ITMI961755A1 - AUTOMATIC DEVICE FOR THE FRACTIONAL SAMPLING FROM THE BLOOD VEIN IN ISOBARIC CONDITIONS FOR THE CONTEXTUAL DELIVERY OF - Google Patents

Description

Description of an invention

Title

Automatic device for the fractional withdrawal of blood samples from the vein in isobaric conditions, for the simultaneous dispensing of additive liquids for each fraction taken, and for closing the tubes with caps, using common tubes.

Summary

The device for the automatic collection of blood into a vein consists in arranging common tubes in a motorized trolley, in delivering liquids and solid additives in the tubes placed on the trolley, in inserting a needle connected with a flexible tube that carries a terminal nozzle from the The other side, in advancing the trolley step by step, in transferring the blood with an electric dosing pump inside a flexible tube to the terminal nozzle placed on the collection tube, in capping the tubes at the end of the operation.

Description

The present invention in the medical field and in the Clinical Laboratory Technique has as its object a procedure and equipment for the exact dosage of additives in test tubes and for the transfer and fractional distribution of blood in the tubes themselves. The aim and purpose of the present invention is to solve the aforementioned problems by devising a procedure for carrying out blood sampling in a mainly automatic manner, which can be carried out by even non-specialized personnel in scientifically correct conditions, which is automated, error-proof and without problems. as regards compliance with the stoichiometric ratios between blood volume and dose of additives required by scientific literature, which is robust, easy to use and cost-effective and which is not subject to the usual climatic or environmental conditions in the healthcare world. Another purpose is the possibility of obtaining conditions of absolute safety for the patient and for the operator, excluding any risk of mutual contagion.

As is known, blood sampling is one of the basic problems of modern medicine in which it is necessary to collect liquids in sterile conditions, without danger to the patient and the operator, without tampering or polluting them and with strict compliance with the stoichiometric ratio between the additives and the sample taken. Scientific interest in this problem has always been and still is very high because many of the errors that are committed in the investigations and measurements of clinical parameters depend on its correct solution. I mention only the hemolysis or rupture of the corpuscular forms caused by the technique in use of taking blood with high vacuum tubes to understand, for example, that the red blood cell count can be affected by the sample collection system. Another important source of serious errors is that of the correct stoichiometric ratio between volumes of additives and blood volumes: if it is altered, the blood is in fact diluted or concentrated. Finally, the mechanical traffic around the vein connected and / or with the difficult insertion of the needle into the vein with axial needle syringes rather than eccentric or with the extraction and re-insertion of the various vacuum tubes in the syringe-guide are a source of microtrauma to the vein. The need is therefore increasingly felt to have integrated automatic devices, which carry out the entire collection cycle including the dispensing of additives so that the doctor takes care of the patient and limits his manual involvement in the insertion of the blood into the vein. needle and pressing a start pedal to start the automatic pick-up system.

Currently and up to now, many and different systems have been used to perform the withdrawals: here the best known are mentioned first:

The first is the manual syringe method with blood transfer into test tubes containing additives. The quantity aspirated by hand is different from time to time, the volumes are dispensed by eye and must be repeated when it is insufficient to fill all the tubes. Test tubes with additives must be prepared. Errors in the exchange of additive, volume and stoichiometric ratio between the drawn liquid and additives are possible.

The second is the vacuum method. It consists in arranging a series of vacuum tubes fitted with a vacuum-tight rubber stopper. A sleeve carries a double axial needle which on one side pierces the vein, on the other side pierces the rubber stopper of the vacuum tube when it is pushed against the needle passing inside the sleeve. The internal lumen of the vein is put in communication with the inside of the vacuum tube which thus "sucks" blood. The various vacuum tubes to complete the sampling must be manually replaced one after the other in the sleeve while keeping the needle in the vein.

The third is a mixed method which involves the mechanical transformation of part of the syringe into a sample tube. The plastic syringe is made in such a way that the shaft of the syringe can be pulled off after withdrawal so as to transform the syringe into a test tube. The needle head of the syringe is pulled out, removed and replaced by a cap. The additives initially contained in the syringe are mixed with the blood drawn, thus obtaining the desired mixture.

One of the fundamental problems opposing the adoption of these methods is the fact that each of these systems has defects and drawbacks both to the detriment of the patient and the operator and to the detriment of the reliability of the resulting sampling work. Furthermore, all the methods existing today engage the operator completely so as not to allow him to pay due attention to the patient who, during the collection, is subject to fainting, sweating, when not psychomotor agitation and rash acts. For this reason, special beds and inclined armchairs have been designed for the patient subjected to blood sampling but this, when adopted, prevents the problems of fainting and falls but does not allow the doctor to devote himself to the patient and prevent accidents.

The first system mentioned has the drawback of the objective difficulty of respecting the stoichiometric ratios, presents risks of contagion for the operator with the patient's blood and the need when the blood drawn is insufficient for further blood samples; finally, since syringes with a high overall volume tend to be used, it follows that the last portions of blood introduced in the last tubes of the series may already present alterations such as an undesired start of coagulation even before reaching the additives or anticoagulants in the tube.

The second system mentioned has the drawback of the expiration of the vacuum: the intrinsic problem consists in the decay of the vacuum which is progressive so that the aspirated volume depends on the age of the test tube. Hence the alteration of the stoichiometric ratios because the aspirated volume decreases over time as the vacuum decreases. Other inconveniences of an operational nature such as the operator's doubt that he is in the mood when the vacuum is exhausted in the test tube, such as microtrauma to the vein in the phases of replacement of the various tubes in the guide syringe and in the relative mechanical repercussions, such as the difficulty of perforation of the vacuum caps by the automatic analytical instruments for which the test tube is intended. Finally, the vacuum system is considered to be considerably expensive.

The third system mentioned has the drawback that for each tube a different sample must be made with a different syringe, with trauma and damage to the patient; and that in any case as many syringes as the number of samples required must be used; and that consequently the costs of this system are high.

The scientific interest in better blood sampling in the vein is demonstrated by the number of patents obtained, some of which are listed below:

Walter Sardstedt - Apr. 5, 1983 n ° 4,378,812 - double needle sampling syringe that can be transformed into a test tube at the end of the sampling.

C.H.Barr, SR. Etal - March 3, 1964 - cuff with double needle that pierces the cap of a vacuum tube that sucks blood.

Grabhorn - Oct. 16, 1973 - device for taking different blood fractions from the same patient in vacuum tubes moved with a rotating drum and perforated by a motorized back and forth needle.

Vicario F Guido - Nov.l, 1988 - n ° 4,781,700 - device for taking blood samples into the vein to be analyzed in the laboratory with a motorized syringe.

The aim of the present invention is to solve the aforementioned problems of blood sampling so that it can be performed by an apparatus which is highly robust, which is easy to use and which provides the dispensing of additives and which is automatic from start to finish. end. In the context of this task, an object is to provide an apparatus which has a low cost especially in the overall management of the sampling service, which allows the use of common test tubes of very low cost, which uses commercial additives and which has a Laboratory technical solution and a portable one for outpatient, emergency, or home use.

Another purpose is to create an equipment that offers the maximum guarantees against the possibility of contamination of the samples both from the outside and between them.

Another object is to provide a complete service which leaves the doctor's hands free, which is fully automatable and can be controlled at close range, such as from a pedal. Another purpose is to give the doctor the ability to assist the patient in all phases of the operation by preventing sweating, fainting and ensuring that the patient is relaxed, safe and feels and is continuously assisted.

Another purpose is to provide a portable version for home and emergency use that runs on battery and with the same principles, components and characteristics, excluding automation. Space-saving and light, this version will use the same tubes produced by the main machine. These main tasks of the present invention, as well as this and other purposes which will appear better below, are achieved by a process for taking blood characterized by the fact of consisting of three distinct phases: the first phase consists in dispensing different additives in a plurality of test tubes housed in a motorized trolley in a static position; the second phase consists in aspirating and fractionating the blood with the synchronized movement of the trolley that carries all the tubes inserted under the dispensing nozzle, one after the other; the third phase consists in automatically closing the ready tubes.

The blood is aspirated by means of an electric pump starting from a needle placed in the vein up to the blood delivery nozzle at the other end of a flexible tube that connects the needle and nozzle; since the axis on which the dispensing nozzle is placed is fixed and the underlying motorized trolley driven by a worm screw motor is mobile, the liquid is fractionated into the plurality of prepared test tubes and into the desired volumes, adding to the additives dispensed in the first phase. The dispensing nozzle moves vertically each time on the axis on which it is placed to enter and exit the tubes.

To carry out the method according to the invention, an apparatus is preferably used, characterized in that it comprises: motorized tube-holder trolleys with several places intended to accommodate blood collection tubes, empty tubes made of glass, plastic or other material arranged in the housings of the motorized trolley , multiple micropump system designed to dispense the additives each in the appropriate test tube, hopper system for dispensing gels, microspheres and microcubes, disposable needle for easy insertion into a vein, flexible tube designed for use with peristaltic pump , straight final needle in the shape of a dispensing nozzle, peristaltic-type electric pump, device for automatic closure of caps, electronic programming system and, for the portable version, manual sliding plate and rechargeable battery of a known type.

Further characteristics and advantages of the invention will become clearer from the description of a preferred but not exclusive embodiment of the method, as well as of the apparatus for its execution, according to the invention, illustrated by way of non-limiting example in the accompanying drawings, in which :

Figure 1 schematically illustrates the apparatus as a whole for carrying out the first additive dispensing phase with stationary trolley (19) which consists in dispensing additives of various types and gels, spheres, microcubes in plastic material in a plurality of test tubes housed in a motorized trolley in a static position; the second phase of blood fractionation with moving trolley (20) which consists in transferring the blood by means of an electric pump from a needle placed in the vein to the blood dispensing nozzle by means of a plastic tube; since the dispensing nozzle is fixed while the motorized trolley below is moved by a worm screw motor in successive fixed positions so that the two axes of the test tubes and the dispensing nozzle coincide and that all the tubes are positioned one after the other. 'other under the dispensing nozzle; the third phase (46) consists in the automatic closing of the tubes with caps.

Figure 2 schematically illustrates the operation of an electric pump with rollers squeezing a flexible tube to obtain the metering and transfer of liquids, the pump being formed by the shaft 18 moved by the motor 49 illustrated in Figure 4 and with the rollers 16 it presses the tube 7 held in place by the stop rings 24 by pressing it against the jaw 17: the number of rollers 16, of steps or of motor revolutions determining the volume delivered by the pump.

Figure 3 schematically illustrates the sterile disposable object formed by: flute-beak needle 5, flexible tube 7 of a known type suitable for peristaltic pumps equipped with stop rings 24 welded at the point where it must be engaged in the block niches 25 obtained in the locking jaw of the peristaltic pump and by the blood dispensing nozzle 21. The needle is best illustrated in FIG. 8 which shows the alternative to the butterfly needle consisting of a straight eccentric needle with a grip sleeve provided with a groove for the passage of the tube.

Figure 4 schematically illustrates the portable apparatus derived from the main one (Fig. 1) for carrying out only the phase of aspirating the blood in test tubes already provided with additives: it is formed by a casing 48 which contains the rechargeable battery 27, the peristaltic pump 18 with the pump rotor 8 in which the flute-beak needle 6 is engaged, the flexible tube 7 and the blood dispensing nozzle 21 which fills the test tubes 4 which, placed in the manual sliding plate 26, they are raised and lowered manually.

Figure 5 schematically illustrates the hopper device 35 into which gels, spheres or plastic microcubes can be introduced, the motor 36 of the hopper, the blade 37 of the hopper which causes the selected material of the underlying cuvette 4 housed in the carriage 12 to fall.

figure 6 schematically illustrates the sliding device 28 which introduces the blood dispensing nozzle into each test tube 4 placed in the trolley 12 in which blood 23 is to be dispensed: a motor 39 moves the nozzle 21 up and down with the screw 38 .

Figure 7 schematically illustrates the device which automatically closes with caps 33 mounted on a band 32 the underlying tubes 4 filled with blood 23 by activating a motor 41 by means of the screw 42 the plate beater 44 with female screw which, with the pressure columns 45, pushes the adhesive list with caps 32 until they penetrate into the test tubes 4 and returning the motor 41 to its starting position, Figure 8 schematically illustrates the two types of needles of the invention, both of which are connected to a flexible plastic tube 7, the butterfly needle 6 with the tip 5 like a flute beak and the plastic tube 7 and the eccentric coupling needle 5 with the handle 29 with a groove 47 for the passage of the flexible tube 7.

With reference to the aforementioned figures, the apparatus for carrying out the method according to the invention, indicated with figure 1, comprises both the additive dispensing step 19 of the motorized trolley 12 and the blood fractionation phase 20 of the motorized trolley 12 and the phase closing caps 46; the additive dispensing step 19 comprising various containers for containing different additive liquids 1, a hopper station 35 for dispensing gels, spheres or plastic microcubes 31 used as coagulation accelerators, better illustrated in figure 5, a plurality of electric volumetric pumps 2 for transferring the additive liquids 1, pumps of the type indicated in detail in figure 2, flexible connection hoses 14 for the suction, 13 for the transfer and 3 for the connection with the dispensing nozzle 15 of the additive liquids 1 in the test tubes, dispensing nozzles 15 placed in correspondence with test tubes 4; the flexible connection pipes 13, 14 and 3 passing through the electric volumetric pumps as better indicated in figure 2 where the flexible connection pipe 3 is pressed between the rollers 16 activated by the rotor 18 and the fixed jaw 17 which acts as a contrast determining the number of motor steps the volume of the dosed liquid; the motorized phase 20 comprising the test tubes 4 which are housed in a motorized trolley and which are dominated by the blood dispensing nozzle 21 which is connected with the flexible tube 7 which passes into the electric volumetric pump 8 better illustrated in fig. 2 and which joins with the butterfly needle 6 inserted into the vein 23 from which it sucks the blood. The test tubes 4 in Figure 1 are housed in the motorized carriage 12 and are surmounted by the nozzles 15; the blood fractionation phase 20 of the motorized trolley 12 indicated schematically in figure 1 comprises the motor 11 which acts on the worm screw 10 obtaining with the mechanical connection 9 the movements of the motorized trolley from phase 19 to phase 20 and therefore of the test tubes contained therein . A butterfly needle 6 is inserted into the vein 23 by the operator in an easy way thanks to the sharp bevel 5 of the needle itself: the butterfly needle 6 is connected to the dispensing nozzle 21 with the flexible tube 7 passing into the volumetric pump electrical 8 better illustrated in fig. 2 where the flexible connection tube 7, held in place by the stop rings 24, is pressed between the rotor 18 which acts with the rollers 16 and the fixed jaw 17 which acts as a contrast, obtaining the progressive movement of the liquid contained in the tube in the direction rotation of the motor for small segments of liquid between each roller and the next; the phase of closing the caps 46 schematically indicated in figure 1 comprises the motor 11 which acts on the worm screw 10 obtaining with the mechanical connection 9 the movements of the motorized trolley from phase 20 to phase 46 and therefore of the test tubes contained therein which are be under the series of caps 32, which, pressed by the device illustrated in figure 7, inserts the caps 33 into the test tubes 4 pressed by the plate beater 44 activated by the screw 42 moved by the motor 41.

The use of the equipment in carrying out the procedure according to the invention is as follows. The operator inserts a certain number of test tubes 4 according to his own requirement which changes from time to time in the motorized trolley 12 in which a series of electronic sensors 22 signals the presence of the test tube to a known electronic device, not shown, and then gives the order both to add preservatives and to dispense the necessary volumes of blood in the various tubes inserted. The motorized carriage 12 is brought by the motor 11 to one end of the stroke as indicated in 19 of figure 1. The operator inserts the pump 8 fig. 1 the flexible tube 7, engages the nozzle 21 in the arm of the automatic sliding device 28 and finally the butterfly needle 6, taking the components from a sterile wrapper. By means of the butterfly needle 6 the operator penetrates into the vein 23 with the flute-beak tip 5. The operator acts on a general control pedal (not shown) which, through an electronic device of a known type, sets in motion in the first phase the various volumetric pumps 2 involved in dispensing the various preservative liquids 1 and the plastic gel, spheres or microcubes from the hopper 35 of fig. 5. The volumetric pumps 2 of Figure 1 act simultaneously but with different volumes delivered according to the volumetric setting made. The sensors 22 signal to the programming device the presence of a test tube for dispensing the preservative liquids. In phase 20 the motor 11 acting on the worm 10 with the fitting 9 carries the test tubes placed on the motorized trolley 12 under the blood dispensing nozzle 21, without stopping and without dispensing in the positions in which the tubes are not inserted. The first test tube that arrives in position activates the automatic sliding device of fig. 6 which introduces the blood dispensing nozzle 21 into the test tube 4; the volumetric pump 8 delivers the programmed volume of blood through the nozzle which rises upwards moved by the motor 39 and by the screw 38: each time the motorized trolley 12 presents a test tube under the nozzle 21, the cycle is repeated both of the electric volumetric pump 8 and of the automatic sliding device 28. After the filling of the last test tube, the motorized trolley 12 advances to step 46 where the cap closing device illustrated in fig. 7 closes the test tubes 4 with the caps 33 pushed by the plate beater 44 which, thanks to the columns 45, presses the series of caps 32 moved by the motor 41 and by the screw 42. Once the test tubes have been discharged, the trolley 12 returns to the starting position operated by the motor 11, ready to receive new tubes and to perform a new sampling operation on a subsequent patient. The operator removes the butterfly needle 6, the tube 7 and the nozzle 21 and disposes of them as waste according to the law.

For a home collection or in urgent conditions, the simplified invention 48 illustrated in fig. 4, portable and independent from the electrical network, is used with the following procedure which is completely similar to the main device: a series of test tubes already equipped with additives produced by the main machine in fig. 1 and with the invention 48 only the blood aspiration phase is carried out: the blood dispensing nozzle 21 is placed in its housing on the axis of the test tube 4 which, placed in the manual latch tube holder plate 26, is raised manually, the flexible tube 7 is inserted into the pump rotor 8 to whose peristaltic pump 18 the rechargeable battery 27 supplies the energy; then the operator inserts the flute-beak needle 5 into the vein, starting the blood aspiration cycle which will be followed by other tubes already prepared with the additives according to the program.

In practice it has been found, apart from the portable device of fig. 4, that the method according to the invention and the apparatus for carrying it out fully accomplish the intended aim as they allow to take blood from the patient in a completely automatic way, leaving the operator only with the task of inserting the needle. in the mood and press the control pedal. The operator can therefore devote himself completely to the patient, assist him avoiding collapses or states of apprehension and can count on strict compliance with the sampling rules; he will experience much less stress himself and will work to a much higher standard than manual ones.

Although the procedure and the equipment for its execution have been designed in particular for blood sampling, they can also be used with advantage to perform the sampling of other heterogeneous liquids; milk, urine, etc. or for a standardized and automated procedure for the subsequent treatment of the liquids taken until the final samples to be analyzed are obtained: for example, blood serum separated from the clot by taking the supernatant phase.

The process, as well as the equipment, thus conceived, are susceptible of numerous modifications and variations, all of which fall within the scope of the inventive concept; furthermore, all the details can be replaced by other technically equivalent elements.

In practice, the materials used, as well as the dimensions, can be replaced according to the needs and the state of the art, the use of different materials and construction opportunities.

Claims (29)

Claims 1. Device for the collection with a single introduction into the vein of the needle of a series of blood samples to be analyzed in the laboratory characterized by an electronic, mechanical, pneumatic and chemical device and by a flexible tube equipped with stops which brings a needle to the ends and a dispensing nozzle, characterized in that the flexible tube with the clips is mounted in a housing of a needle pump whose rotation causes the transfer of all the liquids involved, both the blood and the chemical additives; this while the electronic device is programmed by the operator by means of the same tubes with suitable sensors or with other programming devices and while a motorized trolley provides the fractionation of the samples in synchrony with the blood dispensing of the needle pump. 2. Device according to claim 1 characterized by the fact that the invention is also described in a simplified battery-operated version for portable use, equipped with a roller pump, a flexible tube with stops which carries a sampling needle and a dispensing nozzle at the ends. and with a manual latching tube holder since the tube to be inserted manually is already prepared with additives. 3. Device according to claims 1 and 2 characterized in that the flexible tube provided with stops which carries at the ends a dispensing nozzle and a withdrawal needle can be fitted with a butterfly needle or a handle with a coupling for the coupling needle eccentric and a groove for the passage of the flexible tube thus facilitating the use for those accustomed to the traditional syringe. 4. Device according to claims 1, 2 and 3 characterized by the fact that the invention allows blood to be collected in a fractional manner, to withdraw it and transfer it to different test tubes, to deliver additives to each tube intended to receive the fraction of liquid drawn, to house said test tubes in a motorized trolley, to use test tube presence sensors in each housing of the motorized trolley, to use sampling needles and dispensing nozzles placed at the ends of a plastic tube, to connect said needles and nozzles with a predisposed plastic tube with stop rings for re-insertion in a peristaltic pump, to place said plastic tube between a roller rotor driven by an electric motor and a contrast jaw, to house special stop rings mechanically connected to the plastic tube in housings provided in the jaw contrast, to make the dispensing nozzle coincide with the axis of the various tubes underneath many positioned on a motorized trolley, to connect said dispensing nozzle with a sliding mechanism that brings the dispensing nozzle inside the collection tube during the transfer operation, to obtain a regular and programmed squeezing of the plastic tube so to obtain that segments of liquid proceed from the sampling needle to the dispensing nozzle, to use plastic tubes to connect containers containing additives with the additive dispensing nozzles, to arrange a plastic tube for each container of additive and place it between a roller rotor driven by a motor and a contrast jaw, to house special stop rings mechanically connected to the plastic tube in housings prepared in the contrast jaw, to obtain a regular and programmed squeezing of the plastic tube flexible in order to obtain the desired volume of liquid inside the sample tube in the exact volume required. 5. Device according to one of the preceding claims, characterized in that the invention resets itself automatically at the end of the pick-up with the simple introduction of a subsequent trolley. 6. Device according to one of the preceding claims, characterized in that the invention accepts any type of programming of volumes, times, withdrawal speed and additives. 7. Device according to one of the preceding claims, characterized by the fact that the sampling is preferably programmed by means of the same test tube presence inserted in the trolley by the operator acting on a sensor. 8. Device according to one of the preceding claims, characterized by! fact that the programming of the withdrawal takes place also and alternatively by means of electronic programming via computer or via bar code or via keyboard. 9. Device according to one of the preceding claims, characterized in that the type and volume of the preservative liquids is programmed and memorized by an electronic device in combination with a series of sensors which makes the type of preservative specific for that test tube and for that position disbursed and so for all the others. 10. Device according to one of the preceding claims, characterized in that the volume of the liquid withdrawn is divided into various test tubes according to what is programmed by the operator and memorized by an electronic device in combination with a series of sensors which makes it specific for that test tube and for that position the volume of liquid withdrawn and transferred. Device according to one of the preceding claims, characterized in that the dosage of the volume of blood delivered into the test tube reaches accuracies of tenths of a milliliter. Device according to one of the preceding claims, characterized in that the stoichiometric ratio between blood and additives is respected with a precision greater than a tenth of a percentage unit. 13. Device according to one of the preceding claims, characterized by the fact that the withdrawal needle, the nozzle and the tube are disposable materials, which are the only object to be replaced at each withdrawal and which are easy to assemble. 14. Device according to one of the preceding claims, characterized in that the motorized trolley with test tubes can be arranged with or without caps with international colors in a sealed and sterile disposable execution. Device according to one of the preceding claims, characterized in that sterile or non-sterile collateral supplies of disposable and consumable materials for the machine such as needles and transfer tubes, caps, test tubes and chemical and solid additives of all kinds can be carried out. 16. Device according to one of the preceding claims, characterized by the fact that the invention makes work more relaxed for the operator than replacing vacuum tubes or dividing the contents of a common syringe by hand. Device according to one of the preceding claims, characterized in that the invention is separated from the patient to whom it is connected only by the tube with the needle and that this avoids hematomas and damage to the vein with the maneuvers now required to replace test tubes close to the vein. 18. Device according to one of the preceding claims, characterized in that the invention has a single and general pedal or alternatively button control. 19. Device according to one of the preceding claims, characterized in that the invention considerably reduces the stress for the operator. 20. Device according to one of the preceding claims, characterized in that the invention allows the doctor to assist the patient with a continuous presence from the beginning to the end of the sample. 21. Device according to one of the preceding claims, characterized in that the invention operates in isobaric conditions and therefore keeps the corpuscular forms of the blood intact and eliminates the problem of hemolysis typical of vacuum systems and which eliminates the risks for the operator linked to opening of the caps in the vacuum tubes with residual vacuum (implosions of air and splashes of blood). Device according to one of the preceding claims, characterized in that the invention allows the operator to see the blood flowing into the transparent flexible tube as soon as the needle enters the vein, thereby ensuring that the puncture of the vein has taken place regularly. 23. Device according to one of the preceding claims, characterized by the fact that the invention automatically doses all the chemical additives including solid or gelled ones in the test tubes, leaving the operator full freedom to choose test tubes and additives. 24. Device according to any one of the preceding claims, characterized in that in addition to additives, the invention can dose and deliver gelled compounds, spheres or microcubes of plastic material that accelerate coagulation and similar materials. 25. Device according to one of the preceding claims, characterized by the fact that the invention reduces the management costs and the volumes of materials in the warehouse of test tubes with pre-dosed additives both under vacuum and at ambient pressure and which eliminates the problem of expiry of the test tubes because it works in isobaric (it does not need vacuum) as it introduces the additives into the tubes at the time of collection. 26. Device according to one of the preceding claims, characterized in that the invention there saves time for the operator who can thus perform a greater number of withdrawals in the unit of time. 27. Device according to one of the preceding claims, characterized in that the invention eliminates the problem of the hospital administration having to check the expired withdrawal materials in the warehouse. 28. Device according to one of the preceding claims, characterized in that the invention drastically reduces the types of test tubes required in stock (today a test tube corresponds to each volume and each additive): found doses the additives in only three types of test tubes. 29. Device according to any one of the preceding claims, characterized in that the invention uses common low-cost test tubes and does not need vacuum tubes.