Accurate direct spectrophotometric bilirubin measurement combined with blood gas analysis

Laterza, Omar; Smith, Carl H.; Wilhite, Timothy R.; Landt, Michael

doi:10.1016/s0009-8981(02)00178-x

Cited by 17 publications

(10 citation statements)

References 6 publications

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“…However, the accuracy of TSB measurement in our unit by reflectance spectrophotometry (GB 13/A TM Bilirubinometer, Bertocchi SRL Elettromedicali, Italy) was recently tested, and the correlation between our laboratory method and the HPLC method was high (r = 0.927; 95% CI = 0.906-0.944) [6] . Moreover, some reports have shown that the new multi-wavelength spectrophotometric method developed by Radiometer measures TSB concentrations accurately and precisely in conjunction with blood gas analysis/co-oximetry (ABL 735 TM ) [15,16] .…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous Bilirubin Measurement: Evaluation of Bilitest™

et al. 2007

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Objective: The early discharge of neonates from hospitals makes transcutaneous measurement of total serum bilirubin concentration a useful tool to monitor neonatal jaundice. The objective of this study was to evaluate the Bilitest BB 77™ (Bertocchi SRL Elettromedicali, Cremona, Italy), a new device for noninvasive transcutaneous total bilirubin measurement. Methods: We studied 241 newborn infants ≧32 weeks of gestation admitted to the Neonatal Nursery of Careggi University Hospital, Florence. These infants had total serum bilirubin (TSB) levels measured by a standard laboratory test (group B = 198) as part of their normal care, and transcutaneous bilirubin (TcB) levels were obtained within 10 min after heel pricking. Results: There was a good correlation between TSB and TcB values. The linear regression plot showed a general underestimation of Bilitest BB 77 measurement compared to standard laboratory test; the negative difference between Bilitest BB 77 values and TSB increased at higher bilirubin levels, as confirmed by the Bland-Altman error plot. To visualize the accuracy of the Bilitest BB 77 measurements, ROC curves plot sensitivity versus specificity and the maximum range of difference between Bilitest BB 77 and TSB were considered. Pearson correlation analysis demonstrated that Bilitest BB 77 accuracy was independent of gestational and postnatal age of newborns. Conclusion: We conclude that the Bilitest BB 77, a new device for bilirubin transcutaneous measurement, shows a good correlation with standard laboratory method and has the merit to be quite inexpensive and does not need calibration with consumable or disposable parts. However, because TcB measurements with Bilitest BB 77 underestimated STB levels particularly at STB ≧12 mg/dl, serum bilirubin measurements are still required when treatment with phototherapy or exchange transfusion is being considered.

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Section: Discussionmentioning

confidence: 99%

Transcutaneous Bilirubin Measurement: Evaluation of Bilitest™

et al. 2007

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“…57 A range of more quantitative techniques based on derivate spectrophotometry have been described. [58][59][60] These techniques may be relevant for determining the longitudinal profile of CSF bilirubin as proposed above.…”

Section: The Uk Experiencementioning

confidence: 99%

Spectrophotometry for Cerebrospinal Fluid Pigment Analysis

Petzold

Sharpe²,

Keir³

2006

NCC

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The use of spectrophotometry for the analysis of the cerebrospinal fluid (CSF) is reviewed. The clinically relevant CSF pigments -oxyhemoglobin and bilirubin -are introduced and discussed with regard to clinical differential diagnosis and potentially confounding variables (the four "T"s or: traumatic tap, timing, total protein and total bilirubin). The practical laboratory aspects of spectrophotometry and automated techniques are presented in the context of analytical and clinical specificity and sensitivity. The perceptual limitations of human color vision are highlighted and the use of visual assessment of the CSF is discouraged in light of recent evidence from a national audit in the United Kingdom. Finally, future perspectives including the need for longitudinal CSF profiling and routine spectrophotometric calibration are outlined.

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“…Some validation studies using neonatal whole blood samples provided conflicting correlations between blood gas analyzers and chemistry analyzers [ [5] , [6] , [7] , [8] , [9] ], which confused physicians in interpreting whole blood bilirubin results for patient management. The common causes of bias are a lack of standardized plasma bilirubin reference methods [ 10 , 11 ] and the difference in methodologies between blood gas analyzers using multiple-wavelength photometry and chemistry analyzers using diazo based assay [ [5] , [6] , [7] , [8] , [9] ].…”

Section: Introductionmentioning

confidence: 99%

Neonatal hemoglobin affects the accuracy of whole blood bilirubin measurement on GEM Premier 4000 blood gas analyzers

Yun

Dean

Dubbelman

et al. 2021

Practical Laboratory Medicine

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Objectives Whole blood bilirubin measured on blood gas analyzers is accepted by physicians in neonatal hyperbilirubinemia management since it requires a small sample volume. The accuracy of bilirubin measurement on blood gas analyzers is instrument dependent and remains controversial. Design and Methods Bilirubin in adult and umbilical cord whole blood samples, spiked with an unconjugated bilirubin standard, and non-spiked adult plasma samples was measured on a blood gas analyzer (GEM 4000) and a Core Laboratory Chemistry analyzer (Architect c16000) respectively. We also investigated the linear regression for neonatal and adult hemoglobin measured on the blood gas analyzer and the Core Laboratory hematology analyzer (Alinity h-Series). Results Plasma bilirubin measured on the blood gas analyzer and the chemistry analyzer was statistically identical. Adult whole blood bilirubin showed slightly increased proportional bias. When umbilical cord whole blood samples were used, the Deming regression showed GEM bilirubin =1.233(Architect) (95% CI 1.199 ~ 1.266)-44.43 μmol/L (95% CI -53.6 ~ −35.2). The regression was significantly different from that in plasma (p < 0.001) or adult whole blood (p < 0.001) samples. 36.1% neonatal samples with bilirubin levels >50 μmol/L showed that the bias% was above laboratory standards. In addition, the regression of neonatal hemoglobin measurement between the GEM and the Alinity was significantly different from adult hemoglobin (p < 0.01). Conclusions Neonatal whole blood bilirubin measurement on blood gas analyzers may be affected by neonatal hemoglobin. The method should be validated using neonatal whole blood samples or samples with a similar matrix before the analyzers are implemented into neonatal hyperbilirubinemia management.

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Accurate direct spectrophotometric bilirubin measurement combined with blood gas analysis

Cited by 17 publications

References 6 publications

Transcutaneous Bilirubin Measurement: Evaluation of Bilitest™

Transcutaneous Bilirubin Measurement: Evaluation of Bilitest™

Spectrophotometry for Cerebrospinal Fluid Pigment Analysis

Neonatal hemoglobin affects the accuracy of whole blood bilirubin measurement on GEM Premier 4000 blood gas analyzers

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