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. 2020 Jan 23;39(2):171-177.
doi: 10.2478/jomb-2019-0030.

Newborns bilirubin concentration determined by different methods in relation to hematocrit and albumin level

Joanna Berska  1 , Jolanta Bugajska  1 , Krystyna Sztefko  1
Affiliations

Newborns bilirubin concentration determined by different methods in relation to hematocrit and albumin level

Joanna Berska et al. J Med Biochem. .

Abstract
in English, Serbian

Background: Monitoring of bilirubin is essential during early neonatal life. Bilirubin in high concentration is toxic to the brain and might cause irreversible neurological damage. Several different methods for bilirubin determination are available nowadays, but inconsistent results may be obtained. The study aimed to compare dry chemistry methods with vanadate oxidation method for bilirubin determination in relation to hematocrit and albumin level in neonates and infants.

Methods: The study included 98 consecutive serum samples from newborns and infants (47 boys and 51 girls, mean age 19 ± 15 days) treated in the University Children's Hospital in Krakow. Total bilirubin (TBil) and neonatal bilirubin (NBil) concentration were measured by dry chemistry analyser (Vitros 4600, Ortho Clinical Diagnostics Inc.). Total bilirubin (TBilV) was also measured using vanadate oxidation method (Cormay, Poland). Albumin concentration and blood morphology have been routinely determined in all children.

Results: No significant differences between the mean value of NBil (69.00 ± 67.76 μmol/L), TBil (81.26 ± 70.13 μmol/L) and TBilV (75.90 ± 60.62 μmol/L) were noticed. High coefficient correlation between NBil and TBil as well as between NBil and TBilV were noticed (Pearson's analysis, r = 0.99, r = 0.97, respectively; p < 0.0001 in both cases). There was a positive correlation between the difference (TBilV - NBil) and hematocrit (p < 0.009, r = 0.2664).

Conclusions: In newborns and infants the same method for bilirubin determination should be used when the concentration of bilirubin is monitored. When using vanadate oxidation method for bilirubin determination, hematocrit value should be taken into account when results are interpreted.

Uvod: Praćenje bilirubina je neophodno tokom ranog neonatalnog perioda. Bilirubin u visokoj koncentraciji je toksičan za mozak i može izazvati nepovratna neurološka oštećenja. Danas imamo nekoliko metoda za određivanje bilirubina, ali se mogu dobiti nedosledni rezultati. Cilj istraživanja bio je da se uporede suve hemijske metode sa metodom oksidacije vanadata za određivanje bilirubina u odnosu na nivo hematokrita i albumina kod novorođenčadi i odojčadi.

Metode: Studija je obuhvatila 98 uzastopnih uzoraka seruma novorođenčadi i odojčadi (47 dečaka i 51 devojčica, prosečne starosti 19 ± 15 dana), koji su lečena u Univerzitetskoj dečjoj bolnici u Krakovu. Ukupni bilirubin (TBil) i koncentracija neonatalnog bilirubina (NBil) mereni su suvim hemijskim analizatorom (Vitros 4600, Ortho Clinical Diagnostics Inc.). Ukupni bilirubin (TBilV) je takođe meren korišćenjem metode oksidacije vanadata (Cormay, Poljska). Koncentracija albumina i morfologija krvi rutinski su određivani kod sve dece.

Rezultati: Nisu uočene značajne razlike između srednje vrednosti NBila (69,00 ± 67,76 mmol/L), TBil (81,26 ± 70,13 mmol/L) i TBilV (75,90 ± 60,62 mmol/L). Uočena je visoka korelacija između NBil i TBil, kao i između NBil i TBilV (Personova analiza, r = 0,99, r = 0,97, redom; p < 0,0001 u oba slučaja). Postoji pozitivna korelacija između razlike (TBilV - NBil) i hematokrita (p < 0,009, r = 0,2664).

Zaključak: Treba korisititi isti metod praćenja koncentacije bilirubina kod novorođenčadi i odojčadi. Kada se koristi metoda oksidacije vanadata za određivanje bilirubina, treba uzeti u obzir vrednost hematokrita pri interpretiranju rezultata.

Keywords: albumin; bilirubin; diazo method; hematocrit; newborns; vanadate oxidation method.

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Conflict of interest statement

Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1. The correlation between NBil and TBil (A) and NBil and TBilV (B).
NBil – neonatal bilirubin; TBil – total bilirubin; TBilV – total bilirubin measured by vanadate oxidation method
Figure 2
Figure 2. The Bland-Altman plots for the differences between TBil and NBil (A) and TBilV and NBil (B)
Solid lines in Figure 2 represent a trend; it is statistically significant (p < 0.0001) only for the difference (TBilV - NBil) and average values between them. (TBil – total bilirubin; NBil – neonatal bilirubin; TBilV – total bilirubin measured by vanadate oxidation method)
Figure 3
Figure 3. The correlation between the difference (TBil - NBil) and hematocrit (A) and the difference (TBilV – NBil) and hematocrit (B)
TBil – total bilirubin; NBil – neonatal bilirubin; TBilV – total bilirubin measured by vanadate oxidation method
Figure 4
Figure 4. The correlation between the difference (TBil - NBil) and albumin (A) and the difference (TBilV - NBil) and albumin (B)
TBil – total bilirubin; NBil – neonatal bilirubin; TBilV – total bilirubin measured by vanadate oxidation method
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