| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Received on March 31, 2003
Accepted on October 9, 2003
General Clinical Chemistry |
1 Reference Standards Laboratory, Department of Pathology and Laboratory Medicine, Children’s Hospital of Wisconsin, Milwaukee, WI and Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
2 ARUP Laboratories, Department of Pathology, University of Utah, Salt Lake City, UT
* To whom correspondence should be addressed. E-mail: slo{at}mail.mcw.edu.
Background: The diagnosis and management of hyperbilirubinemia in the newborn requires accurate and precise bilirubin determinations. We evaluated the current status of bilirubin measurements in US laboratories by examining data submitted by laboratories participating in the College of American Pathologists (CAP) Neonatal Bilirubin (NB) Surveys.
Methods: We analyzed specimens from the CAP NB and Chemistry (C) Surveys by the reference method for total bilirubin in three laboratories. The reference method bilirubin values were compared with bilirubin values reported by Survey participants.
Results: The precision (CV) for all instruments combined (CAP-All Instruments) ranged from 4.7% to 5.6% at the bilirubin concentrations tested. The CVs of the four most commonly used instruments were smaller, ranging from 1.9% to 4.5%. Differences between bilirubin values by the reference method and mean values from the four most common instruments ranged from -21.6% to 10.9%. When the same specimens from the NB Surveys were used in the C Surveys, the Vitros values were strikingly different from those of the NB Surveys. The use of different methods in the NB and C Surveys coupled with the presence of a nonhuman protein base and ditaurobilirubin (DTB) in the Survey specimens accounted for the discrepant results.
Conclusions: The evaluation of accuracy is impossible from the CAP Surveys because the specimens consist of bovine serum containing a mixture of unconjugated bilirubin and DTB. For the evaluation of accuracy, we recommend that Survey specimens consist of human serum enriched with unconjugated bilirubin. ©2004 American Association for Clinical Chemistry
The following articles in journals at HighWire Press have cited this article:
|
|
 |
|
  S. N. El-Beshbishi, K. E. Shattuck, A. A. Mohammad, and J. R. Petersen Hyperbilirubinemia and Transcutaneous Bilirubinometry Clin. Chem., July 1, 2009; 55(7): 1280 - 1287. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M Kirk Neonatal jaundice: a critical review of the role and practice of bilirubin analysis Ann Clin Biochem, September 1, 2008; 45(5): 452 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. F. McDonagh Ex Uno Plures: The Concealed Complexity of Bilirubin Species in Neonatal Blood Samples Pediatrics, September 1, 2006; 118(3): 1185 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Keren, V K Bhutani, X Luan, S Nihtianova, A Cnaan, and J S Schwartz Identifying newborns at risk of significant hyperbilirubinaemia: a comparison of two recommended approaches Arch. Dis. Child., April 1, 2005; 90(4): 415 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Stevenson, R. J. Wong, and H. J. Vreman Reduction in Hospital Readmission Rates for Hyperbilirubinemia Is Associated with Use of Transcutaneous Bilirubin Measurements Clin. Chem., March 1, 2005; 51(3): 481 - 482. [Full Text] [PDF]
|
|
|
|
|
|
Subcommittee on Hyperbilirubinemia Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation Pediatrics, July 1, 2004; 114(1): 297 - 316. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
