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Determination of total bilirubin in whole blood from neonates: results from a French multicenter study
- Source :
- Clinical chemistry and laboratory medicine. 44(9)
- Publication Year :
- 2006
-
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, 58.1 micromol/L) and high (N2, 275.3 micromol/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 micromol/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-microL 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.
- Subjects :
- Pediatrics
medicine.medical_specialty
Bilirubin
Point-of-Care Systems
Clinical Biochemistry
Gastroenterology
Sensitivity and Specificity
chemistry.chemical_compound
Internal medicine
Medicine
Humans
Whole blood
Reproducibility
business.industry
Biochemistry (medical)
Infant, Newborn
Reproducibility of Results
General Medicine
Repeatability
Jaundice
Bilirubin encephalopathy
Jaundice, Neonatal
Multicenter study
chemistry
Spectrophotometry
France
medicine.symptom
Blood Gas Analysis
Hyperbilirubinemia, Neonatal
business
TBIL
Subjects
Details
- ISSN :
- 14346621
- Volume :
- 44
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Clinical chemistry and laboratory medicine
- Accession number :
- edsair.doi.dedup.....d51a05e6f4b3d929ba06549df42b48cd