Determining hemoglobin reference values in children and teenagers from Sibiu area

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Objectives: Reference values are fundamental for the interpretation of laboratory results, which are useful for medical decisions. Each laboratory has to have its own reference values classified according to age groups in order to interpret test results correctly. The expression “normal values” has been replaced by “reference values” because there are various variables that are considered to influence these values. The majority of “reference values” were established over two decades ago using obsolete medical devices and in many cases undefined populations; therefore, nowadays these intervals are not relevant anymore for modern testing technology in clinic laboratories. Methods and materials: The study was carried out at Sibiu Clinic Pediatric Hospital using the laboratory’s electronic archive. The samples were taken from hospitalized patients (children and teenagers) and outpatients registered between January and December, 2010. Blood sample testing was performed using the Sysmex XS 1000i analyzer. The reference values for hemoglobin was calculated based on results from a population sample of 9838 patients. The patients were classified into 3 age categories: 1 month - 2 years old; 2 - 10 years old; 10 - 18 years old. Reference values were determined after eliminating outliers,using the robust method to calculate 2.5 and 97.5 percentiles with the SPSS statistical software. Results and Conclusions: The results obtained differed from those specified in the Roche Diagnostics 2004 Guide but were found to be close to the results mentioned in Lothar Thomas’s publication, in Laboratory diagnostics.

1. Guidi G.C., Lippi G., Solero G. P., Poli G., Plebani M., Managing transferability of laboratory data- Clin Chim Acta, 2006, 374, 57-62.

2. Jung B., Adeli K., Clinical laboratory reference intervals in pediatrics: The CALIPER initiative - Clin Biochem, 42, 2009, 1589-1595.

3. Kulasingam V., Jung P.B., Ivan M. B., Baradaran S., Chan M. K., Aytekin M., et al, Pediatric reference intervals for 28 chemistries and immunoassays on the Roche Cobas® 6000 analyzer-A CALIPER pilot study - Clin Biochem, 2010, 43, 1040-1045.

4. Clinical and Laboratory Standard Institute. Reference and Selected Proceeding for the Quantitative Determination of Hemoglobin in Blood; Approved Standard-Third Edition. CLSI, FDA. Wayne, Pennsylvania : s.n., 2000. 1-56238-425-2.

5. Barbara J. B., Blood Cells. A Practical Guide. s.l. : Blackwell Science, 2002, 181-183.

6. Christensen D. R., Henry E., Jopling J., Wiedmeier E.S., The CBC: Reference Ranges for Neonates - Semin Perinatol, 2009, 33, 3-11.

7. Katayev A., Balciza C., Seccombe W. D., Establishing Referance Intervals for Clinical Laboratory Test Results - Am J Clin Pathol, 2010, 130, 180-186.

8. Hoffmann RG. Statistics in the practice of medicine. JAMA.1963;185:864-873.

9. Lothar T., - Hemoglobins, Clinical Laboratory Diagnostics, Use and Assesment of Clinical Laboratory Results - Frankfurt/Main : TH Books Verlagsgesellschaft mbH, 1998: 475-476.

Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

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