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• Title: Performance of Bilirubin Determinations in US Laboratories--Revisited (General Clinical Chemistry)
• Author : Clinical Chemistry
• Release Date : January 01, 2004
• Genre: Chemistry,Books,Science & Nature,
• Pages : * pages
• Size : 183 KB

Description

Hyperbilirubinemia in healthy newborn infants is a common condition treated by pediatric practitioners. Guidelines for the management of hyperbilirubinemia in healthy term newborns were published in 1994 by the American Academy of Pediatrics (1). The guidelines rely heavily on the ability of the physician to recognize jaundice and on the measurement of serum total bilirubin. Thus, the importance of precise and accurate bilirubin results is critical to proper management of hyperbilirubinemia. Historically, interlaboratory agreement of bilirubin measurements has not been good (2). In 1995, Vreman et al. (3) conducted a study on the status of bilirubin measurements in 14 university hospital laboratories in the US. They used commercial lyophilized controls consisting of bovine serum albumin (BSA) [4] enriched with unconjugated bilirubin (UBIL). The instruments used in the study were the Kodak Vitros (then Ektachem; n = 9 sites), Hitachi (n = 3), and Paramax (n = 2). The mean values from the Vitros and the Hitachi instruments were, respectively, 5% and 11% higher than the values assigned by the manufacturer of the lyophilized controls; those from the Paramax were lower by 15%. In the College of American Pathologists (CAP) Survey of the same year, the CV for all Vitros participants was 3.3%, whereas in the study by Vreman et al. (3), the Vitros data had a CV of 17%. The high imprecision reported by Vreman et al. was surprising because according to the authors all nine Vitros instruments used the total bilirubin (TBIL) method (TBIL slide) for measuring bilirubin. Similarly the imprecision (CV ~11%) of the three Hitachi analyzers was approximately three times greater than that of all Hitachi participants in the Survey (CV ~3.5%). Interestingly, the CVs for all instruments combined in the CAP (CAP-All Instruments) ranged from 7.9% to 8.2%, lower than those for the Vitros and Hitachi reported by Vreman et al. (3).

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