Bilirubin measured on a blood gas analyser: a suitable alternative for near-patient assessment of neonatal jaundice?

Peake, Michael; Mazzachi, Beryl; Fudge, Andrew; Bais, Renze

doi:10.1258/0004563011901127

Cited by 7 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results of Passing-Bablok regression analysis and Bland-Altman deviation chart analysis showed that the consistency of the two methods was poor, especially in the >300 μmol/L Group. The cause of deviation may have been the interference of neonatal hemoglobin (11), the calculation of plasma equivalent on the blood gas analyzer (7,12), the increase of bound bilirubin or delta bilirubin in the sample, and different albumin levels (13,14). There may also have been C D E methodological differences between blood gas analyzers and chemical analyzers (11).…”

Section: Discussionmentioning

confidence: 99%

“…The cause of deviation may have been the interference of neonatal hemoglobin (11), the calculation of plasma equivalent on the blood gas analyzer (7,12), the increase of bound bilirubin or delta bilirubin in the sample, and different albumin levels (13,14). There may also have been C D E methodological differences between blood gas analyzers and chemical analyzers (11). Meanwhile, it should be noted that the biochemical analyzer (enzymatic method) as the gold standard also needs to be standardized (15).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Analytical performance validation and clinical application of blood gas analyzer on the detection of neonatal bilirubin

et al. 2021

View full text Add to dashboard Cite

Background: It is not yet clear whether the trace blood gas analyzer can be used for biochemical detection of newborns. This study aimed to evaluate the reliability of the method for the detection of bilirubin in infants.Method: Based on the CLSI EP15-A2 document, the analytical performance of the blood gas analyzer method for bilirubin detection in neonates was validated. The resulting data of 363 simultaneous bilirubin detection with blood gas analyzer (optical method) and biochemical analyzer (enzymatic method) were reviewed. According to the CLSI EP9-A3 document, the relevance and consistency of the measurement results were evaluated by Pearson correlation analysis, Passing-Bablok regression, and Bland-Altman deviation analysis. Results:The precision and accuracy of the Werfen GEM 4000 blood gas analyzer for the detection of different levels of bilirubin samples adhered to the manufacturer's statement and industry quality standards.The bilirubin detection values of the 2 methods showed a good correlation, and both of them were significantly correlated (P<0.001). Passing-Bablok regression results showed that the regression equation of the bilirubin detection value of the 2 methods is y = −21.00 + 1.17x, with the slope as 1.17 [95% confidence interval (CI): 1.15 to 1.19], and the intercept was −21.00 (95% CI: −23.62 to −18.71), the data of the 2 sets were not consistent in each concentration range. The Bland-Altman plot demonstrated that the bilirubin detection value of 16/363 cases (4.4%) for the 2 methods exceeded the 95% limits of agreement (95% LoA); of which the maximum bias was −30.34 (95% CI: −38.48 to −22.26) and there were 5/76 cases (6.6%) outside the 95% LoA in the >300 μmol/L group. Conclusions:The method for detecting neonatal total bilirubin by trace blood gas analyzer basically meets the clinical requirements and can be used for the preliminary screening of neonatal jaundice. However, for severe hyperbilirubinemia that requires close monitoring of dynamics, a precise enzymatic quantification is required.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analytical performance validation and clinical application of blood gas analyzer on the detection of neonatal bilirubin

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Capillary samples are measured using spectrophotometry with multiple wavelength readings and algorithms to correct for haemoglobin, fetal haemoglobin and lipaemia. Comparisons with wet 46,47 and dry slide 48 Diazo laboratory methods for neonates have shown an insignificant bias over a wide range of bilirubin concentrations, albeit with a wide scatter.…”

Section: First-line Assessment Of Jaundicementioning

confidence: 99%

Neonatal jaundice: a critical review of the role and practice of bilirubin analysis

Kirk

2008

Ann Clin Biochem

View full text Add to dashboard Cite

Neonatal jaundice is common, and usually harmless, because of physiological jaundice or breast-feeding. In some neonates unconjugated bilirubin concentration, coupled with other risk factors, is sufficient to allow free bilirubin to cross the bloodbrain barrier and cause kernicterus. Another subgroup of infants is jaundiced because of elevated conjugated bilirubin; a marker for a number of pathological conditions. Bilirubin measurement must identify those infants at risk. Transcutaneous bilirubin measurement is increasingly used in healthy infants, especially before early discharge or at home, to assess the need for laboratory bilirubin measurement. Transcutaneous measurements are not covered by laboratory quality assessment schemes. Guidelines on management of neonatal jaundice utilize age in hours and other risk factors to define bilirubin action thresholds, which may be as low as 100 mmol/L for sick premature infants, whereas early discharged babies may only present after bilirubin concentrations are extremely high. Hence, there is a requirement for accurate total bilirubin measurement from ,100 to .500 mmol/L, with sufficient precision to assess the rate of bilirubin change with time. Babies presenting with late jaundice always require conjugated bilirubin measurement. It is of concern that many total and direct bilirubin automated kit methods suffer from haemolysis interference, while use of in-house methods or modification of commercial methods has virtually disappeared. External quality assessment has a vital role in providing data on different methods' performance, including accuracy, precision and susceptibility to interference. Laboratories should consider whether their adult bilirubin methods are suitable for neonates.

show abstract

“…8,9 However, most existing methods for optical analysis of turbid media are not able to extract a , s , and g simultaneously and many methods also focus on either the absorption or the scattering properties, i.e., the scattering effects are treated as interference during absorption measurements 9,10 or vice versa. 11,12 Yet other methods rely on removal of the scattering components prior to absorption measurements, e.g., some types of clinical blood analysis 13,14 where the blood cells are hemolyzed (the cell walls are crushed) and subsequently removed from the sample either by means of sedimentation or centrifugation.…”

Section: Introductionmentioning

confidence: 99%

Real-time absorption and scattering characterization of slab-shaped turbid samples obtained by a combination of angular and spatially resolved measurements

Dam¹,

Yavari²,

Sörensen

et al. 2005

Appl. Opt.

View full text Add to dashboard Cite

General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Real-time absorption and scattering characterization of slab-shaped turbid samples obtained by a combination of angular and spatially resolved measurementsJan S. Dam, Nazila Yavari, Søren Sørensen, and Stefan Andersson-EngelsWe present a fast and accurate method for real-time determination of the absorption coefficient, the scattering coefficient, and the anisotropy factor of thin turbid samples by using simple continuous-wave noncoherent light sources. The three optical properties are extracted from recordings of angularly resolved transmittance in addition to spatially resolved diffuse reflectance and transmittance. The applied multivariate calibration and prediction techniques are based on multiple polynomial regression in combination with a Newton-Raphson algorithm. The numerical test results based on Monte Carlo simulations showed mean prediction errors of approximately 0.5% for all three optical properties within ranges typical for biological media. Preliminary experimental results are also presented yielding errors of approximately 5%. Thus the presented methods show a substantial potential for simultaneous absorption and scattering characterization of turbid media.

show abstract

Bilirubin measured on a blood gas analyser: a suitable alternative for near-patient assessment of neonatal jaundice?

Cited by 7 publications

References 0 publications

Analytical performance validation and clinical application of blood gas analyzer on the detection of neonatal bilirubin

Analytical performance validation and clinical application of blood gas analyzer on the detection of neonatal bilirubin

Neonatal jaundice: a critical review of the role and practice of bilirubin analysis

Real-time absorption and scattering characterization of slab-shaped turbid samples obtained by a combination of angular and spatially resolved measurements

Contact Info

Product

Resources

About