Revisadas
16 de diciembre de 2002 Revisión de algunas notas
Abril de 2004 Actualización de clave de error
Diciembre de 2005 Actualización de Elite/Elite Pro

3
Índice
1.0 Introducción 4
1.1 Objeto 4
2.0 Descripción General 5
2.1 Perspectiva del Producto 5
3.0 Requerimientos Específicos 6
3.1 Especificación del Protocolo 6
3.2 Interfaz de Nivel Bajo 6
3.3 Vínculo de Datos y Capa Lógica 6
3.4 Sesiones 6
3.4.1 Encabezado de Mensaje y Registros Terminadores de
Mensaje 7
3.5 Bajada de Orden de Prueba 8
3.5.1 Sesión de Recepción de DMS 8
3.5.1.1 Mensaje de Solicitud de Prueba 9
3.5.1.2 Mensaje de Orden de Prueba 10
3.5.1.2.1 Registro de Información del Paciente 10
3.5.1.2.2 Registro de Orden de Prueba 12
3.5.2 Pregunta a Computadora Principal 14
3.5.3 Mensaje de Solicitud de Prueba 15
3.5.4 Mensaje de Orden de Prueba 16
3.6 Mensaje de Prueba Rechazada 17
3.7 Bajar Volúmenes de Sesión 18
4.0 Subir Resultados de Prueba 19
4.1 Mensaje de Resultados de Prueba 20
4.1.1 Registro de Información del Paciente 20
4.1.2 Registro de Orden de Prueba 21
4.1.3 Registro de Resultados 22
4.1.4 Registro de Comentarios 23
4.1.5 Claves de Errores 24
4.2 Subir Volúmenes de Sesión 26
5.0 Registros No Soportados 27
6.0 Abortar Transmisión 27
7.0 Apéndice – Claves de Pruebas de ACL Elite/Elite Pro 28
8.0 Apéndice – Caracteres Soportados de ACL Elite/Elite Pro 31
8.1 Caracteres Soportados para Identificación de Muestras 31
8.2 Caracteres Soportados para nombre del Paciente y
313
Departamento 31
8.3 Caracteres Soportados para Delimitadores 31
9.0 Apéndice – Unidades Soportadas de ACL Elite/Elite Pro 32
4
1.0 Introducción
1.1 Objeto
Este documento es una guía para integrar un sistema de
Administración de Información de Laboratorio con la familia
de instrumentos de ELITE/ELITE PRO de Instrumentation
Laboratory, con el uso de la especificación de la ASTM
(Sociedad Norteamericana para Pruebas y Materiales) para
transferir información entre instrumentos clínicos y sistemas
de cómputo.
ASTM especificación E-1394-91 Especificación de la Norma para
la Transferencia de Información entre Instrumentos Clínicos y
Sistemas de Cómputo y E-1381-91 Especificación de la Norma
para el Protocolo de Nivel Bajo para la transferencia de
Mensajes entre Instrumentos de Laboratorios Clínicos y
Sistemas de Cómputo, se han utilizado como norma para
elaborar el Protocolo de Comunicación de ELITE/ELITE PRO con
la Computadora Principal.
La Especificación E-1394 define la capa lógica de la norma
ASTM; toda la información importante para la aplicación de
los instrumentos ELITE/ELITE PRO puede hallarse en los
capítulos de Requerimientos Específicos y los siguientes.
La Especificación E-1381 se refiere al protocolo de nivel
bajo; la información importante para la aplicación de la
familia de instrumentos ELITE/ELITE PRO puede hallarse
posteriormente en este documento.
5
2.0 Descripción General
2.1 Perspectiva del Producto
Las sesiones de comunicación con la computadora principal
pueden ser iniciadas en la familia ELITE/ELITE PRO mediante
solicitud del operador o automáticamente al terminarse la
sesión.
En caso de que el operador requiera una sesión para bajar
manualmente, el instrumento abrirá la comunicación con la
computadora principal que proveerá la transmisión de todas
las órdenes de pruebas.
En caso de que el operador requiera una sesión para subir, el
instrumento transmitirá un subconjunto de resultados de las
pruebas (identificados por el usuario), almacenados en la
base de datos del paciente en el instrumento, o la base de
datos de Control de Calidad o la base de datos de la
Referencia Analítica.
314
Cuando el instrumento está configurado debidamente, las
sesiones para bajar o subir pueden ser iniciadas por el
instrumento ELITE/ELITE PRO.
Ocurrirá la operación de bajar automáticamente al iniciar la
sesión cuando estén configuradas las preguntas a la
computadora principal. En esta condición, el instrumento
solicitará órdenes de pruebas para identificaciones de
muestras específicas, reconocidas en la charola de muestras.
Ocurrirá la segunda condición cuando se haya solicitado subir
automáticamente, al terminar la sesión.
En caso de que no se genere la sesión de comunicación desde
el instrumento, se hace caso omiso de cualquier mensaje de la
computadora principal.
Toda la información recibida por la computadora principal
debe estar asociada a una Identificación de la Muestra, que
es la clave primaria de la base de datos. Además de las
pruebas programadas, puede asociarse cierta cantidad de
información a una Identificación de la Muestra (datos del
paciente) y almacenarse en la base de datos del ELITE/ELITE
PRO. Esta información es optativa.
La Identificación de la Muestra es la clave primaria para
tener acceso a la información en la base de datos.
Cuando fallan las verificaciones, se abortarán cualesquiera
operaciones para bajar. Ver la sección de Bajar Órdenes de
Pruebas.
Pueden almacenarse 1000 muestras como mucho en la base de
datos del ELITE/ELITE PRO; cada muestra puede tener un máximo
de 30 pruebas asociadas (las pruebas dobles se consideran
como 3 pruebas).
Cuando se exceden estos límites, se explica el comportamiento
del sistema en el párrafo Bajar Órdenes de Pruebas.
Cuando hay 1000 muestras presentes en la base de datos, el
sistema FIFO (lo que entra primero sale primero) no aceptará
muestras adicionales durante una operación de Bajar
Manualmente.
La última operación para ordenar, para identificar el tipo de
prueba ordenada, por parte de la computadora principal, debe
hacer referencia a una clave de computadora que sea
específica para el instrumento. Consulte Bajar Orden de
Prueba para mayores detalles y el Apéndice al final de este
documento para la tabla de claves de las pruebas.
Nota: para bajar, la Computadora Principal debe enviar
información en secuencia al ELITE/ELITE PRO, en un solo
cuadro (una sola línea) durante la transmisión o hasta 240
bytes como máximo durante la transmisión.
6
3.0 Requerimientos Específicos
315
3.1 Especificación del Protocolo
3.2 Interfaz de Nivel Bajo
La interfaz de nivel bajo está conforme a la especificación
ASTM E-1381-91. Las características siguientes están
soportadas y son configurables por la Interfaz del Operador.
Velocidad en Baudios 2400, 4800, 9600, 19200, 38600
Longitud de Caracteres 8 bits
Paridad Ninguna paridad
Bits de Paro 1
3.3 Vínculo de Datos y Capa Lógica
Para la Vinculación de Datos y la Capa Lógica, la
especificación ASTM E-1381-91 se ha mantenido como
referencia. Los límites y restricciones del protocolo son
aquellos declarados por la norma.
Para mencionar algunos de ellos, la parte de datos de los
cuadros, que se intercambian entre el instrumento y la
computadora principal, debe efectuarse como un solo cuadro.
Como consecuencia, durante las sesiones de transmisión, las
rutinas específicas proveen la capacidad para dividir
registros grandes en múltiples cuadros y, durante una sesión
de recepción, reconstruyen los cuadros parciales en un solo
registro. El nivel de aplicación no tiene ninguna evidencia
de este mecanismo.
De acuerdo con la norma ASTM, los caracteres siguientes no
pueden ser parte de los registros de datos: <SOH>, <STX>,
<ETX>, <EOT>, <ENQ>, <ACK>, <DEL>, <NAK>, <SYN>, <ETB>, <LF>,
<DC1>, <DC2>, <DC3>, <DC4>.
La lógica de nuevo intento y la terminación del tiempo son
aquellas especificadas por la norma; el Diagrama del Estado
de los Mensajes Clínicos de Nivel Bajo, que representa al
automático implementado, es la referencia.
En el estado de solicitud de interrupción, el instrumento
acepta EOT remoto.
3.4 Sesiones
Hay dos tipos de sesiones que maneja el instrumento con la
interfaz ASTM: bajar las órdenes de pruebas y subir los
resultados de las pruebas. Estas sesiones pueden ser
iniciadas por el operador o activadas automáticamente por el
instrumento.
Cuando el usuario/operador solicita una operación de bajar
(Comando de Recibir), el instrumento enviará una solicitud a
la computadora principal para las órdenes de prueba
disponibles (todas) o para órdenes de prueba solicitadas para
muestras específicas, y la computadora principal responderá
con las órdenes de pruebas disponibles para el instrumento.
Subir los resultados de las pruebas (Comando de Transmitir)
es iniciado por el usuario o automáticamente por el
instrumento de la misma manera. No se permite que la
316
computadora principal transmita mensajes no solicitados,
algún tipo de preguntas u órdenes de pruebas que el
instrumento no requiera explícitamente.
7
3.4.1 Encabezado de Mensaje y Registros Terminadores de
Mensaje
Siguiendo la especificación ASTM, cada tipo de transacción
entre el instrumento (DTE) y la computadora principal (DCE)
tiene dos registros comunes que son el registro del
Encabezado del Mensaje y el registro de Terminador del
Mensaje. Estos registros abren y cierran la transmisión de
datos entre los instrumentos ELITE/ELITE PRO y la computadora
principal.
Sus campos se describen en lo siguiente:
Registro de Encabezado de Mensaje:
Identificación del Tipo de Registro Se establece siempre en “H”
Definición de Delimitador Los 5 caracteres ASCII que componen a este campo definen el
tipo de delimitadores que se utilizaran en los registros
siguientes. Ver el Apéndice B para los delimitadores
soportados
Identificación de Control de Mensaje No se proporciona
Contraseña de Acceso No se proporciona
Nombre o Identificación del Remitente Establecido a “ACL9000” cuando se transmite a la
computadora principal o se recibe. Como una opción, se
soporta también la capacidad de identificar inequívocamente el
instrumento por medio de una extensión del nombre del
instrumento: la sintaxis del nombre se convierte en “ACL9000-
xx”, en que xx es una clave de dos dígitos en el rango 01-99.
La extensión del nombre del instrumento es configurable por el
usuario en el ambiente de ajuste.
La identificación del instrumento es siempre ACL9000,
independientemente del modelo; el ELITE/ELITE PRO.
Dirección Particular del Remitente No se proporciona
Campos Reservados No se proporcionan
Número de Teléfono del Remitente No se proporciona
Características del Remitente No se proporcionan
Identificación del Receptor Debe establecerse en “ACL9000” cuando se reciba de la
computadora principal. Dependiendo del ajuste del
instrumento, la capacidad para identificar inequívocamente al
instrumento por medio de la extensión del nombre del
instrumento, se soporta también: la sintaxis del nombre se
convierte en “ACL9000-xx” en que xx es la clave de dos dígitos
en el rango 01-99.
Cuando la identificación es diferente de la esperada, se
interrumpe la sesión.
Comentario o Instrucciones especiales No se proporcionan
Identificación de Procesamiento Se establece siempre en “P” que significa Producción
Versión No. Se establece en la versión de la norma ASTM actual = “1”
Fecha y Hora del Mensaje El Formato es YYYYMMDDHHMMSS
317

Ejemplo de mensaje enviado por el ELITE/ELITE PRO


Hl\^&lllACL9000lllllllPl1l20021205123956<CR>
Ejemplo de mensaje enviado por la Copmutadora Principal
Hl\^&llllllllACL9000llPl1l20021205123956<CR>
8
Registro Terminador de Mensaje:
Identificación de Tipo de Registro Siempre se establece en “L”
Número de Secuencia Se establece siempre en “1”
Clave de Terminación Se establece en “N” para la terminación normal y en “E” para la
terminación anormal mientras se transmite a la computadora
principal; no se considera para los datos recibidos.

Ejemplo de Terminador:
Ll1lN<CR>
3.5 Bajada de Orden de Prueba
Bajar órdenes de prueba se utiliza para solicitar las órdenes
disponibles en la computadora principal y hacer que estén en
el instrumento. Esta operación puede obtenerse de dos
maneras: abriendo manualmente una sesión de bajar del
ambiente DMS o activando la función de pregunta a la
computadora principal en el instrumento.
En el primer caso, la computadora principal tendrá que
transmitir a los instrumentos todas las solicitudes de prueba
pendientes; en el segundo caso, el instrumento requerirá
automáticamente información específica para las muestras
colocadas en la charola de muestras y sin ningunas
solicitudes de pruebas.
Los detalles para ambas modalidades se explican en los
párrafos de Sesión de Recepción de DMS y Pregunta a
Computadora Principal.
3.5.1 Sesión de Recepción de DMS
El operador inicia manualmente bajar órdenes de pruebas
provenientes del ambiente DMS.
La computadora principal proporcionará al instrumento todas
las solicitudes de pruebas disponibles. La computadora
principal puede enviar cero o más órdenes de pruebas en uno o
más mensajes, pero todos los mensajes serán parte de la misma
sesión de transmisión.
Durante una sesión de transmisión, pueden requerirse más
órdenes de prueba para la misma muestra. La computadora
principal envía habitualmente todas las órdenes de pruebas
para las que no haya recibido todavía resultados, aunque se
hayan transmitido previamente.
Los instrumentos ELITE/ELITE PRO procesarán cada orden de
prueba recibida para validar los campos soportados; se
extraerá cierta información del registro recibido, en tanto
318
que se hará caso omiso de otra información. Se consideran
solamente las órdenes de pruebas relacionadas con las
muestras del paciente; en caso de que la identificación de la
muestra requerida no exista en la base de datos del paciente
y no se utilice la identificación de la muestra requerida en
la base de datos de Control de Calidad, se crea un nuevo
registro. Cuando la base de datos está llena, se abortará la
sesión de transmisión.
En caso de que las órdenes de pruebas sean para una muestra
que ya existe en la base de datos de las muestras, se
añadirán las nuevas órdenes a las pruebas existentes, pero
todas las pruebas ya ordenadas o efectuadas permanecerán sin
cambio.
En caso de que se envíe una orden de prueba con más del
número máximo de pruebas programables, se rechazará la
solicitud. El límite es de 30 pruebas individuales o 10
pruebas dobles.
En caso de que la orden de prueba no sea reconocida como una
de aquellas soportadas por los instrumentos de la familia
ELITE/ELITE PRO, se rechaza. El instrumento informará a la
computadora principal con el uso de un registro que contenga
la lista de órdenes de prueba rechazadas.
Durante una sesión de bajar, pueden detectarse las
condiciones de error incluidas en la lista; el comportamiento
del instrumento asociado y las acciones se incluyen también
en la lista.
319
9
Condición del Error Acción Mensaje al Usuario
Identificación de la muestra Abortar comunicación La Identificación de la
utilizada en la base de datos de muestra ya se utiliza en la
Control de Calidad base de datos de Control de
Calidad
Identificación de la Muestra Mala Abortar comunicación Identificación de la Muestra
(longitud, caracteres sin soporte) Inválida
Base de Datos llena Abortar comunicación La Base de Datos del
Paciente está llena
El registro del paciente no tiene Abortar comunicación Identificación de Muestra no
ningún registro de orden de prueba identificada para los datos del
asociado paciente
La orden de prueba no tiene ningún Abortar comunicación No hay ningún registro del
registro del paciente asociado paciente para las pruebas
ordenadas
Identificador del instrumento Abortar comunicación Identificador de instrumento
diferente del ACL9000 o nombre inválido
extendido
Demasiadas solicitudes de pruebas Rechazar orden de -
para la misma Identificación de prueba
muestra
Solicitud de prueba desconocida Rechazar orden de -
prueba
Prueba Mala Rechazar órdenes de -
pruebas
Formato de registro ilegal Abortar comunicación Formato de registro incorrecto
en mensajes de la
computadora principal

Todas las condiciones de aborto implican que los


instrumentos de la familia ELITE/ELITE PRO enviarán a la
computadora principal un mensaje con la razón para la
interrupción de la transmisión (ver Rechazar Orden de
Prueba), en tanto que se presenta un mensaje para el usuario
en el instrumento. Cuando no se implica el aborto de la
transmisión, al tener lugar la terminación de la
transmisión, seguirán uno o más registros (ver Rechazar
Orden de Prueba) con una indicación de órdenes de pruebas
rechazadas.
La información rechazada corresponde normalmente a
solicitudes de pruebas desconocidas o solicitudes de pruebas
que exceden el tamaño del registro de muestras en el Sistema
de Manejo del Datos del ELITE/ELITE PRO. Debe observarse
que, en caso de que se rechace cualquiera de esta
información, no implica que se han rechazado todos los datos
de las muestras.
320
El conjunto de solicitudes de pruebas legales se almacenan
normalmente, en tanto que se rechazarán las solicitudes
ilegales para la misma identificación de la muestra.
Debe también subrayarse que ELITE/ELITE PRO limita el tamaño
de los registros manejados (independientemente del tipo de
registro soportado por ASTM) a 1024 bytes durante la sesión
de bajar.
Nota: para bajar, la computadora principal debe enviar a
ELITE/ELITE PRO información en secuencia en un solo cuadro
(una sola línea) durante la transmisión o hasta 240 bytes
como máximo durante la transmisión.
3.5.1.1 Mensaje de Solicitud de Prueba
El Mensaje de Solicitud de Prueba es utilizado por el
ELITE/ELITE PRO para comenzar la sesión de bajar la orden de
la prueba. Está compuesto de un registro de Encabezado de
Mensaje, un registro de Solicitar Información y un registro
de Terminador de Mensaje.
El “registro de Solicitar Información” solicita a la
computadora principal TODAS las órdenes de pruebas
disponibles para el instrumento específico.
Después de la especificación ASTM, los campos que componen a
Solicitar Información se describen en lo siguiente.
10
Registro de Solicitar Información:
Identificación del Tipo de RegistroSiempre se establece en “Q”
Número de Secuencia Según lo define la norma establecida en “1” cuando se envía la
pregunta
Número de Identificación de Rango Se establece en la secuencia de “TODAS”
Inicial
Número de Identificación de Rango No se provee
Final
Identificación de Prueba Universal No se provee
Naturaleza del Límite de Tiempo de No se provee
Solicitud
Fecha y Hora de los Resultados de No se proveen
solicitud inicial
Nombre del Médico que Solicita No se provee
Campo #1 del Usuario No se provee
Campo #2 del Usuario No provista
Solicitar Clave del Estado de la Se establece siempre en “O” (solicitudes de órdenes de
Información pruebas y datos demográficos solamente)

Un ejemplo del mensaje completo (compuesto por el mensaje de


encabezado, el registro de solicitar información y el
registro de terminador del mensaje) se proporciona con:
Hl\^&lllACL9000lllllllPl1l20021205123956<CR>
Ql1lALLllllllllO<CR>
Ll1lN<CR>
321
3.5.1.2 Mensaje de Orden de Prueba
Para responder al Mensaje de Solicitud de Prueba del
ELITE/ELITE PRO, la computadora principal envía el Mensaje
de Orden de Prueba, que contiene los registros que
especifican cuáles pruebas están solicitando para cada
muestra especificada. La computadora principal puede
responder con uno o más mensajes, cada uno de los cuales
contiene una o más especificaciones de la orden de prueba.
La especificación de la orden de prueba consiste en un
registro de Información del Paciente, seguido por uno o más
registros de Órdenes de Pruebas.
La computadora principal puede enviar un registro de
Información del Paciente para la misma identificación de una
muestra, seguido por muchos registros de Órdenes de Pruebas;
o, para cada prueba que va a ordenarse, un par compuesto por
el registro de Información del Paciente, seguido por el
registro de Orden de Prueba.
El ELITE/ELITE PRO hace caso omiso de los mensajes de
Registro de Comentarios durante las operaciones de bajar.
3.5.1.2.1 Registro de Información del Paciente
Los campos que caracterizan a ese registro se especifican en
lo siguiente:
11
Registro de Información del Paciente:
Identificación del Tipo de Registro Debe ser “P”
Número de Secuencia Debe comenzar con “1” y debe luego incrementarse con uno
para cada nuevo registro de Información del Paciente
Identificación del Paciente Asignada Se hace caso omiso
en la Práctica Médica
Identificación del Paciente Asignada Almacenada, en caso de estar disponible, como una
en el Laboratorio secuencia en el campo de Identificación del Paciente del
registro de la muestra.
No se efectúan ningunas verificaciones para este campo y la
secuencia se truncará en 15 caracteres.
Identificación del Paciente #3 Se hace caso omiso
Nombre del Paciente Almacenado, en caso de estar disponible, como una
secuencia única en el campo del “nombre” del registro de
muestras, considerando solamente los dos primeros
subcampos en este campo de datos (segundo y primer
nombre). La secuencia se truncará en 30 caracteres. En
caso de que se halle un caracter no soportado (ver el
Apéndice para los caracteres soportados), se hará caso omiso
del nombre del paciente y de todas las demás secuencias en
el mismo registro del paciente.
En caso de que el nombre del paciente no esté disponible,
deben transmitirse 4 separadores ^^^^.
Nombre de soltera de la madre Se hace caso omiso
Fecha de nacimiento Almacenado, en caso de que estuviera disponible. Los datos
se convertirán y mostrarán en lo siguiente de acuerdo con el
322
formato soportado por el ELITE/ELITE PRO.
El formato esperado, conforme con la norma ASTM es
YYYYMMDD
Sexo del Paciente Almacenado en caso de que estuviera disponible. Los
caracteres permitidos son “M”, “m”, “F”, “f”, “U”, “u”; cualquier
otro carácter se interpreta como “U”.
Raza-Origen Étnico del Paciente Se hace caso omiso
Dirección del Paciente Se hace caso omiso
Campo Reservado Se hace caso omiso
Número de Teléfono del Paciente Se hace caso omiso
Identificación del Médico que Atiende Se hace caso omiso
Campo Especial #1 Se hace caso omiso
Campo Especial #2 Se hace caso omiso
Altura del Paciente Se hace caso omiso
Peso del Paciente Se hace caso omiso
Diagnóstico Conocido o que se Se hace caso omiso
Sospecha del Paciente
Medicaciones Activos del Paciente Se hace caso omiso
Dieta del Paciente Se hace caso omiso
Campo de Práctica #1 Se hace caso omiso
Campo de Práctica #2 Se hace caso omiso
Fechas de Admisión y Dada de Alta Se hace caso omiso
Estado al tener lugar la Admisión Se hace caso omiso
Ubicación Almacenada, en caso de estar disponible, como secuencia
libre en el campo de “departamento” del registro de la
muestra. La secuencia se truncará en 30 caracteres. Ver el
Apéndice B para los caracteres soportados.
Naturaleza de Clave de Diagnóstico Se hace caso omiso
Alternativo y Clasificadores
Clave de Diagnóstico Alternativo y Se hace caso omiso
Clasificadores
Religión del Paciente Se hace caso omiso
Estado Civil Se hace caso omiso

12

Estado de Aislamiento Se hace caso omiso


Idioma Se hace caso omiso
Servicio de Hospital Se hace caso omiso
Institución Hospitalaria Se hace caso omiso
Categoría de Dosificación Se hace caso omiso

3.5.1.2.2 Registro de Orden de Prueba


Los campos que caracterizan a este registro se especifican
en lo siguiente:
Registro de Orden de Prueba:
1. Identificación del Tipo de Registro Debe ser “O” (letra)
2. Número de Secuencia Debe comenzar con “1” y debe incrementarse a continuación
en uno para cada nuevo registro de orden de prueba para el
323
mismo paciente.
3. Identificación de la Muestra Es la identificación de la muestra del ELITE/ELITE PRO; el
campo debe ser inferior o igual a 15 caracteres y debe ser
congruente con las reglas sobre la identificación de la muestra
(las identificaciones ya en uso para la base de datos de
Control de Calidad no son legales). Las identificaciones de
las muestras no conformes ocasionarán el aborto del proceso
de bajar.
Ver el Apéndice B para los caracteres soportados por el
ELITE/ELITE PRO.
4. Identificación de la Muestra del Se hace caso omiso
Instrumento
5. Identificación de Prueba Universal El campo está compuesto por 4 partes; se utiliza solamente el
componente de la Clave del Fabricante como clave de 4
caracteres (configurable por el usuario a bordo); se rechazará
la identificación de la prueba desconocida.
6. Prioridad En caso de que el campo contenga a cualquiera de los
subcampos, el caracter S de la identificación de la muestra se
considerará como muestra prioritaria; se hará caso omiso de
cualquier indicador adicional. En caso de que el campo no
contenga al caracter S o esté vacío, la muestra se identificará
como muestra rutinaria.
7. Fecha y Hora Solicitada/Ordenada Se hace caso omiso
8. Fecha y Hora de Recolección de Se hace caso omiso
Muestra
9. Hora Final de Recolección Se hace caso omiso
10. Volumen de Recolección Se hace caso omiso
11. Identificación del Recolector Se hace caso omiso
12. Clave de Acción Se hace caso omiso
13. Clave de Peligro Se hace caso omiso
14. Información Clínica Pertinente Se hace caso omiso
15. Fecha y Hora de Recepción de la Se hace caso omiso
Muestra
16. Descripción de la Muestra Se hace caso omiso de ambos campos
17. Médico que Ordena Almacenado, en caso de que estuviera disponible, como
secuencia libre en el campo del “médico” del registro de la
muestra. La secuencia se truncará en 30 caracteres. Ver el
Apéndice para los caracteres soportados.
18. Número de Teléfono del Médico Se hace caso omiso
19. Campo No. 1 del Usuario Se hace caso omiso
20. Campo No. 2 del Usuario Se hace caso omiso
21. Campo No. 1 de Laboratorio Se hace caso omiso

13

22. Campo No. 2 de Laboratorio Se hace caso omiso


23. Fecha y Hora de Reporte de Se hace caso omiso
Resultados o Última Modificación
24. Carga del Instrumento en el Se hace caso omiso
Sistema de Cómputo
324
25. Identificación de Sección del Se hace caso omiso
Instrumento
26. Tipos de Reportes Se establece en “O” (letra); otras claves ocasionarán el
rechazo de los registros
27. Campo Reservado Se hace caso omiso
28. Ubicación de Pabellón de Se hace caso omiso
Recolección del Espécimen
29. Indicador de Información del Se hace caso omiso
Hospital
30. Servició de Muestras Se hace caso omiso
31. Institución de las Muestras Se hace caso omiso
325
Un ejemplo de la orden de prueba completa se proporciona
por:
Hl\^&llllllllACL9000llPl1l19982110134700<CR>
Pl1llPTNT1llROSSI^MARIO^^^ll19391127lMlllllllllllllllllDEP
1llllllllll<CR>
Ol1lSMP01ll^^^0001lSllllllllll^lDR. VERDIllllllllllOl<CR>
Ol5lSMP02ll^^^0001lllllllllll^lIllllllllllOl<CR>
Pl2llPTNT2llGIALLI^LUCA^^^ll19551028lFlllllllllllllllllDEP
2llllllllll<CR>
Ol1lSMP01ll^^^0001lllllllllll^lIllllllllllOl<CR>
Ll1lN<CR>
Ejemplos de bajar sin el nombre del paciente:
Hl\^&llllllllACL9000llPl1l20021205123956<CR>
Pl1lllll^^^^lllllllllllllllllllllllllllll<CR>
Ol1Llaura01ll^^^0001lllllllllll^lIllllllllllOl<CR>
Ll1lN<CR>
Nota: Los separadores se esperan siempre de la computadora
principal y se transmiten siempre independientemente de la
información contenida en la secuencia.
14
3.5.2 Pregunta a Computadora Principal
La pregunta a la computadora principal es activada
automáticamente por el instrumento cada vez que el sistema
está configurado de manera apropiada. A partir de la fase
previa al análisis de una sola prueba, o perfil o grupo de
pruebas, una o más muestras no tienen ningún tipo de
solicitudes de pruebas asociado.
El instrumento enviará, con el uso del registro de
información solicitada, las identificaciones de las muestras
que requieren programación de pruebas y aceptará solamente
las órdenes de pruebas para esas identificaciones de
muestras.
El instrumento aceptará, para las muestras con respecto a
las cuales se hizo la pregunta, cualesquiera órdenes de
pruebas independientemente por el tipo de prueba que se
ejecutará en la sesión inicial.
El mecanismo soportado por ASTM requiere el envío del
registro de Solicitar Información a la computadora
principal, con respecto a cada identificación de muestra o
el envío de un rango de identificaciones de muestras con
respecto a las cuales se hizo la pregunta, a la computadora
principal. El mecanismo soportado por ELITE/ELITE PRO es la
primera opción, por lo que será independiente del sistema de
clasificación utilizado por el instrumento o la computadora
principal para las muestras.
326
Como consecuencia, el instrumento enviará una pregunta para
la primera muestra, esperará la información de la
computadora principal y enviará posteriormente una nueva
pregunta para las muestras siguientes (en caso de que las
hubiera). Todas las sesiones de preguntas a la computadora
principal se organizarán de la misma manera.
Debido a que el instrumento está pidiendo información con
respecto a la identificación de una muestra específica,
rechazará cualquier tipo de información asociada a
identificaciones de muestras diferentes.
La computadora principal proporcionará al instrumento todas
las solicitudes de pruebas disponibles. La computadora
principal puede enviar cero o más órdenes de pruebas en uno
o más mensajes, pero todos los mensajes serán parte de la
misma sesión de transmisión.
Durante una sesión de transmisión, pueden requerirse más
órdenes de pruebas para la misma muestra.
ELITE/ELITE PRO procesará cada orden de prueba recibida,
validando los campos que ELITE/ELITE PRO soporta; se
extraerá cierta información del registro recibido, en tanto
que se hará caso omiso de otra información.
En caso de que la orden de prueba no sea reconocida como una
de las soportadas por ELITE/ELITE PRO, será rechazada. El
instrumento informará a la computadora principal con el uso
de un registro que contenga la lista de órdenes de prueba
rechazadas.
Se efectúa la Pregunta a la Computadora Principal cuando la
Identificación de la Muestra no se localice en la base de
datos para el sistema ACL.
Durante una sesión de bajar, pueden detectarse las
condiciones de error incluidas en la lista; se incluye
también en la lista la acción del ELITE/ELITE PRO asociado.
15
Condición del Error Acción Mensaje al Usuario
Identificación de la muestra Abortar comunicación La Identificación de la
utilizada en la base de datos de muestra ya se utiliza en la
Control de Calidad base de datos de Control de
Calidad
Identificación de la Muestra Mala Abortar comunicación Identificación de la Muestra
(longitud, caracteres sin soporte) Inválida
Base de Datos llena Abortar comunicación La Base de Datos del
Paciente está llena
El registro del paciente no tiene Abortar comunicación Identificación de Muestra no
ningún registro de orden de prueba identificada para los datos del
asociado paciente
La orden de prueba no tiene Abortar comunicación No hay ningún registro del
ningún registro del paciente paciente para las pruebas
327
asociado ordenadas
Identificador del instrumento Abortar comunicación Identificador de instrumento
diferente del ACL9000 o nombre inválido
extendido

Condición del Error Acción Mensaje al Usuario


Demasiadas solicitudes de Rechazar orden de -
pruebas para la misma prueba
Identificación de muestra
Solicitud de prueba desconocida Rechazar orden de -
prueba
Prueba Mala Rechazar órdenes de -
pruebas
Formato de registro ilegal Abortar comunicación Formato de registro
incorrecto en mensajes de la
computadora principal

Todas las condiciones de aborto implican que los


instrumentos de la familia ELITE/ELITE PRO enviarán a la
computadora principal un mensaje con la razón para la
interrupción de la transmisión (ver Rechazar Orden de
Prueba), en tanto que se presenta un mensaje para el usuario
en el instrumento. Cuando no se implica el aborto de la
transmisión, al tener lugar la terminación de la
transmisión, seguirán uno o más registros (ver Rechazar
Orden de Prueba) con una indicación de órdenes de pruebas
rechazadas.
La información rechazada corresponde normalmente a
solicitudes de pruebas desconocidas o solicitudes de pruebas
que exceden el tamaño del registro de muestras en el Sistema
de Manejo del Datos del ELITE/ELITE PRO. Debe observarse
que, en caso de que se rechace cualquiera de esta
información, no implica que se han rechazado todos los datos
de las muestras.
El conjunto de solicitudes de pruebas legales se almacenan
normalmente, en tanto que se rechazarán las solicitudes
ilegales para la misma identificación de la muestra.
Debe también subrayarse que ELITE/ELITE PRO limita el tamaño
de los registros manejados (independientemente del tipo de
registro soportado por ASTM) a 1024 bytes durante la sesión
de bajar.
Nota: En caso de que la Identificación de la Muestra no esté
presente en el nivel de la computadora principal durante la
Pregunta a la Computadora Principal, la Computadora
Principal regresará solamente el Encabezado y el Terminador.
Hl\^&llllllllACL9000llPl1l20021205123956<CR>
328
Ll1lN<CR>
Nota: En caso de que la Computadora Principal solicite una
prueba que esté desactivada en el ELITE/ELITE PRO, no se
programará la prueba en el ELITE/ELITE PRO y se regresará un
mensaje de rechazo de este tipo a la Computadora Principal.
Cl1lllUKNOWN_TlPatientID^0080ll<CR>
3.5.3 Mensaje de Solicitud de Prueba
El Mensaje de Solicitud de Prueba es utilizado por el
ELITE/ELITE PRO para solicitar información para cada muestra
específica que no tenga órdenes de pruebas en la base de
datos del instrumento. Está compuesto por un Encabezado de
Mensaje, un registro de Solicitar Información y un
Terminador de Mensaje.
16
El registro de Solicitar Información solicita, en este caso,
información para una identificación específica a la vez. El
protocolo ASTM limita el número de registros de Solicitar
Información a uno. Como consecuencia, el instrumento
esperará la respuesta de la computadora principal antes de
enviar un segundo registro de Solicitar Información para una
segunda muestra.
De acuerdo con la especificación de la ASTM, se describen a
continuación los campos que componen a Solicitar
Información:
Registro de Solicitar Información:
Identificación del Tipo de RegistroSiempre se establece en “Q”
Número de Secuencia Según lo define la norma, se establece en “1” cuando se envía
la pregunta
Número de Identificación de Rango Se establece en la identificación de la muestra específica para
Inicial requerir información; el componente significativo es el segundo
Número de Identificación de Rango No se provee
Final
Identificación de Prueba Universal No se provee
Naturaleza del Límite de Tiempo de No se provee
Solicitud
Fecha y Hora de los Resultados de No se proveen
solicitud inicial
Nombre del Médico que Solicita No se provee
Campo #1 del Usuario No se provee
Campo #2 del Usuario No provee
Solicitar Clave del Estado de la Se establece siempre en “O” (solicitudes de órdenes de
Información pruebas y datos demográficos solamente)

Un ejemplo del mensaje completo (compuesto por el mensaje de


encabezado, el registro de solicitar información y el
registro de terminador del mensaje) se proporciona con:
Hl\^&lllACL9000lllllllPl1l20021205123956<CR>
Ql1lALLllllllllO<CR>
329
Ll1lN<CR>
Respuesta de la Computadora Principal:
Hl\^&llllllllACL9000llPl1l19960210103256<CR>
Pl1llllROSSI^MARIO^^^ll19391127lMlllllllllllllllllDEP 1llllllllll<CR>
Ol1lS001ll^^^0001lSllllllllll^lDR. VERDIllllllllllOl<CR>
Ol5lS001ll^^^0002lllllllllll^lllllllllllOllllll<CR>
Ll1lN<CR>
3.5.4 Mensaje de Orden de Prueba
Como respuesta al Mensaje de Solicitar Prueba del
ELITE/ELITE PRO, la computadora principal envía el Mensaje
de Orden de Prueba, que contiene los registros que
especifican cuáles pruebas se están solicitando para la
Identificación de la Muestra con respecto a la cual se hizo
la pregunta.
Ver Mensaje de Orden de Prueba para detalles.
17
3.6 Mensaje de Prueba Rechazada
Al terminar las operaciones de bajar o al completar la
operación para una sola muestra en el mecanismo de pregunta
a la computadora principal, el ELITE/ELITE PRO puede
transmitir un mensaje para informar a la computadora
principal acerca de las muestras y órdenes de pruebas
rechazadas, o acerca de los motivos para la interrupción de
la transmisión.
El Mensaje de Órdenes de Pruebas Rechazadas consiste en un
registro de Encabezado de Mensaje, seguido por uno o más
registros de Comentarios y se completa por el Registro
Terminador de Mensaje. Se transmitirá un registro de
comentarios para cada información rechazada.
Debe observarse que en caso de que no se haya recibido
ninguna información legal, el proceso de bajar se interrumpe
y el mensaje de órdenes de pruebas rechazadas señalará el
motivo de la interrupción. En caso de que se haya
completado normalmente el proceso de bajar, el posible
mensaje siguiente de órdenes de pruebas rechazadas reportará
que no hay ningunas órdenes de pruebas legales.
La estructura del Registro de Comentarios se describe en la tabla siguiente:
Identificación del Tipo de Registro Siempre se ajusta en “C”
Número de Secuencia Debe comenzar con “1” y se incrementará a continuación en 1
para cada nuevo registro de comentarios
Fuente de Comentarios Se establece siempre en “I” (de acuerdo con ASTM: sistema
de instrumentos clínicos)
Texto de Comentarios Este campo indica la razón del rechazo de la orden de prueba.
Es una secuencia con dos componentes; cada uno puede
asumir los valores reportados:
Motivo del Rechazo:
BAD_TEST: la clave de la prueba transmitida es inválida.
QC:MA_ID: la identificación especificada ya se ha usado
330
como un material en la Base de Datos de Control de Calidad.
BD_S_ID: la identificación especificada es inválida
WRONG_ID: la computadora principal está enviando
información para una identificación de muestra diferente de la
esperada.
PDB_FULL: la base de datos de los pacientes está llena.
M_TEST_E: más pruebas de las esperadas.
UKNOWN_T: prueba solicitada desconocida.
INSTR_ID: identificador de instrumento inválido.
NO_TESTS: ninguna prueba ordenada para el registro del
paciente.
NO_PATIE: ningún registro del paciente para la prueba
ordenada.
BAD_RECO: formato de registro incorrecto.
Identificación: Esta secuencia contiene la identificación de la
muestra que ocasiona el problema; en caso de que una orden
de prueba haya causado el problema, la identificación de la
muestra y la identificación de la prueba se transmiten en
secuencia. El caracter utilizado para separar el motivo del
rechazo, y las dos secuencias utilizadas para el campo de
identificación es “I”.
La ausencia de información se señalará como
“DESCONOCIDA”.
En caso de que BAD_RECO sea el motivo del rechazo, el
campo contendrá el número del registro y el número del
campo que ocasionaron la falla.
Tipo de Comentario Se establece siempre como “I” (según ASTM: comentario de
indicador del instrumento).

Para resumir, los valores posibles para el motivo del


rechazo y los campos de identificación se reportan en la
tabla siguiente:
18
Motivo del Transmisión Identificación: primer subcampo Identificación: segundo subcampo
Rechazo Interrumpida
QC_MA_ID sí Identificación de la muestra DESCONOCIDO
(ocasiona el problema)
BAD_S_ID sí Identificación de la muestra DESCONOCIDO
(ocasiona el problema)
PDB_FULL sí Identificación de la muestra Identificación de la prueba
(ocasiona el problema)
NO_TESTS sí DESCONOCIDO DESCONOCIDO
NO_PATIE sí Identificación de la muestra Identificación de la prueba
(ocasiona el problema)
INSTR_ID sí DESCONOCIDO DESCONOCIDO
M_TEST_E no Identificación de la muestra Identificación de la prueba (ocasiona
el problema)
UNKNOWN_T no Identificación de la muestra Identificación de la prueba (ocasiona
el problema)
BAD_TEST no Identificación de la muestra Identificación de la prueba (ocasiona
el problema)
BAD_RECO sí Registro No. (finalidad de Campo No. (finalidad de depuración)
331
depuración)

Un ejemplo para una fase de rechazo completa se proporciona


por:
Hl\^&lllACL9000lllllllPl1l19982110103227<CR>
Cl1lIlM_TEST_ElSMP01 ^010lI<CR>
Cl2lIlBAD_TESTlSMP01 ^010lI<CR>
Ll1lN<CR>
3.7 Bajar Volúmenes de Sesión
Los volúmenes de datos aproximados para las sesiones de
bajar se proporcionan como guía para estimar el tiempo
requerido para completar sesiones típicas. No se consideran
las latencias del sistema (tanto en ELITE/ELITE PRO como en
la computadora principal).
La sesión mínima ocurriría en caso de que la computadora
principal no tuviera órdenes de prueba disponibles para el
ELITE/ELITE PRO. En esta condición, el ELITE/ELITE PRO
envía el mensaje de solicitud de prueba y la computadora
principal respondería con un mensaje que no contuviera
ningunas órdenes de pruebas (sólo el encabezado de mensaje y
el registro terminador de mensaje). En condiciones en que
la computadora principal tuviera órdenes de pruebas para el
instrumento, el volumen de datos estimados es:
Mensaje de Solicitud de Prueba = Encabezado de Mensaje (41)+17+Registro Terminador de Mensaje (6)=64
Mensaje de Orden de Prueba = Encabezado de Mensaje (41)+
Número de Registros de Pacientes (82+55*número de prueba ordenada)
Más Registro Terminador de Mensaje (6)
Orden de Prueba Rechazada = Encabezado de Mensaje (41)+
+41*número de registros rechazados
+Registro Terminador de Mensaje (6)
Así que, al considerar la siguiente situación: la
computadora principal tiene 50 identificaciones de muestras
para bajarse, cada una con 4 pruebas; consideremos 10
registros rechazados; el volumen de datos puede estimarse
en:
Mensaje de Solicitud de Prueba = 64
Mensaje de Orden de Prueba = 41+50 (82+55*4)+6 = 15147
Orden de Prueba Rechazada = 41+(41*10)+6 = 457
Total = 15668 caracteres
Con una “velocidad de baudios” de 9600 y sin ninguna
sobrecarga del sistema, tomaría aproximadamente 17 segundos
y, al considerar una eficiencia del sistema del 60%, se
convierte en 27 segundos.
19
Todas las estimaciones se han efectuado utilizando la
longitud máxima esperada para campos de secuencias.
20
4.0 Subir Resultados de Prueba
332
Subir los Resultados de las Pruebas permite la transmisión
de los resultados de las pruebas efectuadas en el
ELITE/ELITE PRO a la computadora principal. Los resultados,
relacionados con el paciente, las muestras de Control de
Calidad y los materiales de la Referencia Analítica, se
transmiten a solicitud explícita del usuario o
automáticamente al completarse la sesión.
En el primer caso, el usuario debe solicitar el comando de
transmisión en el DMS, o en el Control de Calidad o en el
ambiente de la Referencia Analítica, seleccionar las
muestras del paciente, o las muestras de Control de Calidad
o el conjunto de datos de la AR para transmitirse (de
acuerdo con uno de los criterios de selección soportados) y
comenzar la operación.
En el segundo caso, la transmisión sucederá automáticamente
al completarse la sesión y el instrumento proporcionará los
datos de las muestras del paciente y/o de Control de Calidad
y/o los datos de la AR para subirse.
El tipo de datos para transferirse durante la sesión de
subir automática depende del ajuste del instrumento (la
transmisión automática de datos puede ajustarse en “muestras
del paciente solamente”, o muestras de Control de Calidad y
del paciente” o “muestras de Control de Calidad y de la
AR”).
Cuando se solicita manualmente subir, se transmiten todos
los datos independientemente del indicador de transmisión.
Cuando se efectúa la transmisión automáticamente al terminar
la sesión, el instrumento subirá (para las muestras del
paciente) todos los datos disponibles para las
identificaciones de las muestras que se acaban de analizar y
subirá (para los datos de Control de Calidad) los resultados
apenas obtenidos.
Desde un punto de vista general, la transmisión automática
de datos de las muestras del paciente es equivalente a la
transmisión manual de datos, solicitada en DMS, de las
muestras del paciente que pertenecen a una lista de carga
específica. Aunque la transmisión automática de datos de
Control de Calidad o de la AR es equivalente a la
transmisión manual de datos, que se solicita en la base de
datos de Control de Calidad o la base de datos de la AR, o
los datos en un intervalo especificado para el material de
Control de Calidad presente en la lista de carga.
Al considerar que el ELITE/ELITE PRO llena las secuencias
utilizadas para la Identificación de la Muestra, el
departamento y el nombre del paciente con caracteres de
espacio (para alinear datos), la computadora principal debe
333
hacer caso omiso de los caracteres de espacio a la derecha
de estos campos.
Cuando se completa con éxito la operación de subir para las
muestras del paciente, de Control de Calidad y de los datos
de la AR, el indicador de transmisión asociado al registro
individual se actualizará de “L” a “T” (transmitido).
Debe también subrayarse que, en el ELITE/ELITE PRO, las
modificaciones de los datos de las muestras ya transmitidos
(tal como la adición de un nuevo resultado de la prueba o
modificaciones de los datos de las muestras), ocasionan que
el indicador de la transmisión cambie de “T” a “L”.
No se aplica a los datos de Control de Calidad o de la AR,
debido a que la única modificación que el usuario puede
solicitar en estos datos es omitir o despejar la
estadística. El efecto de la operación de omitir es excluir
los datos de la estadística, pero los datos no se modifican.
Las modificaciones en los valores de ajuste y el campo de
notas no modifican al estado de la transmisión de los datos
de Control de Calidad y de los datos de la AR.
Mientras la transmisión está en proceso, se actualizará al
usuario con respecto a la muestra que se está transmitiendo.
ELITE/ELITE PRO no acepta preguntas para resultados de las
pruebas.

21
4.1 Mensaje de Resultados de Prueba
El Mensaje de Resultados de Prueba se utiliza en el
ELITE/ELITE PRO para transmitir cualesquiera resultados de
pruebas para una muestra. Todos los resultados de pruebas
disponibles se transmitirán para las muestras del paciente,
aun cuando los datos se hayan ya transmitido parcialmente.
El mensaje consiste en un registro de Encabezado de Mensaje,
uno o más pares de registros de Órdenes de Pruebas, seguido
por uno o más registros de Resultados (dependiendo del
número de resultados de pruebas disponibles y del número de
resultados para cada prueba específica).
El registro de Resultados puede completarse con un registro
de Comentarios que contiene indicadores asociados a la
prueba ejecutada.
Las pruebas se suben con el uso de la misma clasificación
que se utiliza a bordo. El conjunto completo de resultados
de pruebas disponibles se sube globalmente a la computadora
principal, independientemente del conjunto de resultados
definidos para mostrarse en la lista de muestras.
En algunas condiciones, dependiendo del estado del
instrumento (es decir, calibrado, no calibrado, AR
utilizada, etc.), se transmitirá a la computadora principal
334
solamente un subconjunto de los resultados soportados por la
prueba.
El registro Terminador del Mensaje completa los datos
transmitidos.
Se utiliza también la misma estructura para subir los datos
de Control de Calidad y de la AR. En los párrafos
siguientes, se subrayarán cualesquiera diferencias en la
manera de tratar los datos del paciente, Control de Calidad
y AR.
4.1.1 Registro de Información del Paciente
Esta información se transmite a la computadora principal
solamente cuando están disponibles en el instrumento. La
estructura de la información del Paciente es:

Registro de Información del Paciente:

Tipo de Archivo Muestra del Paciente Muestra de Control de Calidad o


AR
Identificación del Tipo de Registro Debe ser “P” Debe ser “P”
Número de Secuencia Debe comenzar con “1” y debe Debe comenzar con “1” y debe
luego incrementarse con uno para luego incrementarse con uno para
cada nuevo registro de Información cada nuevo registro de Información
del Paciente del Paciente
Identificación del Paciente No se provee No se provee
Asignada en la Práctica Médica
Identificación del Paciente Se provee cuando se define como No se provee
Asignada en el Laboratorio una secuencia que contiene hasta
15 caracteres
Identificación del Paciente #3 No se provee No se provee
Nombre del Paciente Se provee cuando se conoce como No se provee
una sola secuencia que contiene
hasta 30 caracteres
Nombre de Soltera de la Madre No se provee No se provee
Fecha de nacimiento Se provee cuando se conoce como No se provee
una sola secuencia sin ningunas
verificaciones
Sexo del Paciente Se provee cuando se conoce como No se provee
un solo caracter
Raza-Origen Étnico del Paciente No se provee No se provee
Dirección del Paciente No se provee No se provee
Campo Reservado No se provee No se provee
Número de Teléfono del Paciente No se provee No se provee
Identificación del Médico que No se provee No se provee
Atiende
Campo Especial #1 No se provee No se provee

22

Campo Especial #2 No se provee No se provee


Altura del Paciente No se provee No se provee
Peso del Paciente No se provee No se provee
Diagnóstico Conocido o que se No se provee No se provee
335
Sospecha del Paciente
Medicaciones Activos del Paciente No se proveen No se proveen
Dieta del Paciente No se provee No se provee
Campo de Práctica #1 No se provee No se provee
Campo de Práctica #2 No se provee No se provee
Fechas de Admisión y Dada de Alta No se proveen No se proveen
Estado al tener lugar la Admisión No se provee No se provee
Ubicación Se provee cuando se conoce como No se provee
una secuencia libre de 30
caracteres
Naturaleza de Clave de No se provee No se provee
Diagnóstico Alternativo y
Clasificadores
Clave de Diagnóstico Alternativo y No se provee No se provee
Clasificadores
Religión del Paciente No se provee No se provee
Estado Civil No se provee No se provee
Estado de Aislamiento No se provee No se provee
Idioma No se provee No se provee
Servicio de Hospital No se provee No se provee
Institución Hospitalaria No se provee No se provee
Categoría de Dosificación No se provee No se provee

4.1.2 Registro de Orden de Prueba


Los campos que caracterizan a este registro se especifican
en lo siguiente:
Registro de Orden de Prueba
Tipo de Archivo Muestra del Paciente Muestra de Control de Calidad o
datos AR
Identificación del Tipo de Registro Debe ser “O” Debe ser “O”
Número de Secuencia Debe comenzar con “1” y debe Debe comenzar con “1” y debe
luego incrementarse con uno para luego incrementarse con uno para
cada nuevo registro de orden de cada nuevo registro de orden de
prueba para el mismo paciente prueba para el mismo paciente
Identificación de la Muestra Se provee; es la Identificación del Se provee; es la identificación del
muestra del ELITE/ELITE PRO material de Control de Calidad para
Ver el Apéndice para los caracteres el ELITE/ELITE PRO para los datos
soportados por el ELITE/ELITE de Control de Calidad, o la clave de
PRO la AR para los datos de la AR. Ver
el Apéndice para los caracteres
soportados por el ELITE/ELITE
PRO.
Identificación de la Muestra del No se provee No se provee
Instrumento
Identificación de Prueba Universal El campo está compuesto de 4 El campo está compuesto de 4
partes, se utiliza solamente el partes, se utiliza solamente el
componente de la Clave del componente de la Clave del
Fabricante como una clave de 4 Fabricante como una clave de 4
caracteres (las claves de la caracteres (las claves de la
computadora principal son computadora principal son
configurables por el usuario a configurables por el usuario a
bordo) bordo)
Prioridad Se provee cuando se establece No se provee
como caracter S para
336

23

muestras prioritarias
Fecha y Hora No se proveen No se proveen
Solicitadas/Ordenadas
Fecha y Hora de Recolección de No se proveen No se proveen
Muestra
Hora Final de Recolección No se provee No se provee
Volumen de Recolección No se provee No se provee
Identificación del Recolector No se provee No se provee
Clave de Acción No se provee Establecido en “Q”
Clave de Peligro No se provee No se provee
Información Clínica Pertinente No se provee No se provee
Fecha y Hora de Recepción de la No se proveen No se proveen
Muestra
Descripción de la Muestra No se provee en ambos campos No se provee en ambos campos
Médico que Ordena Se provee, cuando está disponible, No se provee
como una secuencia que contiene
hasta 30 caracteres
Número de Teléfono del Médico No se provee No se provee
Campo No. 1 del Usuario No se provee No se provee
Campo No. 2 del Usuario No se provee No se provee
Campo No. 1 de Laboratorio No se provee No se provee
Campo No. 2 de Laboratorio No se provee No se provee
Fecha y Hora de Reporte de No se proveen No se proveen
Resultados o Última Modificación
Carga del Instrumento en el No se provee No se provee
Sistema de Cómputo
Sección del Instrumento No se provee No se provee
Tipos de Reportes Establecido en F Establecido en F
Campo Reservado No se provee No se provee
Ubicación de Pabellón de No se provee No se provee
Recolección de la Muestra
Indicador de Información del No se provee No se provee
Hospital
Servició de Muestras No se provee No se provee
Institución de las Muestras No se provee No se provee

4.1.3 Registro de Resultados


Los campos que especifican a este registro se especifican en
la tabla siguiente.
Se envía un registro de resultados a la computadora
principal para cada resultado de prueba disponible. Para las
pruebas dobles, se transmitirán todos los valores
individuales disponibles a la computadora principal
(ningunas medias de valores). Cada registro de resultados
contendrá uno de los resultados de pruebas disponibles.
Registro de Resultados
Tipo de Archivo Muestra del Paciente Muestra de QC o datos de AR
Identificación de Tipo de Registro Se establece en “R” Se establece en “R”
Número de Secuencia Debe comenzar con “1” e Debe comenzar con “1” e
337
incrementarse a continuación con incrementarse a continuación con
uno para cada registro de uno para cada registro de
resultados para el mismo registro resultados para el mismo registro
de pruebas del paciente para el de pruebas del paciente para el
mismo registro del paciente mismo registro del paciente
Identificación de Prueba Universal El campo está compuesto por 4 El campo está compuesto por 4
partes, se utiliza solamente el partes, se utiliza solamente el

24
componente de la Clave del componente de la Clave del
Fabricante como una clave de 4 Fabricante como una clave de 4
caracteres (las claves de la caracteres (las claves de la
computadora principal son computadora principal son
configurables por el usuario a configurables por el usuario a
bordo) bordo)
Datos o Valor de Medición El campo contiene el valor El campo contiene el valor
numérico obtenido o el mensaje numérico obtenido o el mensaje
cualitativo (Error xx).Se envían cualitativo (Error xx).Se envían
todos los resultados numéricos* todos los resultados numéricos*
Unidades Se proveen cuando el campo Se proveen cuando el campo
anterior es un valor numérico, es anterior es un valor numérico, es
una secuencia libre (ver el una secuencia libre (ver el
Apéndice C para las unidades Apéndice C para las unidades
estándar), número máximo de estándar), número máximo de
caracteres es de 8. caracteres es de 8.
Rango de referencia No se provee No se provee
Indicador de Resultado Anormal No se provee No se provee
Naturaleza del Indicador de No se provee No se provee
Anormalidad
Estado de los Resultados Se establece en “F” Se establece en “F”
Datos de Cambio en los Valores No se provee No se provee
Normativos o Unidades del
Instrumento
Identificación del Operador No se provee No se provee
Fecha/Hora en que se Inició la No se provee No se provee
Prueba
Fecha/Hora en que se Completó la Tiempo de ejecución, secuencia del Tiempo de ejecución, secuencia del
Prueba tipo YYYYMMDDHHMMSS tipo YYYYMMDDHHMMSS
Identificación del Instrumento No se provee No se provee
* Los rangos específicos deben establecerse en el nivel de
la Computadora Principal.
4.1.4 Registro de Comentarios
El registro de Comentarios permite la integración de los
resultados de las pruebas transmitidos con posibles mensajes
de error.
Uno o más registros de comentarios pueden seguir a los
registros de resultados. Los campos que caracterizan a este
registro se especifican en lo siguiente.
Registro de Comentarios
Identificación del Tipo de Registro Se establece en “C”
Número de Secuencia Debe comenzar con “1” e incrementarse a continuación con uno para
cada registro de comentarios.
Fuente del Comentario Se establece en “I”
338
Texto del Comentario Este campo especifica los errores del instrumento (ver la tabla) como
clave numérica (2 caracteres), más el mensaje asociado
Tipo de Comentario Se establece en “I”

25
4.1.5 Claves de Errores
ADVERTENCIA DE TEMPERATURA
TEMPERATURA DE APILAMIENTO DE ROTORES Fuera de Rango - 41,
TEMPERATURA DE CURSOR Fuera de Rango - 43,
TEMPERATURA DEL REACTIVO Fuera de Rango - 45,
TEMPERATURA DE INCUBACIÓN Fuera de Rango - 49,
ADVERTENCIA MECÁNICA
ADVERTENCIA DEL AUTOMUESTREADOR - 50,
ADVERTENCIA DEL MOTOR DEL ROTOR - 51,
ADVERTENCIA DE MOTOR HORIZONTAL - 52,
ADVERTENCIA DEL MOTOR VERTICAL - 53,
ADVERTENCIA DEL DILUYENTE DE REACTIVO - 53,
ADVERTENCIA DEL DILUYENTE DE MUESTRAS - 54,
ADVERTENCIA DE CUBIERTA FOTOMÉTRICA - 55,
FALLA DEL AGITADOR 1 - 57,
FALLA DEL AGITADOR 2 - 58,
FALLA DEL AGITADOR 3 - 59,
FALLA DEL AGITADOR 4 - 60,

ADVERTENCIA DE LÍQUIDOS
SENSOR DE LÍQUIDOS APAGADO (MUESTRA) - 73,
SENSOR DE LÍQUIDOS APAGADO (REACTIVO) - 74,
FALLA DEL SENSOR DE LÍQUIDOS (MUESTRA) - 75,
FALLA DEL SENSOR DE LÍQUIDOS (REACTIVO) - 76,
ESCASEZ DE MATERIAL - 77,
MATERIAL OBLIGATORIO ESCASO - 78,
ADVERTENCIA PRELAVADO - 79,
ADVERTENCIA DE LAVADO - 80,
LIMPIEZA NO EFECTUADA - 83,

ADVERTENCIAS DIVERSAS
CUBIERTA ABIERTA DURANTE LA CARGA O INCUBACIÓN - 86,
TIEMPO EXPIRADO DURANTE LA CARGA - 87,

ERRORES EN LA RESPUESTA
FUERA DE RANGO DE ESCALA - BAJO - 98
FUERA DE RANGO DE ESCALA - ALTO - 99
ERROR DE SATURACIÓN - 205,
ERROR DEL PRIMER UMBRAL - 206,
ERROR DEL SEGUNDO UMBRAL - 207,
ERROR DELTA - 208,
ERROR DE PENDIENTE INICIAL - 209,
ERROR DE PENDIENTE FINAL - 210,
ERROR DE CURVA DE REACCIÓN FINAL - 211,
ERROR DE PRIMERA DERIVADA - 212,
ERROR DE SEGUNDA DERIVADA - 213,
ERROR DE CURVA DE REACCIÓN EN LA PRIMERA PARTE - 214,

26
339
ERRORES EN LAS CURVAS DE CALIBRACIÓN
PUNTOS ESTÁNDAR INSUFICIENTES EN UN SEGMENTO - 215,
DATOS INSUFICIENTES CURVA INVÁLIDA - 216,
NÚMERO DE ESTÁNDAR FUERA DE RANGO - 217,
TRASLACIÓN INVÁLIDA O ESTÁNDAR OBLIGATORIO - 219,
RÉPLICAS INSUFICIENTES ESTÁNDAR INVÁLIDAS - 220,
RÉPLICAS INSUFICIENTES - 221,
RÉPLICAS INVÁLIDAS - 222,
CV FUERA DE RANGO - 223,
PENDIENTE FUERA DE RANGO, CURVA DE CALIBRACIÓN INVÁLIDA - 225,
R2 FUERA DE RANGO - 226,
CURVA NO MONOTÓNICA - 228,
ERRORES EN LA REFERENCIA ANALÍTICA, CONTROL DE CALIDAD,
RELACIÓN Y RELACIÓN NORMALIZADA
AR INVÁLIDA - 229,
AR FUERA DE RANGO - 230,
AR NO VERIFICADA - 233,
DUPLICADA FUERA DE RANGO - 239,
CONTROL DE CALIDAD INVÁLIDO - 240,
CONTROL DE CALIDAD FUERA DE RANGO - 242,
ERROR DE CÁLCULO DE RELACIÓN - 249,
ERROR DE CÁLCULO DE RELACIÓN S/Sa Fuera de Rango - 250,
ERROR DE RELACIÓN NORMALIZADA, AR/ARa Fuera de Rango - 251,
RELACIÓN NORMALIZADA, ERROR DE CÁLCULO - 252,
NO SE HALLÓ ESTÁNDAR - 253,
NO SE HALLÓ AR - 254,
NO SE HALLÓ MUESTRA ACTIVADA - 255,
NO SE HALLÓ ARa - 256,
NO SE HALLÓ LA RELACIÓN - 257,
AR FUERA DE RANGO - 258,
AR NULA - 259,
ESTÁNDAR NULO - 260,
MUESTRA NULA - 262
REFERENCIA NULA - 263,
RELACIÓN AR NULA - 264,
AR ACTIVADA NULA - 265,
DIFERENCIA NULA - 266,

Las indicaciones fuera de rango con referencia a los rangos


normales o de pruebas no se transmiten a la computadora
principal. El símbolo* (fuera del Rango Normal) se presenta
solamente en los Reportes Acumulativos y de Muestras.
Un ejemplo de la secuencia completa de subir pruebas se
proporciona mediante:
27
Muestra
Hl\^&llllllllACL9000llPl1l19982110134700<CR>
Pl1llPTNT1llBLU^^^^ll19391127lMlllllllllllllllllDEP 1llllllllll<CR>
Ol1lSMP01ll^^^0001lSllllllllll^lDR. VERDIllllllllllOl<CR>
Rl1l^^^0001l12.8lllllFllll19960119114215l<CR>
Cl1lIl31^Invalid for QC lI<CR>
340
Pl2llPTNT1llGialli^^^^ll19391127lMlllllllllllllllllDEP 1llllllllll<CR>
Ol1lSMP01ll^^^0001lSllllllllll^lDR. VERDIllllllllllOl<CR>
Rl1l^^^0001l14.5lsllllFllll19960119114215l<CR>
Cl1lIl31^Invalid for QC lI<CR>
Ll1lN<CR>
Control de Calidad
Hl\^&lllACL9000lllllllPl1l20021205123956<CR>
Pl1lllllllllllllllllllllllllllllllllll<CR>
Ol1lNormal C.ll^^^0001lllllllQllll^lllllllllllFllllll<CR>
Ll1lN<CR>
Referencia Analítica
Hl\^&lllACL9000lllllllPl1l20021205123956<CR>
Pl1lllllllllllllllllllllllllllllllllll<CR>
Ol1lARll^^^0001lllllllQllll^lllllllllllFllllll<CR>
Ll1lN<CR>
4.2 Subir Volúmenes de Sesión
Los volúmenes de datos aproximados para las sesiones de
subir se proporcionan como guía para estimar el tiempo
requerido para completar sesiones típicas. Es evidente que
no se consideran las latencias del sistema (tanto en el
ELITE/ELITE PRO como en la computadora principal).
Ocurriría la sesión mínima en caso de que el ELITE/ELITE PRO
no tuviera ningunos resultados de pruebas para transmitirse;
no se envían ningunos datos y el volumen de datos es de
cero.
En condiciones en que el ELITE/ELITE PRO tiene resultados
para transmitirse, el volumen de datos puede estimarse en
la base del tamaño del registro de Órdenes de Pruebas y
Resultados de Pruebas.
Mensaje de Orden de Prueba = Encabezado de Mensaje (41) +
Número de Registros de Pacientes (82 + Resultados) +
Registro Terminador de Mensaje (6)
Resultados = número de prueba ordenada (55 + 60* número de resultado de prueba + 56*
número de mensajes de error)
Así que, al considerar la siguiente situación: la
ELITE/ELITE PRO tiene 50 identificaciones de muestras para
subirse, cada una con 4 pruebas, cada prueba con 3
resultados y cada prueba con 2 indicadores, el volumen de
datos puede estimarse en:
Mensaje de Resultados de Prueba = 41+50 (82+4(55+60*3+56*2))+6
Total = 69547 caracteres
Con una “velocidad de baudios” de 9600 y sin ninguna
sobrecarga del sistema, tomaría aproximadamente 73 segundos
y, al considerar una eficiencia del sistema del 60%, se
convierte en 116 segundos.
28
5.0 Registros No Soportados
341
El registro Científico y el registro de información del
Fabricante no están soportados por el protocolo del
ELITE/ELITE PRO.
Como consecuencia, el instrumento hace caso omiso de
cualquier tipo de información que contengan.
6.0 Abortar Transmisión
La sesión de transmisión de bajar o subir puede
interrumpirse para una solicitud de usuario explícita,
detectada en el instrumento, debido a que la computadora
principal no está respondiendo o debido a que la computadora
principal requirió la interrupción del proceso de
transmisión.
Además, como se reportó antes, el proceso de bajar puede
interrumpirse debido a que se ha recibido un identificador
de muestra ilegal. El comportamiento del instrumento en esta
condición en particular se definió y se Rechazaron las
Órdenes de Pruebas.
El comportamiento de los instrumentos de la familia
ELITE/ELITE PRO en cada una de las condiciones incluidas se
describe en lo siguiente:

Condición Acción
El operador del ELITE/ELITE PRO solicitó el paro del El ELITE/ELITE PRO señalará el final de la
proceso de bajar. transmisión a la computadora principal y desechará
cualesquiera mensajes siguientes. La computadora
principal debe considerar la solicitud interna.
IL debe hacer hincapié en que el ELITE/ELITE PRO
señalará la interrupción de la transmisión con un
mensaje que es una orden de prueba rechazada en
caso de que se haya rechazado alguna información o
con encabezado de mensaje, más un registrador
terminado de mensaje en caso de que no se haya
rechazado ninguna información.
El operador del ELITE/ELITE PRO solicitó parar el El ELITE/ELITE PRO completará el mensaje en
proceso de subir. proceso con el terminador de mensaje y no transmitirá
ningunos resultados de pruebas adicionales.

La computadora principal no responde Durante las sesiones de transmisión de bajar y subir,


se detiene la operación por el ELITE/ELITE PRO. En
caso de que la operación de bajar haya estado en
proceso, no se transmitirán ningunos mensajes de
pruebas rechazadas.
Un mensaje informará al usuario que se ha
interrumpido la transmisión: “La Computadora Principal
no responde”.
La computadora principal requirió EOT Durante las sesiones tanto de bajar como de subir, se
342
detiene la operación por el ELITE/ELITE PRO. En caso
de que la operación de bajar haya estado en proceso,
no se transmitirán ningunos mensajes de pruebas
rechazadas.
Debe hacerse hincapié en que la computadora
principal debe solicitar la interrupción de la transmisión
con un mensaje compuesto por un encabezado de
mensaje, más un registro terminador de mensaje.
Formato de registro incorrecto Se aborta la transmisión/recepción y se informa al
usuario: “formato incorrecto en los mensajes de la
computadora principal”

29
7.0 Apéndice: Claves de Pruebas del ELITE/ELITE PRO
Las claves de pruebas pueden ser definidas por el usuario.
Las claves de 1 a 500 se asignan a las pruebas previamente
definidas de IL. Las claves mayores de 500 se asignan para
las pruebas que el usuario puede definir. La biblioteca de
IL propone que las claves de pruebas por omisión que se
reportan en la tabla siguiente.
Clave de Prueba Clave de Prueba para la Identificación de la Nombre de Prueba
computadora principal Prueba (8 caracteres Extendido (18
máximo) caracteres máximo)
001 0001 PT PT
002 0002 PT e PT Extendido
003 0003 PT d PT Doble
004 0004 PT ed PT Ext Db
005 0005 PT HS PT HS
006 0006 PT HS e PT HS Extendido
007 0007 PT HS d PT HS Doble
008 0008 PT HS ed PT HS Ext Db
009 0009 PT HS + PT PLUS
010 0010 PT HS + e PT PLUS Extendido
011 0011 PT HS + d PT PLUS Doble
012 0012 PT HS + ed PT PLUS Ext Db
013 0013 R-PT Recombipl-PT
014 0014 R-PTe Recombipl-PTex
015 0015 PT R PT Rec.
016 0016 PT Re PT Rec. Extendido
017 0017 PT R d PT Rec. Doble
018 0018 PT R ed PT Rec.Ext.Db.
023 0023 R-PT d Rec.-PT Doble
024 0024 R-PT ed Rec-PT Ext Db

030 0030 FIB_ FIB (PT)


031 0031 FIB FIB (PT)
032 0032 FIB e_ FIB (PT e)
033 0033 FIB e FIB (PT e)
034 0034 FIB d_ FIB (PT d)
035 0035 FIB d FIB (PT d)
036 0036 FIB ed FIB (PT ed)
037 0037 FIB ed FIB (PT ed)
038 0038 FIB HS_ FIB (PT HS)
343
039 0039 FIB HS FIB (PT HS)
040 0040 FIB HSe_ FIB (PT HS e)
041 0041 FIB HSe FIB (PT HS e)
042 0042 FIB HSd_ FIB (PT HS d)
043 0043 FIB HS d FIB (PT HS d)
044 0044 FIBHSed_ FIB (PT HS ed)
045 0045 FIB HSed FIB (PT HS ed)
046 0046 FIB HS+_ FIB (PT PLUS)
047 0047 FIB HS+ FIB (PT PLUS)
048 0048 Fib hs+e_ FIB (PLUS e)
049 0049 FIB HS+e FIB (PLUS e)
050 0050 FIB HS+d_ Fib (PLUS db)
051 0051 FIB HS+d FIB (PLUS db)
052 0052 FIBN+ed_ FIB (PLUS ed)
053 0053 FIB+ed FIB (PLUS ed)
054 0054 R-FIB_ Recombipl-FIB
055 0055 R-FIB Recombipl-FIB
056 0056 R-FIBe_ Recombipl-FIBex

30
Clave de Prueba Clave de Prueba para la Identificación de la Nombre de Prueba
computadora principal Prueba (8 caracteres Extendido (18
máximo) caracteres máximo)
057 0057 R-FIBe Recombipl-FIBex
058 0058 FIB R_ FIB (Rec)
059 0059 FIB R FIB (Rec)
060 0060 FIB Re_ FIB (Rec e)
061 0061 FIB Re FIB (Rec e)
062 0062 FIB Rd_ FIB (Rec d)
063 0063 FIB Rd FIB (Rec d)
064 0064 FIB Red_ FIB (Rec d)
065 0065 FIB Red FIB (Rece ed)
074 0074 R-Fibd_ Recombipl-FIBd
075 0075 R-Fibd Recombipl-FIBd
076 0076 R-Fibed_ Recombipl-FIBed
077 0077 R-Fibed Recombipl-FIBed

080 0080 APTT Ly APTT Ly


081 0081 APTT Lye APTTLy Ext
082 0082 APTTLyd APTTLy Db.
083 0083 APTTLyed APTT Ly Ext.Db.
084 0084 APTT-SP APTT-SP
085 0085 APTT-SPe APTT-SP Ext.
086 0086 APTT-SPd APTT-SP Db.
087 0087 APTT-SPed APTT-SP Ext.Db.
088 0088 APTT-C APTT-C
089 0089 APTT-C e APTT-C Ext.
090 0090 APTT-C d APTT-C Db.
091 0091 APTT-Ced APTT-C-Ext..Db
092 0092 APTTSYS APTT SynthASil
093 0093 APTTSYSe APTT SynthASile
094 0094 APTTSYSd APTT SynthASild
095 0095 APTTSSed APTTSynthASiled
096 0096 APTTSYF APTT SynthAFax
344
097 0097 APTTSYFe APTT SynthAFaxe
098 0098 APTTSYFd APTT SynthAFaxd
099 0099 APTTSFed APTT SynthAFaxed

102 0102 FVIII SF FVIII SynthAFax


107 0107 FIX SF FIX SynthAFax
112 0112 FXI SF FXI SynthAFax
117 0117 FXII SF FXII SynthAFax

120 0120 TT-5 TT-5


121 0121 TT e-5 TT Ext. 5
122 0122 TT d-5 TT Dbl.5
123 0123 TT ed-5 TT Ext. Dbl. 5
124 0124 TT-8 TT-8
125 0125 TT e-8 TT Ext.8
126 0126 TT d-8 TT Dbl.8
127 0127 TT ed-8 TT Ext.Dbl.8
128 0128 TT-2 TT-.2
129 0129 TT e-2 TT Ext.2
130 0130 TT d-2 TT Dbl. 2
131 0131 TT ed-2 TT Ext.Dbl.2

150 0150 PCX Pro-IL-Complex


151 0151 HPX Hepatocomplex
152 0152 P-ClotLy Pro-Clot Ly

31
Clave de Prueba Clave de Prueba para la Identificación de la Nombre de Prueba
computadora principal Prueba (8 caracteres Extendido (18
máximo) caracteres máximo)
153 0153 P-ClotSP Pro-Clot SP
154 0154 P-ClotC Pro-Clot C
159 0159 PS Proteín S
160 0160 Free PS Free Protein S
161 0161 Pro S Protein S
199 0199 AT* Antithr. Liquid
200 0200 AT Antithr In cup

201 0201 FIB-C_ Fib. Clauss


202 0202 FIB-C Fib.Clauss
203 0203 FIB-C I_ Fib.Clauss low
204 0204 FIB-C I Fib.Clauss low
205 0205 FIB-C h_ Fib. Clauss high
206 0206 FIB-C h Fib.Clauss high

225 0225 APCR-V APCR V


208 0208 HEP LMW Heparin LW
210 0210 HEP UHF Heparin UHF
212 0212 PLG Plasminogen
213 0213 PL-IN Plasmin Inhib.
214 0214 P-C Protein C
220 0220 F8 Chr H F8Chr High
221 0221 F8 Chr L F8 Chr Low
225 0225 APCR V APCR V
345
250 0250 D-Dimer D-Dimer
251 0251 D-Dh D-Dimer high
275 0275 F8SP-P FVIII SP Par
276 0276 F9SP-P FIX SP Par

300 0300 FVIII Ly F VIII-Ly


302 0302 FVIII SP F VIII-SP
304 0304 FVIII C F VIII-C
305 0305 FVIII SS FVIII SynthASil

310 0310 FIX Lyo FIX-Ly


312 0312 FIX SP F IX-SP
314 0314 FIX C F IX-C
315 0315 FIX FIX SynthASil

320 0320 FXI Lye FXI-Ly


322 0322 FXI SP FXI-SP
324 0324 FXI C F XI-C
325 0325 FXI SS FXI SynthASil

330 0330 FXII Lyo F XII-Ly


332 0332 FXII SP F XII SP
334 0334 FXII C F XII-C
335 0335 FXII SS FXII SynthASil

336 0336 FVII PT F VII-PT


338 0338 FVII HS F VII-HS
340 0340 FVII HSP F VII-HS Plus
342 0342 FVII R F VII-R
343 0343 R FVII FVII RecombPT

350 0350 FX PT FX-PT


32
Clave de Prueba Clave de Prueba para la Identificación de la Nombre de Prueba
computadora principal Prueba (8 caracteres Extendido (18
máximo) caracteres máximo)
352 0352 FX HS FX-HS
354 0364 FX HSP FX-HS Plus
356 0354 FX R FX – R
357 0357 R FX FX RecombPT

360 0360 FV PT FV-PT


362 0362 FV HS FV-HS
364 0364 FV HSP FV-HS Plus
366 0366 FV R FV-R
367 0367 R FV FV RecombPT

370 0370 FII PT F iI-PT


372 0372 FII HS F II-HS
374 0374 FII HSP F II-HS Plus
376 0376 FII R F II-R
377 0377 R FII FII RecombPT

155 155 SCT-S SCT Screen


346
156 156 SCT-C STC Confirm
400 0400 VWF:Ag vWF Antigen
401 0401 vWF:AgH vWF Antigen Hig

410 0410 LAC_S LAC_S


411 0411 LAC_C LAC_Confirm

Nota: Esta tabla representa la situación para la Biblioteca


IL 7.
33
8.0 Apéndice – Caracteres Soportados de ACL Elite/Elite Pro
8.1 Caracteres Soportados para Identificación de Muestras
El conjunto de caracteres ASCII que se consideran se
encuentra dentro del rango decimal de 32 a 126, debido a que
puede aceptarse una Identificación de Muestra solamente
cuando contiene por lo menos un carácter diferente de un
espacio.
8.2 Caracteres Soportados para nombre del Paciente,
Departamento y Unidades
Es el conjunto de caracteres ASCII considerado en el rango
decimal de 32 a 255.
8.3 Caracteres Soportados para Delimitadores
! ” # $ %
& . ( ) *
+ / : ; =
@ [ \ ] ^
- { L }
El caracter ASCII 127 no se acepta como delimitador.
Nota: Los separadores se esperan siempre de la Computadora
Principal y se transmiten siempre independientemente de la
información contenida en la secuencia.
34
9.0 Apéndice – Unidades Soportadas de ACL Elite/Elite Pro
Unidad Abreviatura
Tiempo s
Actividad %
Relación R
Relación Normalizada Internacional INR
NR
Concentración mg/dL
g/L
ng/mL
U/mL
µg/L
µmol/L
IU/mL
mg/L
ug/mL
Absorbencia Óptica Delta ∆ Abs
347
Delta ∆ (∆ ASCII clave es 7F)
Muestra Sa Activada Sa (Hex clave EC)

Unidad Abreviatura
Comportamiento de curva compensación
mín.
máx.
Final
Definido por usuario secuencia libre que
contiene hasta 8 caracteres
Notas: Para las pruebas duplicadas (d) y duplicadas
extendidas (ed), se envían solamente los resultados de las
réplicas individuales al sistema de la computadora
principal. La media del valor no se envía desde el sistema
ACL8/9/10000. Lo anterior se aplica a todos los tipos de
muestras, con inclusión de aquellas del paciente, Control de
Calidad y la Referencia Analítica.
• * * * * * *
APÉNDICE B
ACL Elite/Elite Pro
Especificación de Etiqueta de Código de Barras
2
Índice
1. INTRODUCCIÓN 3
1.1 OBJETO 3
1.2 DEFINICIONES, SIGLAS Y ABREVIATURAS 3
1.3 REFERENCIAS 3
2 DESCRIPCIÓN GENERAL 4
2.1 CLAVES SOPORTADAS Y TIPO DE SUMA DE COMPROBACIÓN 4
2.2 ESPECIFICACIONES DE LOS SÍMBOLOS DEL CÓDIGO DE BARRAS 4
2.3 PARÁMETROS DEL CÓDIGO DE BARRAS 5
2.4 POSICIONAMIENTO DE LA ETIQUETA DEL CÓDIGO DE BARRAS 6
2.5 APÉNDICE A – MAPA DE ZONA DE DESCODIFICADOR 7
2.6 APÉNDICE B – DIMENSIONES DE LA ETIQUETA DEL CÓDIGO DE BARRAS 8

1. INTRODUCCIÓN
En las secciones siguientes, se describen las
características de las etiquetas del código de barras que
pueden leerse con el escáner Welch Allyn SCANTEAM 3700,
instalado en los instrumentos de la familia ACL Elite/Elite
Pro.
1.1 Objeto
El objeto de este documento es proporcionar la indicación de
las características del escáner en términos de códigos
legibles, identificar los requisitos con los que deben
cumplir las etiquetas de los códigos de barras y definir las
348
restricciones en términos del posicionamiento de las
etiquetas dentro del instrumento ACL Elite/Elite Pro.
1.2 Definiciones, Siglas y Abreviaturas
WA Welch Allyn SCANTEAM 3700
Distancia Cercana es la distancia más próxima que un escáner puede
digitalizar un código de barras dado con
exactitud
Distancia Lejana es la distancia más lejana que un escáner puede
digitalizar un código de barras dado con
exactitud
Ancho de Escaneado es la longitud del código de barras más ancho
que el escáner puede interpretar con éxito
Zona Silenciosa es el área en blanco situada justo antes y justo
después del patrón del espacio de la barra
1.3 Referencias
Ref.1 SCANTEAM 3700 – Manual Técnico – Welch Allyn
4
2 DESCRIPCIÓN GENERAL
El WA es un escáner de código de barras CCD de montaje fijo,
con descodificador integrado para integración fácil al
equipo principal (los instrumentos de la familia ACL
Elite/Elite Pro en nuestro caso).
El 3700 incluye a los algoritmos descodificadores Welch-
Allyn comprobados en el transcurso del tiempo, en un escáner
de código de barras/descodificador controlados por
microprocesador y ofrece parámetros de operación
configurables.
Las siguientes características medias están disponibles con
cada WA:
• Velocidad elevada de escaneado por segundo (100 es la
norma).
• Configuraciones flexibles de disparo de escáner.
• Descodificador configurable para alta seguridad
• Facilidad de configuración por medio de la interfaz RS-
232.
2.1 Claves Soportadas y Tipo de Suma de Comprobación

Tipo de Código Tipo de Suma de Comprobación Dígitos de Datos


Código 128 Ninguna suma de comprobación Hasta 15
Código 39 Módulo 43 Hasta 15
Ninguna suma de comprobación Hasta 15
Interpuestos 2 de 5 USS-Módulo 10 Hasta 15
OPCC-Módulo 10 Hasta 15
Ninguna suma de comprobación Hasta 15
Codabar AIM-Módulo 16 con dígitos de inicio/paro Hasta 15
NW7-Módulo 16 con dígitos de inicio/paro Hasta 15
NW7-Módulo 16 con dígitos de inicio/paro Hasta 15
Ninguna suma de comprobación Hasta 15

2.2 Especificaciones de los Símbolos del Código de Barras


349
Todos los símbolos de código de barra tienen que cumplir con
la Especificación de la Simbología Uniforme AIM. En
particular, tienen que considerarse las características
siguientes:
• Substrato de fondo: el símbolo del código de barras debe
imprimirse en un tipo de materil que sea reflejante y
que tenga un acabado mate (no brillante). Se sugiere una
reflectancia difusa de fondo de por lo menos 70% a 80%
para contraste óptimo.
5
• Color y tipo de tinta: el tipo de tinta debe ser
compatible con los LEDs de 660 nm que se utilizan en el
escáner. Las barras con tinta de lo símbolos del código
de barras no deben exceder de 100% de reflectancia a 660
nm, que es la que se utiliza para la lectura, ya sea que
se imprima con tinta negra o tinta de color.
• Huecos y Manchas: el código tiene que estar impreso
claramente, libre de huecos, manchas, defectos y líneas
que pudieran “engañar” al escáner.
• Definición: las barras en los símbolos del código de
barras deben estar bien definidas. Sus bordes no deben
ser ásperos o borrosos, de manera de que la barra y los
espacios tengan las anchuras máximas que se tiene la
intención para la simbología del código de barras que se
utiliza. La definición debe ser nítida y uniforme.
• Tolerancia: la relación de los anchos y los espacios en
el símbolo de un código de barras debe estar conforme
con las especificaciones de código de barras AIM
apropiadas y puede ocasionar problemas en caso de que no
se corrijan en todo el código de barras. Pueden ocurrir
problemas en caso de que los bordes de la barra estén
manchados o sean ásperos, o cuando muestren huecos.
2.3 Parámetros del Código de Barras
Los parámetros que deben considerarse en ese contexto son:
• La densidad (código de barras) se refiere al número de
caracteres en una pulgada lineal del código de barras.
• La relación se refiere a la relación del elemento de
anchura nominal con la anchura nominal del elemento
angosto.
A fin de asegurar una buena lectura del código de barras
(además de la indicada en la sección 2.2), los parámetros
antes mencionados debe ser como sigue:
• Densidad: no menor de 10 milésimas de pulgada
• Relación: no menor de 2.5
Estos valores son válidos para todos los tipos de códigos de
barras antes mencionados.
350
La relación entre las distancias de lectura, ancho del
escaneado y densidad del código de barras se muestra en lo
siguiente:
Distancia Cercana Distancia Lejana Ancho de Escaneado Ancho de Escaneado Densidad
(distancia cercana) (distancia lejana) (código de barras)
63.5 mm 114.5 mm 101.6 mm 152.4 mm 7.5 milésimas de
(161.29”) (290.83”) (258.064”) (387.096”) pulgada
34.3 mm 130.3 mm 82.3 mm 178.3 mm 13 milésimas de pulgada
(87.122”) (330.962”) (209.042”) (452.882”)

En el Apéndice de Mapa de la Zona de Descodificador, el


dibujo que se anexa define al “mapa de la zona de
descodificador” para los datos mostrados arriba. La gráfica
mostrada se ha obtenido experimentalmente en los Welch Allyn
Laboratories debido a que el WA equipado para los
requerimientos de IL no tiene sistema óptico estándar.
6

2.4 Posicionamiento de la Etiqueta del Código de Barras


En el Apéndice de Dimensiones de la Etiqueta del Código de
Barras, el dibujo adjunto define las dimensiones de la
etiqueta del código de barras e identifica las restricciones
en el posicionamiento de las etiquetas en los Vacutainers®
#. Se han considerado vacutainers de 13x75. Las dimensiones
y el posicionamiento de las etiquetas del código de barras
propuestos se aplican a todos los modelos de charolas de
muestras.
Se reportan las medidas siguientes:
Característica de la etiqueta del código de barras Dimensión
Longitud máxima de la etiqueta (tamaño global de la etiqueta) 52.6 mm (2.071”)
Longitud máxima del código de barras (área impresa) 39.6 mm (1.500”)
Zona de silencio (área en blanco antes y después del área impresa) 6.35 mm (0.258”)
Posición de la etiqueta (se identifica como el borde de la etiqueta medido a 58 mm (2.283”)
partir del borde inferior del Vacutainer)

# ®Vacutainers es una marca registrada de Becton Dickinson.


7
2.5 Apéndice A – Mapa de Zona de Descodificador
(Ilustración)
8
2.6 Apéndice B – Dimensiones de la Etiqueta del Código de
Barras
(Ilustración)
* * * * * * *
APÉNDICE C
ACL Elite/Elite Pro
Procedimientos para Pruebas Especiales
Revisión 3
2
3
351
Pruebas Especiales en el ACL Elite/Elite Pro
• APCR-V Página 4
• Antitrombina (Líquida) Página 8
• Dímero D Página 12
• Ensayos de Factores Página 18
• Factor VIII Cromogénico Página 24
• Fib-C Página 28
• Proteína S Libre Página 34
• Heparina Página 38
• Hepatocomplex Página 44
• LAC-Pantalla/Confirmar Página 48
• Plasminógeno Página 52
• Inhibidor de Plasmina Página 56
• Pro-IL-Complex Página 60
• ProClot Página 64
• Proteína C Página 68
• Pro S Página 72
• Tiempo de Coagulación de Sílice Página 76
• Tiempo de Trombina Página 80
• Actividad de vWF Página 84
• Antígeno de vWF Página 88
352
4

APCR-V

Preparación del Reactivo

Activar la prueba dentro del

Analizador

AjustePruebasVer/Definir

Editar la Referencia de Rango/Corte

de la Prueba

AjustePruebasVer/Definir

Ajustar el QC para APCR-V

QCAjustar/Revisar

Analizar Muestras de Paciente /

QC (Control de Calidad)
353
5
APCR-V – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo APCR-V Cat. No. 20008700
• Plasma de Calibración Cat. No. 20003700
Configuración del Estuche de Reactivo APCR-V
Contenido del Estuche Estabilidad Preparación
2 x 4 mL de Reactivo APTT 1 mes a 2-8ºC Mezcle perfectamente antes del
1 semana a 15-25ºC uso
8 horas a º5ºC en el ACL
**Nota: No se Congele
2 x 4 mL de Plasma de Reactivo de 8 horas a 15-25ºC Añada 4.0 mL de H2O
Factor V 24 horas a 2-8ºC Agite, deje reposar por 30 minutos
3 meses a -20ºC en el frasquito a 15-25ºC
original Invierta. ¡No agite¡
(Descongele a 37ºC y mezcle antes
de usar. No vuelva a congelar)-
2 x 2 mL APC Ca/Cl2 8 horas a 15-25ºC Añada 2.0 mL de H2O
Nota: La posición por omisión en el 5 días a 2.8ºC Agite, deje reposar por 30 minutos
analizador es la R7 (APC Ca Act) 3 meses a -20ºC en el frasquito a 15-25º C.
original Invierta. ¡No agite¡
2 x 2 mL de Ca/Cl2 1 mes a 2-8ºC Mezcle perfectamente antes de
Nota: La posición por omisión en el 1 semana a 15-25ºC usar.
analizador es la R8 (APC CaCl2) 3 días a 15ºC en el ACL
2 x 1 mL Plasma de Control APC 6 horas a 15-25ºC Añada 1.0 mL de H2O
Nivel 1 6 horas a 2-8ºC Agite, deje resposar por 30 minutos
3 meses a -20ºC en el frasquito a 15-25ºC
original. Invierta. ¡No agite¡
(Descongele a 37ºC y mezcle bien
antes de usar. No vuelva a
congelar)
2 x 1 mL Plasma de Control APC 6 horas a 15-25ºC Añada 1.0 mL de H2O
Nivel 2 6 horas a 2-8ºC Agite, deje resposar por 30 minutos
3 meses a -20ºC en el frasquito a 15-25ºC
original. Invierta. ¡No agite¡
(Descongele a 37ºC y mezcle bien
antes de usar. No vuelva a
congelar)

6
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba APCR-V. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
3. Editar el Rango de Referencia/Corte de la Prueba
354
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba APCR-V y oprima el Icono
de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades de reporte
deseadas, y haga clic en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- La curva de reacción mínima y máxima puede también
establecerse. Cuando se desconocen los valores, despeje
el mínimo y el máximo para efectuar un zoom
(acercamiento) de la indicación de la curva a la escala
completa.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos para el Reactivo de APTT,
Reactivo de Factor V, APCCaCl2 y CaCl se asignan
automáticamente cuando se pone la prueba en un perfil o
corrida como un solo ensayo. Consulte la pantalla del
mapa de Materiales cuando se corre el ensayo para
colocación.
5. Ajuste de Control de Calidad
Antes de ajustar los rangos de Control de Calidad, necesita
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga definido el líquido de
Control de Calidad apropiado. La prueba APCR-V puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control APC Nivel 1
- Plasma de Control APC Nivel 2
En el ACL Elite/Elite Pro, se define lo anterior en el menú
de AjustarLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones detalladas acerca de la definición de nuevos
líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el
Objetivo, la DE que Constituye el Objetivo y el rango de
la DE para la prueba. En caso de que no se conozca la
355
Media y el rango de la DE, déjelos inicialmente
ajustados en cero. Una vez que se conozcan los rangos,
puede entonces redefinirse; haga clic en el botón...
6
...de marcado del Rango del Control de Calidad para el
indicador del resultado del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
6 Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a
37ºC durante 15 minutos. Centrifugue el plasma antes de
someter a prueba. Las muestras deben analizarse dentro de
las 2 horas.
Los resultados se reportan en segundos o en una Relación de
los Segundos. La relación se calcula como sigue:
APCR-V = APTT(con APC)/APTT (sin APC)
Cada laboratorio debe establecer su propio valor de corte
para la relación.
Consulte la hoja de inserto del paquete de Resistencia V
HemosILTM APCTM para un procedimiento para establecer el
valor de corte.
356
7

Preparación de Reactivo

Antitrombina (Líquida)

Activar la prueba dentro del

analizador

AjustePruebasVer/Definir

Editar la Referencia de Rango/Corte

de la Prueba

AjustePruebasVer/Definir

Ajustar el QC para AT Líquida

QC Revisar/Ajustar

Calibrar la prueba de AT Líquida

CalibraciónCalibrar

Validar Calibración y

Analizar Muestras de Paciente


357

8
Antitrombina Líquida – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Antitrombina Líquida Cat. No. 20002500
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Control HemosIL Anormal Alto no Ensayado Cat. No. 20003320
• Control HemosIL Anormal Alto Ensayado* Cat. No. 20003310
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Diluyente de Factor Cat. No. 09757600
• Solución Limpiadora (Limpiador A) Cat. No. 09831700
Configuración del Estuche de Reactivo de Antitrombina
Líquida
Contenido del Estuche Estabilidad Preparación
4 x 4 mL Reactivo Factor Xa Hasta la caducidad cuando no se Invierta para mezclar antes del uso
abre y almacena a 2-8ºC
5 semanas en el frasquito original a
2-8ºC
2 días en el ACL, cuando se abre
**Nota: No se Congele
2 x 2 mL Substrato Cromogénico Hasta la caducidad cuando no se Invierta para mezclar antes del uso
abre y almacena a 2-8ºC
5 semanas en el frasquito original a
2-8ºC
2 días en el ACL, cuando se abre
**Nota: No se Congele

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba AT*. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
10
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba AT* y oprima el Icono de
Detalles.
358
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic
en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de AT*.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al
Plasma de Calibración, el Factor Xa, el Substrato
Cromogénico, el Diluyente de Factor y el Limpiador A se
asignan automáticamente cuando se pone la prueba en un
perfil o corrida como un solo ensayo. Consulte la
pantalla del mapa de Materiales cuando calibre o corra
el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido
de Control de Calidad apropiadas. La prueba de AT* puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Cromogénico Anormal Nivel 1
- Plasma de Control Cromogénico Anormal Nivel 2
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
11
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
359
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el
Objetivo, la DE que Constituye el Objetivo y el rango de
la DE para la prueba. En caso de que no se conozca la
Media y el rango de la DE, déjelos inicialmente
ajustados en cero. Una vez que se conozcan los rangos,
puede entonces redefinirse; haga clic en el botón de
marcado del Rango del Control de Calidad para el
indicador del resultado del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba de AT*
del menú desplegable descendente en la ventana de Probar
para Calibrar.
- Confirme que los líquidos necesarios están en su lugar
de acuerdo con el Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibración.
- Cuando se complete la calibración, la gráfica y los
datos de la curva de calibración serán visibles. En caso
de que los datos de la curva sean aceptables, haga clic
en marcar para aceptar el uso de la curva.
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a
37ºC durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150% de actividad.
360
12

Preparación de Reactivo

Dímero D

Activar la prueba dentro del

analizador

AjustePruebasVer/Definir

Editar la Referencia de Rango/Corte

de la Prueba

AjustePruebasVer/Definir

Ajustar la Nueva Corrida Automática

para Dímero D Alto

Ajuste PruebaPruebas Reflejas

Ajustar el QC para Dímero-D

QCRevisar/Ajustar

Calibrar la prueba de Dímero D

CalibraciónCalibrar

Validar Calibración y Analizar las


Muestras del Paciente
361

13
Dímero-D/Dímero-D Alto – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Dímero D Cat. No. 20008500
• Estuche de Control de Doble Nivel de Dímero-D Cat. No. 20008610
• Diluyente de Factor Cat. No. 09757600
Configuración del Estuche de Reactivo de Dímero-D
Contenido del Estuche Estabilidad Preparación
4 x 3 mL Reactivo de Látex 1 mes a 2-8ºC Añada 3.0 mL de H2O
1 día en el ACL a 15ºC Agite, deje reposar durante 30
**Nota: No Congele minutos a 15-25ºC
Invierta. No agite
3 x 9 mL de Tampón de Reacción 1 mes a 2-8ºC Listo para usarse
1 día en el ACL a 15ºC Invierta para mezclar antes de
colocar el frasquito en el
instrumento.
2 x 1 mL Calibrador de Dímero-D 1 mes a 2-8ºC Añada 1.0 mL de H2O
3 días a 15-25ºC Agite, deje reposar durante 30
2 meses a -20ºC minutos a 15-25ºC
**Congele yh descongele Invierta. No agite.
solamente 1 vez. Evite la formación de espuma
Descongele a 37ºC y mezcle antes
de usar

Controles de Dímero-D
Contenido del Estuche Estabilidad Preparación
5 x 1.0 mL Control de Dímero-D 1 mes a 2-8ºC Añada 1.0 mL de H2O
Bajo 3 días a 15-25ºC Agite, deje reposar durante 30
Nivel Aproximado: Valor de línea 2 meses a -20ºC minutos a 15-25ºC
limítrofe **Congele y descongele solamente Invierta. No agite
1 vez
Descongele a 37ºC y mezcle antes
del uso
5 x 1.0 mL Control de Dímero-D 1 mes a 2-8ºC Añada 1.0 mL de H2O
Alto 3 días a 15-25ºC Agite, deje reposar durante 30
Nivel Aproximado: Valor anormal 2 meses a -20ºC minutos a 15-25ºC
**Congele y descongele solamente Invierta. No agite
1 vez Evite la formación de espuma
Descongele a 37ºC y mezcle antes
del uso

14
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
362
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de Dímero-D.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
- Repita el paso anterior para la prueba D-D h (ensayo de
Dímero-D Alto)
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba de Dímero-D y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en ng/mL y haga
clic en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Puede también establecerse el mínimo y el máximo de la
curva de reacción. En caso de que no se conozcan los
valores deseados, despeje tanto el mínimo como el máximo
para efectuar el zoom de indicación de la curva a la
escala completa.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Calibración
de D-D.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de Dímero-D.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador de Dímero-D. Este
valor puede encontrarse en el inserto del paquete
incluido en el estuche.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Nota: La prueba de D-Dh (Dímero-D Alto) utiliza la curva de
calibración para la prueba de Dímero-D normal. No es
necesario introducir el valor de calibrador en la prueba de
D-DH.
15
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes a D-D
Cal, Dímero-D Látex, reactivo de Tampón y Diluyente de
363
Factor se asignan automáticamente cuando se pone la
prueba en un perfil o corrida como un solo ensayo.
Consulte la pantalla del mapa de Materiales cuando
calibre o corra el ensayo para colocación.
6. Ajuste del elemento de Nueva Corrida Automática
Nota: El ensayo de Dímero-D es lineal de 200 a 1050 ng/mL.
El sistema ACL Elite/Elite Pro puede volver a correr las
muestras del paciente que excedan del límite de 1050 ng/mL
con el uso de la prueba de Dímero-D alto. Lo anterior
incrementará la linealidad del ensayo 5 veces hasta 5250
ng/mL. Los valores superiores a 5250 ng/mL, provenientes de
la prueba de D-Dh (Dímero-D alto) necesitarán una dilución
manual (1:25 ó 1:125) con diluyente de factor y repetirse
con el uso de la prueba de Dímero-D. Multiplique los
resultados impresos por 5, 25 ó 125 (dependiendo del número
de pasos de dilución efectuados) para corregir la dilución.
No corra la prueba de Dímero-D alto con muestras con un
Dímero-D menor de 1000 ng/mL.
- AjustePruebasPruebas Reflejas
- Definir una nueva regla Refleja para lo siguiente:
- En caso de que el Dímero-D > 1050Añadir prueba D-Dh
(Dímero-D Alto)
- Consultar la sección 4.1.8 en el manual del Operador del
ACL Elite/Elite Pro para las instrucciones detalladas
sobre el ajuste de las reglas Reflejas.
- Para activar las pruebas reflejas: AjusteConfiguración
del Sistema.
- El menú desplegable descendente para el Estado Reflejo
proporciona 3 opciones
1. Programar Prueba solamente
2. Ejecutar antes del cierre de la sesión
3. Desactivado
- Seleccione la opción 1 ó 2 para activar la programación
y/o las pruebas.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido
de Control de Calidad apropiadas. La prueba de Dímero-D
puede utilizar los siguientes materiales de control para
verificar el desempeño del ensayo:
- Control de Dímero Bajo
- Control de Dímero Alto
En el ACL Elite/Elite Pro, se define esto en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual
364
del Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
16
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el
Objetivo, la DE que Constituye el Objetivo y el rango de
la DE para la prueba. En caso de que no se conozca la
Media y el rango de la DE, déjelos inicialmente
ajustados en cero. Una vez que se conozcan los rangos,
puede entonces redefinirse; haga clic en el botón de
marcado del Rango del Control de Calidad para el
indicador del resultado del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba de
Dímero-D del menú desplegable descendente en la ventana
de Probar para Calibrar.
- Confirme que los líquidos necesarios están en su lugar
de acuerdo con el Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibración.
- Cuando se complete la calibración, la gráfica y los
datos de la curva de calibración serán visibles. En caso
de que los datos de la curva sean aceptables, haga clic
en marcar para aceptar el uso de la curva.
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a
37ºC durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 200-1050 ng/mL
365
17
18

Preparación de Reactivo

Factor XII

Activar la prueba dentro del

analizador

AjustePruebasVer/Definir

Editar la Referencia de Rango/Corte

de la Prueba

AjustePruebasVer/Definir

Ajustar el QC para Factores

QCAjustar/Revisar

Calibrar y

Analizar Muestras de Paciente/QC


366
19
Análisis de Factores – ACL Elite/Elite Pro
1. Materiales Necesarios
• Plasma Deficiente en Factor XII Cat. No. 20201200
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Diluyente de Factor Cat. No. 09757600
• APTT SP# Cat. No. 20006300
#Se puede correr el estuche utilizando otras
formulaciones de APTT (consultar la sección 10).
*Para uso en los países seleccionados.
Configuración del Estuche de Reactivo Deficiente en Factor
Contenido del Estuche Estabilidad Preparación
5 x 1 mL Plasma Deficiente en 4 horas a 2-8ºC en el frasquito Añadir 1.0 mL de H2O
Factor XII original Agitar, dejar reposar por 30
minutos a 15-25ºC
Invierta. No agite
5 x 9 mL Reactivo de APTT 1 mes a 2-8ºC Agite por 15 segundos o someta a
5 días a 15ºC en el ACL Vórtice durante 5 segundos antes
**Nota: No congele de usar
5 x 8 mL Cloruro de Calcio 1 mes a 2-8ºC Listo para usarse

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de FXII SP.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
20
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba de FXII SP y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic
en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
367
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de FXII SP.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo de FXII SP se Calibra Una Vez por Sesión a
bordo del ACL Elite/Elite Pro. La calibración de la prueba
ocurre durante el ciclo de análisis. La prueba no puede
calibrarse bajo el Menú de Calibración.
Las pruebas de paralelismo utilizan una calibración
Especializada y se calibran bajo el menú de Calibración.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al
Plasma de Calibración, F Bajo de Calibración, el FXII
Deficiente, APTTSP y APTT Ca/Cl2 se asignan
automáticamente cuando se corre la prueba como un solo
ensayo. Consulte la pantalla del mapa de Materiales
cuando corra el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido
de Control de Calidad apropiadas. La prueba de FXII SP puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Control de Prueba Especial Nivel 2
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
21
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el
Objetivo, la DE que Constituye el Objetivo y el rango de
368
la DE para la prueba. En caso de que no se conozca la
Media y el rango de la DE, déjelos inicialmente
ajustados en cero. Una vez que se conozcan los rangos,
puede entonces redefinirse; haga clic en el botón de
marcado del Rango del Control de Calidad para el
indicador del resultado del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
Ensayos de Factores sin Paralelismo
Se efectúa la calibración durante la Corrida de Análisis
para el FXII SP. La Calibración utiliza 2 calibradores:
Plasma de Calibración y F Bajo de Calibración. F Bajo de
Calibración es una dilución de 1:16 del plasma de
calibración. Se prepara tomando 20 µL de Plasma de
Calibración y diluyéndolo con 300 µL de diluyente de Factor
en una copa de 0.5 mL. Cuando el ACL Elite/Elite Pro ve a
ambos de estos calibradores a bordo durante su verificación
previa al análisis, efectuará una curva de calibración
completa. La curva de calibración cubrirá entre 100% hacia
abajo a 1.56% de actividad.
Cuando el ACL detecta solamente al Plasma de Calibración a
bordo durante la verificación previa al análisis, ejecutará
entonces una calibración y construirá una curva de 100%
hacia abajo a 25% de actividad. Los resultados bajos
inferiores a 25% se extrapolarán con base en la curva. En
cualquiera de los casos, la curva de calibración se
almacenará y utilizará nuevamente en corridas posteriores en
caso de que, durante la verificación previa al análisis para
FXII SP, el instrumento no detecte la presencia del Plasma
de Calibración en la posición A1.
Nota: No coloque F Bajo de Calibración a bordo sin tener el
Plasma de Calibración también a bordo. La Calibración para
las pruebas de Paralelismo de Factores se define como
especializada y efectuada con el uso del Menú de
Calibración.
22
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a
369
37ºC durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Valores Esperados: 50-150% de actividad.
10. Información para Ordenar los Ensayos de Factores
Factores Basados en APTT
Plasma Deficiente en Factor VIII Cat. No. 08466450
Plasma Deficiente en Factor IX Cat. No. 08466550
Plasma Deficiente en Factor XI Cat. No. 08466650
Plasma Deficiente en Factor XII Cat. No. 20201200
Factores Basados en PT
Plasma Deficiente en Factor II Cat. No. 08466050
Plasma Deficiente en Factor V Cat. No. 08466150
Plasma Deficiente en Factor VII Cat. No. 08466250
Plasma Deficiente en Factor X Cat. No. 08466350
Reactivos de Coagulación
APTT SP Cat. No. 20006300
APTT Liofilizado Sílice Cat. No. 08468710
Fib-PT Cat. No. 09756710
Fib-PT Recombinante Cat. No. 20005000
Fib-PT HS Cat. No. 08468210
Fib-PT HS PLUS Cat. No. 08469810
HemosIL SynthASil Cat. No. 20006800
HemosIL RecombiPlasTina Cat. No. 20002900 ó
20003000
370
23
24

Preparación de Reactivo

Factor VIII Cromogénico

Activar la prueba dentro

del

analizador

AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC

QC Revisar/Ajustar

Correr Muestras/Calibrar
371

25
Factor VIII Cromogénico – ACL Elite/Elite Pro
1. Materiales Necesarios
• Factor VIII Electrachrome Cat. No. 49730503
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Diluyente de Factor Cat. No. 09757600
• Limpiador A Cat. No. 09831700
Configuración del Estuche de Reactivo
Contenido del Estabilidad Preparación
Estuche
2 x 3 mL Reactivo de Factor 12 horas a 2-8ºC en el frasquito Añada 3.0 mL de H2O
original Agite, deje reposar por 30 minutos
30 días a -70ºC a 15-25ºC
Invierta. No agite
1 x 6 mL Reactivo de Substrato 1 mes a 2-8ºC en el frasquito Añada 6.0 mL de H2O
Cromogénico – Factor VIII original Agite, deje reposar por 30 minutos
a 15-25ºC
Invierta. No agite

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar las Pruebas F8 Chr H/F8
Chr. L. Haga clic en el botón de Activar/Desactivar para
activar la prueba. Una marca de verificación aparecerá en
la columna de pruebas Activadas para esta prueba. Puede
escogerse correr la prueba Alta, la prueba Baja o ambas.
La prueba seleccionada se debe correr en un modo de
prueba única y no puede colocarse en un perfil.
26
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba F8 Chr H/F8 Chr. L y
oprima el Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
372
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de F8 Chr.H/F8
Chr. L.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo de FVIII SP se Calibra para “Cada Rotor” a
bordo del ACL Elite/Elite Pro. La calibración de la prueba
ocurre durante el ciclo de análisis. La prueba no puede
calibrarse bajo el Menú de Calibración. El ensayo debe
calibrarse cada vez que se corra.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, F Bajo de Calibración, F8 Chr. Buf, F8
Chr. Act. F8 Chr. Sub, Limpiador A y Diluyente de Factor
se asignan automáticamente cuando la prueba se corre como
un solo ensayo. Consulte la pantalla del mapa de
Materiales cuando corra el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de FVIII SP puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Control de Prueba Especial Nivel 2
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
27
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
373
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
F Bajo de Calibración es una dilución de 1:16 del plasma de
calibración.
Se prepara tomando 20 µL del Plasma de Calibración y se
diluye con 300 µL de diluyente de Factor en una copa de 0.5
mL.
Este calibrador se utiliza para la prueba de F8 Chr. L
(Factor VIII Cromogénico Bajo).
La Calibración para las pruebas de Paralelismo de Factores se
define como “Cada Rotor” y se efectúa durante el análisis.
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Nota: Cuando se corre el ensayo, se requerirán 2 copas vacías
(0.5 mL) en las posiciones “A” mostradas en la charola, junto
con una copa vacía (0.5 mL) para cada muestra. Las copas
vacías en la posición de la muestra deben colocarse
comenzando con la posición 21. Necesita colocarse una copa
por muestra de paciente.
Valores Esperados: 50-150% de actividad.
374
28

Preparación de Reactivo
Fibrinógeno de Clauss

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar la Nueva Corrida


Automática para Fib
Alto/Bajo
AjustePruebaPruebas
Reflejas

Ajustar el QC para Fib-C


QC Revisar/Ajustar

Calibrar la prueba Fib-C


CalibraciónCalibrar

Validar Calibración y
Analizar muestras del
Paciente
375

29
Fibrinógeno-C – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo Fibrinógeno-C Cat. No. 84609110
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control de Fibrinógeno Bajo Cat. No. 20004200
• Diluyente de Factor Cat. No. 09757600
• Solución Limpiadora Limpiador A Cat. No. 09831700
*Para uso en países seleccionados
Configuración del Estuche de Reactivo de Fibrinógeno-C
Contenido del Estabilidad Preparación
Estuche
8 x 2 mL Reactivo de Trombina de 3 días a 2-8ºC Añada 2.0 mL de H2O
Bovino 8 horas a 15ºC en el ACL Agite, deje reposar por 30 minutos
1 mes a -20ºC en el frasquito a 15-25ºC
original Invierta. No agite
2 x 1 mL Control Anormal 4 horas a 15-25ºC Añada 1.0 mL de H2O
7 días a -20ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC
Invierta. No agite

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de Fib-C. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la columna
de pruebas Activadas para esta prueba.
- Repita el paso anterior para la prueba de Fib-C h_
(ensayo de Fib Clauss Alto) y la Fib-C I_ (ensayo de Fib
Clauss Bajo)
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
30
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba Fib-C y oprima el Icono de
Detalles.
376
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en mg/dL y haga
clic en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Puede también establecerse el mínimo y el máximo de la
curva de reacción. En caso de que se desconozcan los
valores deseados, despeje tanto el mínimo como el máximo
para efectuar el zoom de la indicación de la curva a la
escala completa.
- Repita los pasos anteriores para la prueba de Fib-C h_
(Ensayo de Fib Clauss Alto) y la Fib-C 1_ (ensayo de Fib
Clauss Bajo).
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de Fib-C.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Plasma de Calibración. Este
valor puede encontrarse en el inserto del paquete del
Plasma de Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Nota: Las pruebas de Fib-C h_ (Fib Clauss Alto) y Fib-C l_
(Fib Clauss Bajo) utilizan la curva de calibración para la
prueba de Fib Clauss regular. No es necesario introducir el
valor del calibrador a estas pruebas adicionales.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, FIB-C Thr., Diluyente de Factor y
Limpiador A se asignan automáticamente cuando la prueba
se corre como un solo ensayo. Consulte la pantalla del
mapa de Materiales cuando corra el ensayo para
colocación.
6. Ajuste del elemento de Nueva Corrida Automática
Nota: El rango del ensayo de Fib-C_ es de 60 a 550 mg/dL. El
sistema del ACL Elite/Elite Pro puede volver a correr las
muestras de pacientes que excedan del rango inferior y
superior, con el uso de las pruebas de Fib Clauss Bajo...
31
377
...Alto. El rango de la prueba de Fib-Clauss Bajo es de 30-
550 mg/dL y el rango de la prueba de Fib-Clauss alto es de
60-1100 mg/dL.
AjustePruebasPruebas Reflejas
- Defina las reglas Reflejas para lo siguiente:
- Si Fib-C- > 550 mg/dLAñada prueba Fib-C h_ (Fib Clauss
Alto).
- Si Fib-C- < 60 mg/dLAñada prueba Fib-C l_ (Fib Clauss
Bajo)
- Consulte la sección 4.1.7 en el manual del Operador del
ACL Elite/Elite Pro para instrucciones detalladas para el
ajuste de las reglas Reflejas.
- Para activar el ajuste reflejo: AjusteConfiguración del
Sistema
- El menú desplegable descendente para el Estado Reflejo
proporciona 3 opciones:
4. Programar Prueba solamente
5. Ejecutar antes del cierre de la sesión
6. Desactivado
- Seleccione la opción 1 ó 2 para activar la programación
y/o las pruebas.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de Fib Clauss puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Control Anormal (empacado en el estuche)
- Control de Fibrinógeno Bajo
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
378
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
32
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba de Fib-
C_ en el menú desplegable descendente en la ventana de
Prueba para Calibrar.
- Confirme que los líquidos necesarios (Fib-C Thr.,
Diluyente de Factor y Limpiador A) estén en su lugar de
acuerdo con el Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibrar.
- Cuando se complete la calibración, la gráfica y la curva
de calibración serán visibles. En caso de que los datos
de la curva sean aceptables, haga clic en la marca para
aceptar el uso de la curva.
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Rangos del Ensayo:
Fib-C_: 60-550 mg/dL
Fib-C l_: 30-550 mg/dL
Fib-C h-: 60-1100 mg/dL
379
33

Preparación de Reactivo
Proteína S Libre

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC para PS
Libre
QCRevisar/Ajustar

Calibrar la prueba PS
Libre
CalibraciónCalibrar

Validar Calibración y
Analizar muestras del
Paciente
380

Proteína S Libre – ACL Elite/Elite Pro


1. Materiales Necesarios
• Estuche de Reactivo Proteína S Libre Cat. No. 20002700
• Plasma de Calibración HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Diluyente de Factor Cat. No. 09757600
*No está disponible en todos los países
Configuración del Estuche de Reactivo de Proteína S Libre
Contenido del Estabilidad Preparación
Estuche
3 x 2 mL Reactivo Látex Anti PS Hasta la Caducidad cuando no se Invierta para mezclar antes del uso.
abre y se almacena a 2-8ºC No agite. Evite la formación de
1 mes a 2-8ºC espuma
1 semana en el ACL, cuando se
abre
**Nota: No Congele
3 x 4 mL Látex C4BP Después de la reconstitución Añada 1 frasquito de Tampón
1 mes a 2-8ºC C4BP, agite suavemente 20
1 semana en el ACL segundos
Deje reposar por 30 minutos a 15-
25ºC
Invierta. No agite

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de PS Libre.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
36
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba PS Libre y oprima el Icono
de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
381
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de PS Libre.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Látex Anti PS, Látex C4BP y Diluyente de
Factor se asignan automáticamente cuando la prueba se
coloca en un perfil o se corre como un solo ensayo.
Consulte la pantalla del mapa de Materiales cuando
calibre o corra el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. El estuche de PS Libre puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Control de Prueba Especial Nivel 1
- Control de Prueba Especial Nivel 2
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
37
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
382
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba de PS
Libre en el menú desplegable descendente en la ventana de
Prueba para Calibrar.
- Confirme que los líquidos necesarios estén en su lugar de
acuerdo con el Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibrar.
- Cuando se complete la calibración, la gráfica y los datos
de la curva de calibración serán visibles. En caso de que
los datos de la curva sean aceptables, haga clic en la
marca para aceptar el uso de la curva.
8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-135%
383
38

Preparación de Reactivo
Heparina

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC para
Heparina
QCRevisar/Ajustar

Calibrar la prueba de
Heparina
CalibraciónCalibrar

Analizar muestras del


Paciente/QC
384

39
Heparina – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Heparina Cat. No. 20009400
• Plasma de Calibración HemosIL Cat. No. 20003700
• Plasma de Control de Heparina Bajo Cat. No. 20004000
• Plasma de Control de Heparina Alto Cat. No. 20004100
• Solución Limpiadora (Limpiador A)# Cat. No. 09831700
# El Limpiador A se utiliza para el ciclo de limpieza
automático incorporado a la definición de la prueba de ensayo
de Heparina.
Configuración del Estuche de Reactivo de Heparina
Contenido del Estabilidad Preparación
Estuche
1 x 4 mL Substrato Cromogénico 3 meses a 2-8ºC Añada 4.0 mL de H2O
(Sub Hep) 7 días a 15ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC
Invierta
1 x 5 mL Reactivo de Factor Xa 3 meses a 2-8ºC Añada 5.0 mL de H2O
(Hep_F(Xa) 7 días a 15ºC en el frasquito Agite, dejereposar por 30 minutos a
original 15-25ºC
Invierta
1 x 3 mL Antitrombina 3 meses a 2-8ºC en el frasquito Añada 3.0 mL de H2O
original Agite, dejereposar por 30 minutos a
15-25ºC
Invierta
1 x 8 mL Tampón 3 meses a 2-8ºC en el frasquito Diluya 1:10 (1 parte de Tampón + 9
original partes de H2O)

Prepare los reactivos de acuerdo con las instrucciones de


arriba y prepare a continuación los reactivos de trabajo para
el ensayo de Heparina después de que los reactivos de arriba
se han reconstituido y estabilizado (30 minutos).
Preparación de los Reactivos de Trabajo de Heparina
Tampón de Trabajo 7 días a 2-8ºC Añada 1.0 mL de Antitrombina a
(Hep W.D.) 7 días a 15ºC 24.0 mL de Tampón Diluido.
Calibrador 0.8 Añada 1.0 mL de 0.8 U/mL de
Heparina* diluida a 1 frasquito de
Plasma de Calibración Liofilizado
Calibrador 0.0 Añada 1.0 mL de H2o a un frasquito
de Plasma de Calibración, deje
reposar 30 minutos.

40
*Preparación de Calibrador de Heparina 0.8
Concentración de Heparina Dilución Relación de
Madre (para crear un estándar de heparina de 20 U/mL) Dilución
385
25,000 unidades/mL Paso 1: 100 µL de heparina + 2.4 mL de agua 1:25
Paso 2: 100 µL de dilución del Paso 1 + 4.9 mL de 1:50
agua
10,000 unidades/mL Paso 1: 100 µL de heparina + 900 µL de agua 1:10
Paso 2: 100 µL de dilución del Paso 1 + 4.9 mL de 1:50
agua

Concentración de Heparina Dilución Relación de


Madre (para crear un estándar de heparina de 20 U/mL) Dilución
5,000 unidades/mL Paso 1: 100 µL de heparina + 400 µL de agua 1:5
Paso 2: 100 µL de dilución del Paso 1 + 4.9 mL de 1:50
agua
1,000 unidades/mL 100 µL de heparina + 4.9 mL de agua 1:50
50 unidades/mL 1.0 mL de heparina + 1.5 mL de agua 1:2.5

Diluya 100 µL de los 20 U/mL de heparina preparados arriba


con 2.4 mL del agua recomendada. Esto dará como resultado
una solución de 0.8 U/mL de heparina. Utilice 1.0 mL de esta
solución para diluir un frasquito de Plasma de Calibración.
Nota: Hay 2 ensayos de Heparina definidos dentro del ACL
Elite/Elite Pro:
1. Hep UHFI: Heparina no Fraccionada
2. Hep LMWI: Heparina de Peso Molecular Bajo
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de Heparina
(ver la lista arriba). Haga clic en el botón de
Activar/Desactivar para activar la prueba. Una marca de
verificación aparecerá en la columna de pruebas Activadas
para esta prueba.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba de Heparina y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en U/mL y haga clic
en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
41
4. Introducción de la concentración del Calibrador
- AjusteLíquidos.
386
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar HEPCAL 0.8.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba de Heparina
deseada.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador (0.8).
- No introduzca un valor de calibración para la HEPCAL 0.0
(calibrador de heparina cero)
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes a HEP
W.D., HEP_F(Xa), HEP Sub, Limpiador A, HepCal 0.0 y
HEPCal 0.8 se asignan automáticamente cuando la prueba se
calibra o se corre como un solo ensayo. HEPCal 0.0 y
HEPCal 0.8 se necesitan solamente durante el ciclo de
calibración. Consulte la pantalla del mapa de Materiales
cuando corra el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de Heparina puede
utilizar los siguientes materiales de control para las
pruebas de Heparina no Fraccionada solamente, para verificar
el desempeño del ensayo:
- Plasma de Control de Heparina Bajo
- Plasma de Control de Heparina Alto
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
387
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
42
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
El ensayo de Heparina utiliza el modo de Calibración
especializada y, por lo tanto, se calibra bajo el menú de
Calibración.
Las copas vacías para la calibración deben colocarse a bordo
del analizador como sigue:
- Prueba HepUHFI: Posición A1
- Prueba HepLMWI: Posición A1
8. Procesamiento de la Muestra
Las pruebas HepUHFI y la HepLMWI no necesitan copas vacías
durante el análisis.
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 0-1.0 U/mL
388
43
44

Preparación de Reactivo
HPX

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango Normal de


la Prueba
AjustePruebasVer/Definir
Introducir un Valor de Cal
e ISI

Ajustar el QC para HPX


QCRevisar/Ajustar

Calibrar la prueba HPX


CalibraciónCalibrar

Analizar muestras del


Paciente/QC
389

45
Hepatocomplex – ACL Elite/Elite Pro**
**Estuche no disponible en los EUA
1. Materiales Necesarios
• Estuche de Reactivo Hepatocomplex Cat. No. 09758710
• Plasma de Calibración HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Control HemosIL Anormal Alto no Ensayado Cat. No. 20003320
• Control HemosIL Anormal Alto Ensayado* Cat. No. 20003310
• Diluyente de Factor Cat. No. 09757600
• Diluyente de Tromboplastina PCX/HPX Cat. No. 08469600
*No está disponible en todos los países
Configuración del Estuche de Reactivo de Hematocomplex
Contenido del Estabilidad Preparación
Estuche
5 x 7 mL Tromboplastina de Calcio Hasta la Caducidad cuando no se Añada 7 mL de diluyente de
de Conejo abre y se almacena a 2-8ºC Tromboplastina PCX/HPX, agite,
5 días en el frasquito original a 2- deje reposar por 30 minutos a 15-
8ºC 25ºC
8 horas en el ACL, cuando se abre Invierta. No agite.
5 x 3 mL Plasma de Bovino Hasta la Caducidad cuando no se Añada 3.0 mL de agua NCCLS
abre y almacena a 2-8ºC Tipo II.
24 horas en el frasquito original a Agite, deje reposar por 30 minutos
2-8ºC cuando se abre. a 15-25ºC.
5 días de estabilidad a -20ºC Invierta. No agite
**Nota: no vuelva a congelar

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
46
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba HPX. Haga clic
en el botón de Activar/Desactivar para activar la prueba.
Una marca de verificación aparecerá en la columna de
pruebas Activadas para esta prueba.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba HPX y oprima el Icono de
Detalles.
390
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a la unidad deseada y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción del valor ISI del Reactivo
- AjusteLíquidos.
- Efectúe el desplazamiento vertical descendente en la
columna de Identificación de Líquidos y haga resaltar la
Tromboplastina de Calcio de Conejo (HPX Thromb).
- Efectúe el desplazamiento vertical descendente en la
columna Utilizado por y haga resaltar la prueba HPX.
- Haga clic en el botón de Asignar Valor e introduzca el
valor ISI. Este valor puede encontrarse en el inserto
del paquete de Hepatocomplex.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de base de datos principal.
5. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba HPX.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
6. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Plasma HPX, HPX Thromb (Tromboplastina de
Calcio de Conejo) y el Diluyente de Factor se asignan
automáticamente cuando la prueba se calibra, se corre en
un perfil o como un solo ensayo. Consulte la pantalla del
mapa de Materiales cuando calibre o corra el ensayo para
colocación.
47
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba HPX puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
391
- Plasma de Control Normal
- Plasma de Control Anormal Bajo/Nivel 1
- Plasma de Control Anormal Alto/Nivel 2
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba HPX en
el menú desplegable descendente en la ventana de Prueba
para Calibrar.
- Confirme que los líquidos necesarios estén en su lugar de
acuerdo con el Mapa de Materiales.
- Coloque 2 copas de 0.5 mL vacías para muestras en las
posiciones “A” (A3 y A4) de acuerdo con el Mapa de
Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibrar.
- Cuando se complete la calibración, la gráfica y los datos
de la curva de calibración serán visibles. En caso de que
los datos de la curva sean aceptables, haga clic en la
marca para aceptar el uso de la curva.
9. Procesamiento de la Muestra
392
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 8-150 % de Actividad
393
48

Preparación de Reactivo
LAC Pantalla y/o LAC
Confirmar

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC para LAC


QCRevisar/Ajustar

Analizar muestras del


Paciente/QC
394
49
LAC Pantalla/Confirmar – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo LAC-Pantalla Cat. No. 20008000
• Estuche de Reactivo LAC-Confirmar Cat. No. 20008200
Configuración del Estuche de Reactivo LAC-Pantalla/Confirmar
Contenido del Estabilidad Preparación
Estuche
10 x 2 mL Reactivo LAC-Pantalla 1 mes a -20ºC Añada 2.0 mL de agua NCCLS
10 x 2 mL Reactivo LAC-Confirmar 48 horas a 2-8ºC o Tipo II.
24 horas a 15-25ºC en el frasquito Agite, deje reposar por 30 minutos
original* a 15-25ºC.
*Nota: No Vuelva a Congelar Invierta. No agite.

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba LAC*. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la columna
de pruebas Activadas para esta prueba.
*LAC-S es el ensayo de LAC Pantalla y LAC-C es el LAC
Confirmar.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba LAC deseada y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en segundos (s) o
relación (r) y haga clic en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
50
4. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al
Reactivo LAC se asignan automáticamente cuando la prueba
se corre como un solo ensayo o en 4.1.11 en el Manual del
Operador para las instrucciones detalladas acerca de la
definición de nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
395
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador para
detalles acerca del ajuste del Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
6. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
7. Resultados
Debe utilizarse el procedimiento siguiente para calcular las
relaciones de LAC Pantalla y LAC Confirmar.
1. Para cada nuevo lote de estuche de LAC Pantalla y LAC
Confirmar, debe determinarse un nuevo Rango Normal de
acuerdo con el Documento NCCLS H21-A3, Vol. 18 No. 20
2. Determine la Media de cada Rango Normal en segundos.
3. Se utilizará la media de cada rango normal como un
denominador constante en los cálculos de relaciones.
LAC Pantalla
1. El resultado de la muestra del paciente en segundos se
divide entre la Media del rango normal de LAC Pantalla.
Relación de Pantalla = Resultados de la Pantalla del Paciente
(segundos)/Media del Rango Normal de Pantalla (segundos).
2. En caso de que el tiempo de coagulación del plasma de
prueba LAC Pantalla sea 20% mayor que la Media del Rango
Normal de Pantalla (es decir, relación de > 1.2), debe
confirmarse la presencia de LA con LAC Confirmar de IL.
51
LAC Confirmar
1. El resultado de la muestra del paciente en segundos se
divide entre la Media del rango normal de LAC Confirmar.
Relación de Confirmar = Resultados de Confirmar del Paciente
(segundos)/Media del Rango Normal de Confirmar (segundos).
396
2. El resultado de la relación de LAC Pantalla se divide
entre el resultado de la relación de LAC Confirmar.
Relación LAC Normalizada = Relación de Pantalla/Relación de
Confirmar.
Interpretación
1. El resultado final debe expresarse como la Relación LAC
Normalizada.
La relación mayor de 2.0 LA está fuertemente presente
La relación entre 1.5-2.0 LA está moderadamente presente
La relación entre 1.2-1.5 LA está débilmente presente
2. Cuando la relación < 1.2 y los tiempos de coagulación de
LAC Pantalla y LAC Confirmar son prolongados, deben
entonces efectuarse estudios de mezclado para investigar
las deficiencias o los inhibidores de los factores II, V
y X. En caso de que la prueba de mezclado siga siendo
prolongada, indica que algún anticoagulante distinto de
LA (por ejemplo, anti-Factor V) puede estar presente en
el plasma de la prueba.
397
52

Preparación de Reactivo
Plasminógeno

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el líquido de QC
para PLG
QCRevisar/Ajustar

Calibrar y Analizar
muestras del Paciente/QC
398
53
Plasminógeno – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Plasminógeno Cat. No. 20009000
• Plasma de Calibración HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
*No disponible en todos los países
Configuración del Estuche de Reactivo de Plasminógeno
Contenido del Estabilidad Preparación
Estuche
2 x 2 mL Substrato Cromogénico 3 meses a 2-8ºC en el frasquito Añada 2.0 mL de H2O
original Agite, deje reposar por 30 minutos
7 días a 15ºC en el frasquito a 15-25ºC.
original Mezcle antes de usar
6 meses a -20ºC en el frasquito
original
2 x 2.5 mL Estreptocinasa 3 meses a 2-8ºC en el frasquito Añada 2.5 mL de H2O
original Agite, deje reposar por 30 minutos
7 días a 15ºC en el frasquito a 15-25ºC.
original Mezcle antes de usar
6 meses a -20ºC en el frasquito
original

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba PLG. Haga clic
en el botón de Activar/Desactivar para activar la prueba.
Una marca de verificación aparecerá en la columna de
pruebas Activadas para esta prueba.

3. Edición del Rango de Referencia/Corte de la Prueba


- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba PLG deseada y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
54
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
399
4. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba PLG.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo PLG se Calibra una Vez por Sesión a bordo
del ACL Elite/Elite Pro. La Calibración de la prueba ocurre
durante el ciclo de análisis. La prueba no puede calibrarse
bajo el Menú de Calibración.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Estreptocinasa (PLG Strept) y sustrato
Cromogénico (PLG Sub) se asignan automáticamente cuando
se corre la prueba. Se puede correr la prueba en el modo
de Prueba Única o Perfil en el analizador. Consulte la
pantalla del mapa de Materiales cuando corra el ensayo
para colocación apropiada.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba PLG puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Cromogénico Anormal Nivel 1 y 2
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
400
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
55
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
Se efectúa la calibración durante la Corrida de Análisis para
PLG. La curva de calibración se guardará y utilizará
nuevamente en corridas posteriores en caso de que, durante la
verificación previa al análisis para PLG, el instrumento no
detecte la presencia de Plasma de Calibración en la posición
A1
8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150 % de Actividad
401
56

Preparación de Reactivo
Inhibidor de Plasmina

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango Normal de


la Prueba
AjustePruebasVer/Definir

Ajustar el líquido de QC
para PL-IN
QCRevisar/Ajustar

Calibrar y Analizar
muestras del Paciente/QC
402
57
Inhibidor de Plasmina – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Inhibidor de Plasmina Cat. No. 20009200
• Plasma de Calibración HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
*No disponible en todos los países

Configuración del Estuche de Reactivo de Inhibidor de


Plasmina
Contenido del Estabilidad Preparación
Estuche
1 x 4 mL Substrato Cromogénico 5 días a 2-8ºC en el frasquito Añada 4.0 mL de H2O
original Agite, deje reposar por 30 minutos
5 días a 15ºC en el frasquito a 15-25ºC.
original Mezcle antes de usar
3 meses a -20ºC en el frasquito
original
2 x 2.5 mL Estreptocinasa 5 días a 2-8ºC en el frasquito Añada 2.5 mL de Tampón Diluido
original Agite, deje reposar por 30 minutos
5 días a 15ºC en el frasquito a 15-25ºC.
original Mezcle antes de usar
3 meses a -20ºC en el frasquito
original
2 x 9 mL Tampón Tampón sin Diluir: Hasta la Diluya según sea necesario 1:10
(El tampón debe diluirse antes del Caducidad cuando no se abre y se añadiendo 1 parte de Tampón +9
uso) almacena a 2-8ºC partes de H2O
Tampón Diluido: 24 horas a 15ºC

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba PL-IN (prueba
no. 213). Haga clic en el botón de Activar/Desactivar
para activar la prueba. Una marca de verificación
aparecerá en la columna de pruebas Activadas para esta
prueba.

58
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba PL-IN deseada y oprima el
Icono de Detalles.
403
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba PL-IN.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo PL-IN se Calibra una Vez por Sesión a bordo
del ACL Elite/Elite Pro. La Calibración de la prueba ocurre
durante el ciclo de análisis. La prueba no puede calibrarse
bajo el Menú de Calibración.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Tampón PI, Plasmina PI y Substrato
Cromogénico (PI Sub) se asignan automáticamente cuando se
corre la prueba. Se puede correr la prueba en el modo de
Prueba Única o Perfil en el analizador. Consulte la
pantalla del mapa de Materiales cuando corra el ensayo
para colocación apropiada.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba PL-IN puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Cromogénico Anormal Nivel 1 y 2
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas...
59
...para definir nuevos líquidos.
404
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
Se efectúa la calibración durante la Corrida de Análisis para
PL-IN. La curva de calibración se guardará y utilizará
nuevamente en corridas posteriores en caso de que, durante la
verificación previa al análisis para PL-IN, el instrumento no
detecte la presencia de Plasma de Calibración en la posición
A1
8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-120 % de Actividad
405
60

Preparación de Reactivo
PCX

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango Normal de


la Prueba
AjustePruebasVer/Definir
Introducir Valor ISI y de
Calibración

Ajustar el líquido de QC
para PCX
QCRevisar/Ajustar

Calibrar la Prueba PCX


CalibraciónCalibrar

Analizar muestras de QC y
del Paciente
406
61
Pro-IL Complex – ACL Elite/Elite Pro**
**Estuche no disponible en los EUA
1. Materiales Necesarios
• Estuche de Reactivo Pro-IL Complex Cat. No. 09758810
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Control HemosIL Anormal Alto no Ensayado Cat. No. 20003320
• Control HemosIL Anormal Alto Ensayado* Cat. No. 20003310
• Diluyente de Factor Cat. No. 09757600
• Diluyente de Tromboplastina PCX/HPX Cat. No. 08469600
*No disponible en todos los países
Configuración del Estuche de Reactivo Pro-IL-Complex
Contenido del Estabilidad Preparación
Estuche
5 x 7 mL Tromboplastina de Calcio Hasta la Caducidad cuando no se Añada 7.0 mL de diluyente de
de Bovino abre y se almacena a 2-8ºC Tromboplastina PCX/HPX. Agite,
5 días a 2-8ºC en el frasquito deje reposar por 30 minutos a 15-
original 25ºC. Invierta. No agite
8 horas en el ACL, cuando se abre
5 x 3 mL Plasma de Bovino Hasta la Caducidad cuando no se Añada 3.0 mL de agua NCCLS
abre y se almacena a 2-8ºC Tipo II
24 horas a 2-8ºC en el frasquito Agite, deje reposar por 30 minutos
original, cuando se abre a 15-25ºC.
5 días de estabilidad a -20ºC Invierta, no agite
**Nota: no vuelva a congelar

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba PCX. Haga clic
en el botón de Activar/Desactivar para activar la prueba.
Una marca de verificación aparecerá en la columna de
pruebas Activadas para esta prueba.
62
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba PCX deseada y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a la unidad deseada y haga clic en
el botón de Rangos.
407
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción del valor ISI del Reactivo
- AjusteLíquidos.
- Efectúe el desplazamiento vertical descendente en la
columna de Identificación de Líquidos y haga resaltar la
Tromboplastina de Calcio de Bovino (PCX Thromb).
- Efectúe el desplazamiento vertical descendente en la
columna Utilizado por y haga resaltar la prueba PCX.
- Haga clic en el botón de Asignar Valor e introduzca el
valor ISI. Este valor puede encontrarse en el inserto
del paquete de Pro-IL-Complex.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de base de datos principal.
5. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba PCX.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
6. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Plasma PCX, Tromboplastina PCX
(Tromboplastina de Ca de Bovino) y el Diluyente de Factor
se asignan automáticamente cuando se calibra o corre la
prueba en un perfil o como un solo ensayo. Consulte la
pantalla del mapa de Materiales cuando corra el ensayo
para colocación.
7. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba PCX puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Anormal Bajo/Nivel 1
63
408
- Plasma de Control Anormal Alto/Nivel 2
En el ACL Elite/Elite Pro, se definen en el menú de
AjusteLíquidos. Consulte la sección 4.1.11 en el manual del
Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de Calibrar, seleccione la prueba PCX en
el menú desplegable descendente en la ventana de Prueba
para Calibrar.
- Confirme que los líquidos necesarios estén en su lugar de
acuerdo con el Mapa de Materiales.
- Coloque 3 copas vacías de 0.5 mL para muestras en las
posiciones “A” apropiadas (A3, A4 y A6) de acuerdo con el
Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibración.
- Cuando se complete la calibración, la gráfica y los datos
de la curva de calibración serán visibles. En caso de
que los datos de la curva sean aceptables, haga clic en
la marca para aceptar el uso de la curva.
9. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
409
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 4-150 % de Actividad
410
64

Preparación de Reactivo
ProClot

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC para ProClot


QCRevisar/Ajustar

Calibrar y Analizar
muestras del Paciente/QC
411
65
ProClot – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo ProClot Cat. No. 08468310
• Plasma de Calibración HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Control HemosIL Anormal Alto no Ensayado Cat. No. 20003320
• Control HemosIL Anormal Alto Ensayado* Cat. No. 20003310
• Diluyente ProClot Cat. No. 08468600
• APTT SP# Cat. No. 20006300
#El estuche puede también correrse con el uso de APTT Sílice
Liofilizado
*No disponible en todos los países
Configuración del Estuche de Reactivo ProClot
Contenido del Estabilidad Preparación
Estuche
4 x 1 mL Reactivo Deficiente en 4 horas a 15-25ºC Añada 1.0 mL de H2O
Proteína C 7 días a -20ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC.
Invierta. No agite
4 x 1.15 mL de Activador de 15 días a 2-8ºC Añada 1.5 mL de H2O
Proteína C (Protac®) 60 días a -20ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC.
Invierta. No agite
Diluyente de Trabajo de Proteína C 8 horas a 2-8ºC Mezcle 4.3 Partes de Diluyente de
ProClot con 1 Parte de Activador
de Proteína C
5 x 9 mL Reactivo APTT 1 mes a 2-8ºC Agite por 15 segundos o someta a
5 días a 15ºC en el ACL Vórtice por 5 segundos antes del
**Nota: No congele Uso.
5 x 8 mL de Cloruro de Calcio 1 mes a 2-8ºC Listo para Uso
2 x 1 mL de Plasma de Control de 4 horas a 15-25ºC Añada 1.0 mL de H2O
Proteína C 7 días a -20ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC
Invierta. No agite

66
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba ProClotSP.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
412
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba ProClotSP y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba ProClotSP.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo ProClot se Calibra una Vez por Sesión a
bordo del ACL Elite/Elite Pro. La Calibración de la prueba
ocurre durante el ciclo de análisis. La prueba no puede
calibrarse bajo el Menú de Calibración. La Calibración bajo
análisis utiliza una copa vacía para la calibración; por lo
tanto, se debe correr la prueba como una sola prueba y no se
puede correr en el modo de perfil.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Deficiente en Proteína C, Diluyente de
Trabajo, APTTSP y APTT Ca/Cl se asignan automáticamente
cuando se corre la prueba como un solo ensayo. Consulte
la pantalla del mapa de Materiales cuando calibre o corra
el ensayo para colocación.
67
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba ProClotSP puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Anormal Nivel 1
413
- Plasma de Control de Proteína C – empacado en el estuche
del reactivo.
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
Se efectúa la calibración durante la Corrida de Análisis para
ProClot. La curva de calibración se guardará y utilizará
nuevamente en corridas posteriores en caso de que, durante la
verificación previa al análisis para ProClot, el instrumento
no detecte la presencia de Plasma de Calibración en la
posición A1
La Calibración durante el análisis requiere una copa vacía
para colocarse en la posición A2 en la charola de muestras.
8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150 % de Actividad
414
415
68

Preparación de Reactivo
Proteína C

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia de la Prueba
AjustePruebasVer/Definir

Ajustar el QC para
Proteína C
QCRevisar/Ajustar

Calibrar y Analizar
muestras del Paciente/QC
416
69
Proteína C – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Proteína C Cat. No. 20009100
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
*No disponible en todos los países

Configuración del Estuche de Reactivo de Proteína C


Contenido del Estabilidad Preparación
Estuche
2 x 2 mL Substrato Cromogénico 3 meses a 2-8ºC y Añada 2.0 mL de H2O
7 días a 15ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC.
Invierta.
2 x 2.5 mL de Activador de 3 meses a 2-8ºC y Añada 2.5 mL de H2O
Proteína C 7 días a 15ºC en el frasquito Agite, deje reposar por 30 minutos
original a 15-25ºC.
Invierta.
1 x 8 mL de Diluyente Almacene a 2-8ºC en el frasquito Mezcle 1 Parte de Diluyente con 9
original Partes de Agua. Mezcle antes de
usar.

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba P-C. Haga clic
en el botón de Activar/Desactivar para activar la prueba.
Una marca de verificación aparecerá en la columna de
pruebas Activadas para esta prueba.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba P-C y oprima el Icono de
Detalles.
70
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la Concentración del Calibrador
417
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba P-C.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo P-C se Calibra una Vez por Sesión a bordo
del ACL Elite/Elite Pro. La Calibración de la prueba ocurre
durante el ciclo de análisis. La prueba no puede calibrarse
bajo el Menú de Calibración.

5. Ajuste de las Posiciones de los Líquidos


- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Activador de Proteína C, PC Sub, y Pchrom
Dil se asignan automáticamente cuando se corre la prueba
como un solo ensayo. Consulte la pantalla del mapa de
Materiales cuando corra el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba P-C puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Cromogénico Anormal Nivel 1 y 2
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
418
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
71
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
Se efectúa la calibración durante la Corrida de Análisis para
P-C. La curva de calibración se guardará y utilizará
nuevamente en corridas posteriores en caso de que, durante la
verificación previa al análisis para P-C, el instrumento no
detecte la presencia de Plasma de Calibración en la posición
A1

8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-120 % de Actividad
419
72

Preparación de Reactivo
Pro S

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia de la Prueba
AjustePruebasVer/Definir

Ajustar el QC para ProS


QCRevisar/Ajustar

Calibrar la prueba ProS y


CalibraciónCalibrar


Validar Calibración y
Analizar las muestras del
Paciente
420
73
ProS – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo ProS HemosIL Cat. No. 20002800
• Calibrador HemosIL Cat. No. 20003700
• Diluyente de Factor Cat. No. 09757600
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Control HemosIL Anormal Alto no Ensayado Cat. No. 20003320
• Control HemosIL Anormal Alto Ensayado* Cat. No. 20003310
• Control de Prot S (se incluye en el Estuche Cat. No. 20002830
del Reactivo ProS)
*Para uso en países seleccionados
Configuración del Estuche de Reactivo ProS
Contenido del Estabilidad Preparación
Estuche
3 x 3 mL Reactivo Proteína S 2 días a 2-8ºC Añada 3.0 mL de H2O
4 horas a 15ºC a bordo Agite suavemente, deje reposar por
*15 días a -20ºC en el frasquito 30 minutos a 15-25ºC.
original. Invierta. No agite
No se requiere agitación
Después de la reconstitución Añada 1.0 mL de H2O
5 x 1 mL de Plasma Deficiente en 4 horas a 15ºC en el frasquito Agite suavemente, deje reposar por
Proteína S original 30 minutos a 15-25ºC.
*7 días a -20ºC Invierta. No agite

2 x 1 mL de Plasma de Control de 4 horas a 15-25ºC en el frasquito Añada 1.0 mL de H2O


Proteína S original Agite suavemente, deje reposar por
*7 días a -20ºC 30 minutos a 15-25ºC.
Invierta. No agite

*El reactivo y los plasmas congelados deben descongelarse a


37ºC y mezclarse suavemente antes. Antes de congelar, pueden
hacerse las alícuotas con el uso de tubos de plástico y
tapones. NO SE VUELVAN A CONGELAR.
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
74
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba ProS. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la columna
de pruebas Activadas para esta prueba.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
421
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba ProS y oprima el Icono de
Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la Concentración del Calibrador
- AjusteLíquidos.
- Efectúe el desplazamiento descendente en la columna de
Identificación de Líquidos y haga resaltar Plasma de
Calibración.
- Efectúe el desplazamiento descendente a la columna de
Utilizado por y haga resaltar la prueba ProS.
- Haga clic en el botón de Asignar Valor e introduzca el
valor correspondiente al Calibrador. Este valor puede
encontrarse en el inserto del paquete del Plasma de
Calibración.
- NO introduzca ningún valor para ProS 50% C.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
Notas: El ensayo ProS se Calibra una Vez por Sesión. La
calibración de la prueba ocurre durante el ciclo de análisis.
La prueba no puede calibrarse bajo el Menú de Calibración,
pero puede verse el reporte de calibración después de correr
el análisis.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, ProS 50% C (Plasma de Calibración diluido
1:1 con Plasma Deficiente en Proteína S), Reactivo de
Proteína S, Plasma Deficiente en Proteína S y Diluyente
de Factor se asignan automáticamente cuando se corre la
prueba como un solo ensayo. Consulte la pantalla del mapa
de Materiales cuando calibre o corra el ensayo para
colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba ProS puede utilizar
los siguientes materiales de control para verificar el
desempeño del ensayo:
- Plasma de Control Normal
- Plasma de Control Anormal Bajo
422
- Plasma de Control Anormal Alto
- Plasma de Control de Proteína S – empacado con el estuche
75
En el ACL Elite/Elite Pro, estos líquidos se definen en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
7. Calibración del Ensayo
Todos los reactivos, calibradores deben reconstituirse de
acuerdo con las direcciones y permitirse que reposen por 30
minutos antes de la calibración.
El ensayo ProS debe Calibrarse Una Vez por Sesión. La
calibración de la prueba ocurre durante el ciclo de análisis.
La prueba no puede calibrarse bajo el Menú de Calibración,
pero puede verse el reporte de calibración después de correr
el análisis.
8. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150 % de Actividad
423
76

Preparación de Reactivo
SCT-Pantalla/Confirmar

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia/Corte de la
Prueba
AjustePruebasVer/Definir

Ajustar el QC para SCT-S/C


QCRevisar/Ajustar

Analizar muestras del


Paciente/QC
424
77
SCT-Pantalla/Confirmar – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo Tiempo de Coagulación Cat. No. 20004800
-Sílice
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
*No disponible en todos los países
Configuración del Estuche de Reactivo de Tiempo de
Coagulación-Sílice
Contenido del Estabilidad Preparación
Estuche
3 x 5 mL Reactivo de SCT Pantalla 20 días a 2-8ºC – Frasquito original Añada 50 µL de reactivo de
5 días a 15ºC en el ACL Confirmar SCT a un frasquito de
**Nota: No congele reactivo de SCT Pantalla
Invierta para mezclar antes de usar
3 x 5 mL de Reactivo de Confirmar 20 días a 2-8ºC – Frasquito original Invierta para mezclar antes de usar
SCT 5 días a 15ºC en el ACL
**Nota: No congele
3 x 10 mL SCT Ca/Cl2 20 días a 2-8ºC – Frasquito original Invierta para mezclar antes de usar

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba SCT-S/STC-C.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba SCT-S/SCT-C-V y oprima el
Icono de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades de reporte deseadas
y haga clic en el botón de Rangos.
78
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Puede también establecerse el mínimo y el máximo de la
curva de reacción. En caso de que se desconozcan los
425
valores, despeje el mínimo y el máximo para efectuar el
zoom de la indicación de la curva a la escala completa.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes a SCT
Pantalla, SCT Confirmar y SCT CaCl2 se asignan
automáticamente cuando se pone la prueba en un perfil o
se corre como un solo ensayo. Consulte la pantalla del
mapa de Materiales cuando corra el ensayo para
colocación.
5. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba SCT
Pantalla/Confirmar puede utilizar los siguientes materiales
de control para verificar el desempeño del ensayo:
Materiales
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemosIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
*No disponible en todos los países
En el ACL Elite/Elite Pro, se define lo anterior en el menú
de AjusteLíquidos. Consulte la sección 4.1.11 en el manual
del Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control. Consulte la sección 3 del Manual del
Operador del ACL Elite/Elite Pro para detalles acerca del
ajuste del Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
426
6. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. La congelación del plasma libera fosfolípidos de
plaquetas residuales, que pueden acortar los tiempos de
coagulación de SCT pantalla. Centrifugue doblemente o filtre
el plasma a través de un filtro de 0.2 micras...
79
...para eliminar las plaquetas antes de congelar. Las
muestras congeladas deben descongelarse a 37ºC durante 15
minutos. Centrifugue el plasma antes de las pruebas. Las
muestras deben analizarse dentro del período de 2 horas.
SCT Pantalla
1. El resultado de la muestra del paciente en segundos se
divide entre la Media del rango normal de SCT Pantalla.

Relación de Pantalla= Resultados de Pantalla del Paciente (en segundos)


Media del Rango Normal de Pantalla (en segundos)

SCT Confirmar
1. El resultado de la muestra del paciente en segundos se
divide entre la Media del rango normal de SCT Confirmar
2. El resultado de la relación de SCT Pantalla se divide
entre el resultado de la relación de SCT Confirmar.
Relación SCT Normalizada = Relación de Pantalla
Relación de Confirmar

Interpretación
1. El resultado final debe expresarse como la Relación SCT
Normalizada:
ACL Elite/Elite Pro Relación > 1.20 indica que hay presente Anticoagulante Lupus
2. Cuando la relación = 1.20 y los tiempos de coagulación de
SCT Pantalla y SCT Confirmar son prolongados, deben
entonces efectuarse estudios de mezclado para investigar
las deficiencias o los inhibidores de factores. En caso
de que la prueba de mezclado siga siendo prolongada,
indica que algún anticoagulante distinto de LA (por
ejemplo, anti-Factor V) puede estar presente en el plasma
de la prueba.
Cada laboratorio debe establecer su propio valor de corte
para la relación. Consulte la hoja del inserto del
paquete de Tiempo de Coagulación – Sílice HemosILTM para
un procedimiento para establecer el valor de corte.
427

80

Preparación de Reactivo
Tiempo de Trombina

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia de la Prueba
AjustePruebasVer/Definir

Ajustar el QC para TT
QC Revisar/Ajustar

Analizar muestras del


Paciente/QC
428
81
Tiempo de Trombina (TT) – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Tiempo de Trrombina Cat. No. 09758515
• Calibrador HemosIL Cat. No. 20003700
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control HemosIL Anormal Bajo no Ensayado Cat. No. 20003220
• Control HemosIL Anormal Bajo Ensayado* Cat. No. 20003210
• Solución Limpiadora Limpiador A Cat. No. 09831700
*No disponible en todos los países
Configuración del Estuche de Reactivo de Tiempo de Trombina
Contenido del Estabilidad Preparación
Estuche
4 x 2.5 u 8 mL de Trombina de 15 días a 2-8ºC en el frasquito Añada 2.0/5.0 u 8.0* mL de
Bovino original Diluyente Diluido
8 horas a 15ºC a bordo del ACL Agite, deje reposar por 30 minutos
a 15-25ºC
Invierta. No agite
1 x 9 mL de Diluyente 1 mes después de la preparación a Diluya la cantidad necesaria 1:5
15-25ºC con el uso de 1 parte de Diluyente
+ 4 partes de H2O

*Terapia de Heparina: 2.0 mL, Prueba de identificación: 5.0 u


8.0 mL reconstitución.
2. Activación de la Prueba en el Analizador
- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de TT*. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la columna
de pruebas Activadas para esta prueba.
*Se refiere al volumen de reconstitución de 2, 5 u 8 mL.
Seleccione la prueba apropiada con base en el volumen de
reconstitución para el Reactivo de Trombina.

3. Edición del Rango de Referencia/Corte de la Prueba


- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba TT* y oprima el Icono de
Detalles.
82
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en segundos (s) y
haga clic en el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
429
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración y al Reactivo de Trombina (TT Thr se
asignan automáticamente cuando la prueba se corre como un
solo ensayo*. Consulte la pantalla del mapa de Materiales
cuando corra el ensayo para colocación.
* Se recomienda correr el Tiempo de Trombina en el modo de
prueba Única y no dentro de un perfil. Necesita
efectuarse un procedimiento de Limpiador A después de que
se complete el Tiempo de Trombina, antes de correr una
prueba adicional en el analizador.
5. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de TT* puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control Normal
En el ACL Elite/Elite Pro, se definen estos líquidos en el
menú de AjusteLíquidos. Consulte la sección 4.1.11 en el
manual del Operador del ACL Elite/Elite Pro para las
instrucciones Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
6. Procesamiento de la Muestra
430
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
431
83
84

Preparación de Reactivo
Actividad de
Factor de von Willebrand

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia de la Prueba
AjustePruebasVer/Definir

Ajustar el QC para WWFACT


QC Revisar/Ajustar

Calibrar la prueba VWFACT


CalibraciónCalibrar

Validar Calibración y
Analizar muestras del
Paciente/QC
432
85
Actividad del Factor de von Willebrand – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Actividad de vWF Cat. No. 2004700

• Control HemosIL Normal no Ensayado Cat. No. 20003120


• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Control de Prueba Especial Nivel 1 Cat. No. 20010100
• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Calibrador HemosIL Cat. No. 20003700
• Diluyente de Factor Cat. No. 09757600
*No disponible en todos los países
Configuración del Estuche de Reactivo VWF
Contenido del Estabilidad Preparación
Estuche
2 x 4 mL de Reactivo de Látex 1 mes a 2-8ºC Vierta el contenido entero de 1
3 días en el Elite/Elite Pro frasquito de Tampón en la botella
**Nota: No se congele de Látex. Tape. Agite por 20
segundos. Permita que repose a la
temperatura ambiental por 25-30
minutos. Invierta para mezclar
antes deusar
2 x 4.5 mL de Tampón

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de VWFACT.
Haga clic en el botón de Activar/Desactivar para activar
la prueba. Una marca de verificación aparecerá en la
columna de pruebas Activadas para esta prueba.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.

3. Edición del Rango de Referencia/Corte de la Prueba


- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba VWFACT y oprima el Icono
de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
86
- Puede establecerse también el mínimo y el máximo de la
curva de reacción. En caso de que se desconozcan los
433
valores deseados, despeje tanto el mínimo como el máximo
para efectuar el zoom de la indicación de la curva a la
escala completa.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos
- Efectúe el desplazamiento descendente en la columna de
identificación de Líquidos y haga resaltar el Plasma de
Calibración.
- Efectúe el desplazamiento descendente en la columna de
Utilizado por y haga resaltar la prueba de VWFACT.
- Este valor puede hallarse en el inserto del paquete del
Plasma de Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, Látex de VWFACT y Diluyente de Factor se
asignan automáticamente cuando la prueba se calibra,
coloca en un perfil o se corre como un solo ensayo.
Consulte la pantalla del mapa de Materiales cuando corra
o calibre el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de VWFACT puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control de Prueba Especial Nivel 1
- Plasma de Control de Prueba Especial Nivel 2
- Control Normal
En el ACL Elite/Elite Pro, se define lo anterior en el menú
de AjusteLíquidos. Consulte la sección 4.1.11 en el manual
del Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir. Los controles recomendados son los
controles Normal y de Pruebas Especiales Niveles 1 y 2.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
434
la prueba. En caso de que no se conozca la Media y el
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
87
8. Calibración del Ensayo
El Plasma de Calibración debe reconstituirse de acuerdo con
las direcciones y permitirse que repose durante 30 minutos
antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba VWFACT
en el menú desplegable descendente en la ventana de
Prueba para Calibrar.
- Confirme que los líquidos necesarios estén en su lugar de
acuerdo con el Mapa de Materiales.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibración.
- Cuando se complete la calibración, la gráfica y los datos
de la curva de calibración serán visibles. Cuando los
datos de la curva sean aceptables, haga clic en la marca
para aceptar el uso de la curva.
6. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150% (VWFACT)
435
88

Preparación de Reactivo
Antígeno de
Factor de von Willebrand

Activar la prueba dentro


del
analizador
AjustePruebasVer/Definir

Editar el Rango de
Referencia de la Prueba
AjustePruebasVer/Definir

Ajustar el QC para VWF:Ag


QC Revisar/Ajustar

Calibrar la prueba VWF:Ag


CalibraciónCalibrar

Validar Calibración y
Analizar muestras del
Paciente/QC
436
89
Antígeno del Factor de von Willebrand – ACL Elite/Elite Pro
1. Materiales Necesarios
• Estuche de Reactivo de Actividad de vWF Cat. No. 2004700

• Control de Prueba Especial Nivel 1 Cat. No. 20010100


• Control de Prueba Especial Nivel 2 Cat. No. 20010200
• Control HemosIL Normal no Ensayado Cat. No. 20003120
• Control HemoSIL Normal Ensayado* Cat. No. 20003110
• Calibrador HemosIL Cat. No. 20003700
• Diluyente de Factor Cat. No. 09757600
*No disponible en todos los países
Configuración del Estuche de Reactivo VWF
Contenido del Estabilidad Preparación
Estuche
2 x 3 mL de Reactivo de Látex 3 meses a 2-8ºC – frasquito original Invierta para mezclar antes del usar
1 semana a 15ºC en el ACL Evite la formación de espuma en el
Elite/Elite Pro reactivo cuando mezcle
**Nota: No congele
2 x 4 mL de Tampón 3 meses a 2-8ºC – frasquito original Invierta para mezclar antes del
1 semana a 15ºC en el ACL usar
Elite/Elite Pro Evite la formación de espuma en el
**Nota: No congele reactivo cuando mezcle

2. Activación de la Prueba en el Analizador


- AjustePruebasVer Definir
- Haga clic en el botón de Mostrar Activada para mostrar
todas las pruebas
- Efectúe el desplazamiento vertical descendente en la
lista de pruebas y haga resaltar la Prueba de VW:Ag. Haga
clic en el botón de Activar/Desactivar para activar la
prueba. Una marca de verificación aparecerá en la columna
de pruebas Activadas para esta prueba.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
90
3. Edición del Rango de Referencia/Corte de la Prueba
- AjustePruebasVer Definir
- Efectúe el desplazamiento vertical descendente en la
lista, haga resaltar la prueba VWF:Ag y oprima el Icono
de Detalles.
- Efectúe el desplazamiento vertical descendente a la
hilera correspondiente a las unidades en % y haga clic en
el botón de Rangos.
- Introduzca los valores Mínimo y Máximo para el rango
normal.
- Puede establecerse también el mínimo y el máximo de la
curva de reacción. En caso de que se desconozcan los
valores deseados, despeje tanto el mínimo como el máximo
437
para efectuar el zoom de la indicación de la curva a la
escala completa.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
4. Introducción de la concentración del Calibrador
- AjusteLíquidos
- Efectúe el desplazamiento descendente en la columna de
identificación de Líquidos y haga resaltar el Plasma de
Calibración.
- Efectúe el desplazamiento descendente en la columna de
Utilizado por y haga resaltar la prueba de VWF:Ag.
- Este valor puede hallarse en el inserto del paquete del
Plasma de Calibración.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
5. Ajuste de las Posiciones de los Líquidos
- Las posiciones de los líquidos correspondientes al Plasma
de Calibración, VWF:AgBuf, VWF:AgLx y Diluyente de Factor
se asignan automáticamente cuando la prueba se calibra,
coloca en un perfil o se corre como un solo ensayo.
Consulte la pantalla del mapa de Materiales cuando corra
o calibre el ensayo para colocación.
6. Ajuste del Control de Calidad (QC)
Antes de ajustar los rangos de Control de Calidad, debe
definirse primero el material de Control de Calidad.
Verifique que el sistema tenga las definiciones de líquido de
Control de Calidad apropiadas. La prueba de VWFACT puede
utilizar los siguientes materiales de control para verificar
el desempeño del ensayo:
- Plasma de Control de Prueba Especial Nivel 1
- Plasma de Control de Prueba Especial Nivel 2
- Control Normal
En el ACL Elite/Elite Pro, se define lo anterior en el menú
de AjusteLíquidos. Consulte la sección 4.1.11 en el manual
del Operador del ACL Elite/Elite Pro para las instrucciones
Detalladas para definir nuevos líquidos.
- Control de Calidad (QC)Revisión y Ajuste de Control de
Calidad.
- Efectúe el desplazamiento descendente en la lista de
Identificación de Líquidos y seleccione el líquido de
Control de Calidad apropiado. Oprima el botón de Ajustar
para definir. Los controles recomendados son los
controles Normal y de Pruebas Especiales Niveles 1 y 2.
- Configure las pruebas en la lista de pruebas Activadas.
Defina las Unidades, la Media que Constituye el Objetivo,
la DE que Constituye el Objetivo y el rango de la DE para
la prueba. En caso de que no se conozca la Media y el
438
rango de la DE, déjelos inicialmente ajustados en cero.
Una vez que se conozcan los rangos, puede entonces
redefinirse; haga clic en el botón de marcado del Rango
del Control de Calidad para el indicador del resultado
del control.
91
Consulte la sección 3 del Manual del Operador del ACL
Elite/Elite Pro para detalles acerca del ajuste del
Control de Calidad.
- Oprima la Marca Verde para Guardar y regresar a la
pantalla de la base de datos principal.
8. Calibración del Ensayo
El Plasma de Calibración debe reconstituirse de acuerdo con
las direcciones y permitirse que repose durante 30 minutos
antes de la calibración.
- CalibraciónCalibrar
- En la pantalla de calibrar, seleccione la prueba VWF:Ag
en el menú desplegable descendente en la ventana de
Prueba para Calibrar.
- Confirme que los líquidos necesarios estén en su lugar de
acuerdo con el Mapa de Materiales. La calibración
requerirá 3 copas vacías de 0.5 mL para muestras.
- Oprima la tecla de Iniciar para comenzar el ciclo de
calibración.
- Cuando se complete la calibración, la gráfica y los datos
de la curva de calibración serán visibles. Cuando los
datos de la curva sean aceptables, haga clic en la marca
para aceptar el uso de la curva.
6. Procesamiento de la Muestra
El plasma citrado centrifugado de nueve partes de sangre
venosa recién extraída, recolectada en una parte de citrato
trisódico. Las muestras congeladas deben descongelarse a 37ºC
durante 15 minutos. Centrifugue el plasma antes de las
pruebas. Las muestras deben analizarse dentro del período de
2 horas.
Linealidad: 10-150% (VWF Antígeno)
Las Muestras Altas que excedan de 150% pueden reprocesarse
con el uso de la prueba VWF:AgH. Este ensayo diluye la
muestra y extiende la linealidad en un factor de 4(40-600%).
439
APÉNDICE D
ACL Elite/Elite Pro
Ejemplos de Impresiones
2
1. Referencia Analítica – Reporte Acumulativo 3
2. Referencia Analítica – Trazo y Estadísticas 4
3. Impresión de Calibración – Ensayo de PT 5
4. Impresión de Calibración – Ensayo de Factor 6
5. Réplica de Calibración – Detalles de la Curva 7
6. Historia de Errores del Archivo 8
7. Ajuste de Líquidos 9
8. Reporte de Libro de Registro 10
9. Reporte de Mantenimiento 11
10. Reporte Acumulativo de Paralelismo 12
11. Reporte de Muestras de Paralelismo 13
12. Reporte de Detalles de Paralelismo 14
13. Reporte de Perfil 15
14. Control de Calidad – Reporte Acumulativo 16
15. Control de Calidad – Trazo y Estadísticas 17
16. Control de Calidad – Impresión Diaria
17. Lógica de las Pruebas Reflejas 18
18. Reporte de Muestras – Única 19
19. Reporte de Muestras – Acumulativo 20
20. Reporte de Historia de Errores de la Sesión 21
21. Reporte de Temperatura 23
22. Reporte de Detalles de las Pruebas 24

3
1. Referencia Analítica – Reporte Acumulativo
REPORTE ACUMULATIVO DE LA REFERENCIA ANALÍTICA
(Ilustración)
4
2. Referencia Analítica – Trazo y Estadísticas
REPORTE DEL TRAZO DE LEVEY-JENNINGS Y ESTADÍSTICAS DE LA
REFERENCIA ANALÍTICA
(Ilustración)
5
3. Impresión de Calibración – Ensayo de PT
REPORTE DE DATOS DE CALIBRACIÓN
(Ilustración)
6
4. Impresión de Calibración – Ensayo de Factor
(Ilustración)
7
5. Réplica de Calibración – Detalles de la Curva
REPORTE DE LOS DETALLES DE LOS PUNTOS DE CALIBRACIÓN
(Ilustración)
8
6. Historia de Errores del Archivo
REPORTE DE LA HISTORIA DE ERRORES DEL ARCHIVO
440
(Ilustración)
9
7. Ajuste de Líquidos
REPORTE DEL AJUSTE DE LÍQUIDOS
(Ilustración)
10
8. Reporte de Libro de Registro
REPORTE DEL LIBRO DE REGISTRO
(Ilustración)
11
9. Reporte de Mantenimiento
REPORTE DE MANTENIMIENTO
(Ilustración)
12
10. Reporte Acumulativo de Paralelismo
REPORTE ACUMULATIVO
(Ilustración)
13
11. Reporte de Muestras de Paralelismo
REPORTE DE LAS MUESTRAS
(Ilustración)
14
12. Reporte de Detalles de Paralelismo
REPORTE DE DETALLES DE PARALELISMO
(Ilustración)
15
13. Reporte del Perfil
REPORTE DEL PERFIL
(Ilustración)

16
14. Control de Calidad – Reporte Acumulativo
REPORTE ACUMULATIVO DE CONTROL DE CALIDAD (QC)
(Ilustración)
17
15. Control de Calidad – Trazo y Estadísticas
REPORTE DEL TRAZO DE LEVEY-JENNINGS Y ESTADÍSTICAS DE CONTROL
DE CALIDAD
(Ilustración)
18
16. Control de Calidad – Impresión Diaria
REPORTE DIARIO DE CONTROL DE CALIDAD
(Ilustración)
19
17. Lógica de las Pruebas Reflejas
REPORTE DE PRUEBAS REFLEJAS
(Ilustración)
441
20
18. Reporte de Muestras
REPORTE DE MUESTRAS
(Ilustración)
21
19. Reporte de Muestras – Acumulativo
REPORTE ACUMULATIVO
(Ilustración)
22
20. Reporte de Historia de Errores de la Sesión
REPORTE DE LA HISTORIA DE ERRORES DE LA SESIÓN
(Ilustración)
23
21. Reporte de Temperatura
REPORTE DE CONTROL DE TEMPERATURA
(Ilustración)
24
22. Reporte de Detalles de las Pruebas
REPORTE DE LOS DETALLES DE LAS PRUEBAS
(Ilustración)
25
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