Comparison of Total Bilirubin Values Measured with ABL 735 Blood Gas Analyzer and Roche Cobas C8000 Chemistry Analyzer in Age-Segregated Pediatric Patients

Open access

Abstract

Aim: Measurement of blood bilirubin levels is a crucial analysis because of the toxic effects of bilirubin on brain tissue, particularly in preterm neonates. The aim of this study was to investigate the consistency of the total bilirubin values obtained by the blood gas analyzer and the autoanalyzer.

Material and Methods: In this study, we used total bilirubin data of 407 pediatric patients from Kocaeli University Medical Faculty Education and Research Hospital Central Laboratory System. Total bilirubin data, provided that it was measured simultaneously, was obtained from ABL 735 blood gas analyzer and Roche Cobas C8000 chemistry analyzer. Pediatric patients (neonates, infant and children under 17 years old) were selected retrospectively by year between 2015-2017.

Results: Under a cut-off value (14.6 mg/dL) ABL 735 blood gas analyzer and Roche COBAS C8000 chemistry analyzer had strong correlation (r = 0.939) for total bilirubin measurements. It was found that 2-15 days old neonates give more scattered total bilirubin data by Bland Altman analysis in two measurements. Statistical analysis performed to compare whole total bilirubin data identity between two measurements: correlation coefficient was found r = 0.949 a statistically significant positive correlation (p < 0.001).

Conclusion: According to our analysis which was supported by previous studies in the literature, we can say that the compatibility between the blood gas analyzer (multi-wave-length spectrophotometric technique) and the chemistry analyzer becomes weaker when the total bilirubin levels exceed 14.6 mg/dL.

1. Porter ML, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002 Feb 15;65(4):599-606.

2. Amin SB, Lamola AA, editors. Newborn jaundice technologies: unbound bilirubin and bilirubin binding capacity in neonates. Seminars in perinatology. Semin Perinatol. 2011 Jun;35(3):134-40. DOI: 10.1053/j.sem-peri.2011.02.007

3. Callen J, Traber Davis Giardina HS, Li L, Paoloni R, Georgiou A, Runciman WB, et al. Emergency physi-cians’ views of direct notification of laboratory and radiology results to patients using the internet: a multisite survey. JJ Med Internet Res. 2015 Mar 4;17(3):e60. DOI: 10.2196/jmir.3721

4. Blick KE. Providing critical laboratory results on time, every time to help reduce emergency department length of stay: how our laboratory achieved a Six Sigma level of performance. Am J Clin Pathol. 2013 Aug;140(2):193-202. DOI: 10.1309/AJCPNUTIPQTRRG0D

5. Nichols JH. Point of care testing. Clin Lab Med. 2007 Dec;27(4):893-908, viii. DOI: 10.1016/j.cll.2007.07.003

6. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, et al. Executive summary: guide-lines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2011 Jun;57(6):793-8. DOI: 10.1373/clinchem.2011.163634

7. Allardet-Servent J, Lebsir M, Dubroca C, Fabrigoule M, Jordana S, Signouret T, et al. Point-of-care versus central laboratory measurements of hemoglobin, he-matocrit, glucose, bicarbonate and electrolytes: a pro-spective observational study in critically ill patients. PloS one. 2017;12(1):e0169593. DOI: 10.1371/journal.pone.0169593

8. Mielsch C, Zimmermann A, Wagner D, Matthes B, Schlebusch H, Luppa PB. Point-of-care determination of neonatal bilirubin with the blood gas analyzer Rapid-Lab 1265. Clin Chem Lab Med. 2010 Oct;48(10):1455-61. DOI: 10.1515/CCLM.2010.279

9. Fujiwara R, Haag M, Schaeffeler E, Nies AT, Zanger UM, Schwab M. Systemic regulation of bilirubin ho-meostasis: potential benefits of hyperbilirubinemia. Hepatology. 2018;67(4):1609-19. DOI: 10.1002/hep.29599

10. Gazzin S, Vitek L, Watchko J, Shapiro SM, Tiribelli C. A novel perspective on the biology of bilirubin in health and disease. Trends Mol Med. 2016 Sep;22(9):758-68. DOI: 10.1016/j.molmed.2016.07.004

11. Chee Y, Chung PH, Wong RM, Wong KK. Jaundice in infants and children: causes, diagnosis, and management. Hong Kong Med J. 2018;24(3):285-92. DOI: 10.12809/hkmj187245

12. Ng MCW, How CH. When babies turn yellow. Singapore Med J. 2015;56(11):599. DOI: 10.11622/smedj.2015167

13. Lano IM, Lyon AW, Wang L, Ruskin R, Lyon ME. Comparative evaluation of neonatal bilirubin using Radiometer whole blood co-oximetry and plasma bilirubin methods from Roche Diagnostics and Ortho Clinical Diagnostics. Clin biochem. 2018;53:88-92. DOI: 10.1016/j.clinbiochem.2017.12.009

14. Doumas BT, Poon Pat K-C, Perry BW. Candidate reference method for determination of TB in serum: Development and validation. Clin Chem. 1985;31(11):1779-89.

15. Tiker F, Gurakan B, Tarcan A. Serum bilirubin levels in 1-month-old, healthy, term infants from southern Turkey. Ann Trop Paediatr. 2002 Sep;22(3):225-8. DOI: 10.1179/027249302125001606

16. Burnett R, Covington A, Fogh-Andersen N, Külpmann W, Maas A, Müller-Plathe O, et al., editors. International Federation of Clin Chem (IFCC). Scientific Division. Committee on pH, Blood Gases and Electrolytes. Approved IFCC recommendations on whole blood sampling, transport and storage for simultaneous determination of pH, blood gases and electrolytes. European journal of Clin Chem and clinical biochemistry: journal of the Forum of European Clin Chem Societies; 1995.

17. Lum G, Gambino SR. A comparison of serum versus heparinized plasma for routine chemistry tests. Am J Clin Pathol. 1974 Jan;61(1):108-13. DOI: 10.1093/ajcp/61.1.108

18. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10. DOI: 10.1016/S0140-6736(86)90837-8

19. Cornbleet PJ, Gochman N. Incorrect least-squares regression coefficients in method-comparison analysis. Clin Chem. 1979;25(3):432-8.

20. Grohmann K, Roser M, Rolinski B, Kadow I, Müller C, Goerlach-Graw A, et al. Bilirubin measurement for ne-onates: comparison of 9 frequently used methods. Pediatrics. 2006;117(4):1174-83. DOI: 10.1542/peds.2005-0590

21. Rosenthal P. Errors in neonatal bilirubin measurement. Clin Chem. 1996;42(11):1880-1.

22. Mussavi M, Niknafs P, Bijari B. Determining the correlation and accuracy of three methods of measuring neonatal bilirubin concentration. Iran J Pediatr. 2013 Jun; 23(3):333–39.

23. Uyanik M, Sertoglu E, Kayadibi H, Tapan S, Serdar MA, Bilgi C, et al. Comparison of blood gas, electrolyte and metabolite results measured with two different blood gas analyzers and a core laboratory analyzer. Scand J Clin Lab Invest. 2015 Apr;75(2):97-105. DOI: 10.3109/00365513.2014.981854

24. Hawkins RC. Laboratory turnaround time. Clin Biochem Rev. 2007 Nov;28(4):179-94.

25. Dimeski G, Barnett R. Effects of total plasma protein concentration on plasma sodium, potassium and chloride measurements by an indirect ion selective electrode measuring system. Crit Care Resuscitation. 2005;7(1):12.

26. Chow E, Fox N, Gama R. Effect of low serum total protein on sodium and potassium measurement by ion-selective electrodes in critically ill patients. British J Biomed Sci. 2008;65(3):128-31. DOI: 10.1080/09674845.2008.11732815

27. Peake M, Mazzachi B, Fudge A, Bais R. Bilirubin measured on a blood gas analyser: a suitable alternative for near-patient assessment of neonatal jaun-dice? Ann Clin Biochem. 2001;38(5):533-40. DOI: 10.1177/000456320103800511

28. Rolinski B, Küster H, Ugele B, Gruber R, Horn K. TB measurement by photometry on a blood gas analyzer: potential for use in neonatal testing at the point of care. Clin Chem. 2001;47(10):1845-7.

29. Nuran Ö, Ataman K, Armağan E, SERT ÇP, BALCI AK, Taylan İ. Acil serviste kan gazı değerlerinin biyokimyasal değerler yerine kullanılabilirliği. Gaziantep Med J. 2012;18(3):155-9.

30. Bozkurt S, Altunören O, Kurutaş E, Doğan M. Venöz kan gazı potasyum sonuçları ile laboratuar potasyum sonuçlarının karşılaştırılması. JAEM. 2012;11(2):73-6. DOI: 10.5152/jaem.2012.02

31. Story DA, Poustie S. Agreement between two plasma bicarbonate assays in critically ill patients. Anaesth Intensive Care. 2000 Aug;28(4):399-402.

32. Kelly AM, McAlpine R, Kyle E. Agreement between bicarbonate measured on arterial and venous blood gases. Emerg Med Australas. 2004 Oct-Dec;16(5-6):407-9.

33. Wongyingsinn M, Suksuriyayothin S. Use of rapid ABG analyzer in measurement of potassium concentration: does it agree with venous potassium concentration? J Med Assoc Thai. 2009 Jul;92(7):925-9.

34. Nambara T, Katayama Y, Enomoto M, Kikuchi S, Takei A, Ikegami H, et al. Reliability of TB Measurements in Whole Blood from Preterm Neonates Using a Blood Gas Analyzer. Clin Lab. 2016;62(11):2285-9.

Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

Journal Information


IMPACT FACTOR 2018: 0,800
5-year IMPACT FACTOR: 0,655



CiteScore 2017: 0.31

SCImago Journal Rank (SJR) 2018: 0.194
Source Normalized Impact per Paper (SNIP) 2018: 0.306

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 74 74 26
PDF Downloads 64 64 15