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Evaluation of hemoglobin interference in capillary heel-stick samples collected for determination of neonatal bilirubin.

Abstract：

OBJECTIVE:In this study, we determined the assay performance criteria necessary to produce acceptable results for >or=98% of neonate bilirubin samples collected by capillary heel-stick. STUDY DESIGN AND METHODS:We determined serum free hemoglobin levels in 151 heel-stick serum samples to determine the hemolysis level. We then tested the effect of hemolysis on total bilirubin levels determined by four commercially available assays. RESULTS:The mean level of serum free hemoglobin was 1.62 g/L. Of the serum total bilirubin assays tested, the Total Bilirubin Special (Roche Diagnostics) and the TBILI (Roche Diagnostics) reagents did not show significant interference at the concentrations of free hemoglobin observed in >or=98% of heel-stick samples. The Vitros Bu/Bc slide (Ortho-Clinical Diagnostics) showed significant interference only at normal bilirubin concentrations; while the Bilirubin DPD reagent (Amresco Inc.) showed significant interference starting at hemoglobin concentrations of 1.0 g/L. CONCLUSIONS:Bilirubin assays that are not sensitive to approximately 6 g/L free hemoglobin should provide accurate results for most samples obtained via capillary heel-stick. Of the four assays tested, the Bilirubin DPD reagent (Amresco Inc.) was the most susceptible to the presence of free hemoglobin and will result in a higher rejection rate of neonate capillary heel-stick samples.

journal_name

Clin Biochem

journal_title

Clinical biochemistry

authors

Algeciras-Schimnich A,Cook WJ,Milz TC,Saenger AK,Karon BS

doi

10.1016/j.clinbiochem.2007.08.003

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

1311-6

issue

16-17

eissn

0009-9120

issn

1873-2933

pii

S0009-9120(07)00305-0

journal_volume

40

pub_type

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