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Body fluid analysis: automated system versus manual method

Anna Finuliar and Alison Hadfield examine the laboratory methods in use to quantify and differentiate cells in body fluids, and assess the value of automation in routine practice.

Body fluid analysis primarily measures total white blood cell (WBCs) and differential counts; mainly mononuclear cells (MNC) and polymorphonuclear cells (PMN). The WBC count and classification of cells in body fluids are used by the clinician in order to differentiate the pathophysiology of inflammation and for arriving at a definitive diagnosis.

The manual differential has been the gold standard for determining WBCs in body fluids;1 however, this method shows low accuracy, is time consuming and labour-intensive as it requires highly skilled professionals to perform the analysis. Therefore, body fluid analysis may be compromised by the lack of qualified staff in the laboratory, but adapting to an automated counting system could overcome this problem.

The Sysmex XN-10 offers an automated body fluid (BF) mode which is able to quantify and differentiate white blood cells into two populations, MNCs and PMNs. The aim of this small study is to compare the manual differential used at Newcastle Upon Tyne Hospital Trust (NUTH) and the Sysmex XN-BF mode for body fluid analysis. The null hypothesis states that there will be no significant difference between the manual method and use of the Sysmex XN-10 BF mode.

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