Determination of total bilirubin in whole blood from neonates: results from a French multicenter study
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Abstract
Background: Jaundice is frequent in neonates and can cause severe complications, especially in premature neonates, particularly the risk of developing acute bilirubin encephalopathy. Our purpose was to verify if determination of total bilirubin (TBIL) in whole blood on an ABL™ 735 blood gas analyzer with a spectrophotometer module could provide an analytical alternative to chemical methods of TBIL measurement.
Methods: Our multicenter comparative study involved four hospital laboratories. We studied the repeatability and reproducibility of ABL 735 TBIL measurements in two control sera of medium (N1, 58.1μmol/L) and high (N2, 275.3μmol/L) TBIL levels. The same study was simultaneously conducted on four chemistry instruments (two LX 20®, one Integra 800® and one Hitachi 917®) using four Jendrassik-Grof derived methods. At one site, repeatability was performed with two adult whole-blood samples containing low and high TBIL levels (55.1 and 312.6 μmol/L).
Results: Repeatability tests provided coefficients of variation (CVs) between 0.67% and 1.86% on the ABL 735 system, vs. 0.35% and 1.96% for the chemistry instruments. Reproducibility tests for the same control sera resulted in CVs between 1.01% and 3.55% for the ABL 735 and between 0.52% and 3.65% for the chemistry instruments. Recovery for the N1 and N2 control sera was 102–120%. A correlation study of TBIL determination in whole blood vs. plasma was conducted on 473 neonatal blood samples. Correlation coefficients between whole blood and plasma TBIL ranged from 0.969 to 0.994. Passing-Bablok equations were y=1.17x+9.7 [site 1 (IP)], y=1.01x+5.6 [site 2 (JPB, MR)], and y=1.00x–20 [site 3 (AS)]. Only 10% of the results fell outside the 10% range in the bias-corrected Bland-Altman difference plot for the ABL 735 method compared to traditional laboratory methods.
Conclusions: The ABL 735 instrument is reliable for measuring TBIL in 70-μL whole blood samples from neonates. Thus, this method might allow significant blood savings in preterm neonates. Correlation with the reference method for plasma or sera must be established to ensure good follow-up of patients.
Clin Chem Lab Med 2006;44:1103–10.
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©2006 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Point-of-care testing – can we move from anecdote to evidence?
- A long and winding road: defining the biological role and clinical importance of paraoxonases
- Point-of-care testing in the cardiovascular operating theatre
- Low-density lipoprotein receptor-related protein 5 and vitamin D receptor gene polymorphisms in relation to vitamin D levels in menopause
- The methylenetetrahydrofolate reductase C677T gene mutation is associated with hyperhomocysteinemia, cardiovascular disease and plasma B-type natriuretic peptide levels in Korea
- Exploring allelic imbalance within paraffin-embedded tumor biopsies using pyrosequencing technology
- Detection of circulating tumour cells in blood by quantitative real-time RT-PCR: effect of pre-analytical time
- Hereditary hyper-ACE-emia due to the Pro1199Leu mutation of somatic ACE as a potential pitfall in diagnosis: a first family outside Europe
- Molecular assay for detection of the common carnitine palmitoyltransferase 1A 1436(C>T) mutation
- Serum cytokine levels and the expression of estrogen and progesterone receptors in breast cancer patients
- Protein Z levels and prognosis in patients with acute coronary syndromes
- Determination of total bilirubin in whole blood from neonates: results from a French multicenter study
- Analysis of protein S-100B in serum: a methodological study
- Lipid peroxidation and homocysteine levels in Behçet's disease
- Lower expression of the α2,3-sialylated fibronectin glycoform and appearance of the asialo-fibronectin glycoform are associated with high concentrations of fibronectin in human seminal plasma with abnormal semen parameters
- Automated processing of whole blood samples for the determination of immunosuppressants by liquid chromatography tandem-mass spectrometry
- Role of methionine residues of albumin in T-R conversion of hemoglobin
- Rheumatoid factor interference in the determination of carbohydrate antigen 19-9 (CA 19-9)
- Significance of Elecsys® S100 immunoassay for real-time assessment of traumatic brain damage in multiple trauma patients
- IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37°C: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): Scientific Division, Committee on Reference Systems for Enzymes (C-RSE): Part 8. Reference procedure for the measurement of catalytic concentration of α-amylase: [α-Amylase: 1,4-α-D-glucan 4-glucanohydrolase (AMY), EC 3.2.1.1]
- ESEAP: the national External Quality Assessment Scheme for clinical chemistry in Greece and Cyprus
- Evaluation of whole-genome amplification using multiple-displacement amplification of a limited number of cells
- Comparison of various methods for the determination of total protein in urine
- Description of examinations and their results and ISO standard 15189
- Congress of Clinical Chemistry and Laboratory Medicine, Annual Congress of the Society of Clinical Chemistry and Laboratory Medicine (DGKL) in association with The Austrian Society for Laboratory Medicine and Clinical Chemistry, The Swiss Society for Clinical Chemistry (SGKC), The German Association of Technical Assistants in Medicine (dvta), Mannheim, Germany, October 1st - 4th, 2006
- First Congress of the Austrian Society for Laboratory Medicine and Clinical Chemistry (ÖGLMKC), Salzburg, October 4 – 7, 2006
