Bilirubin measurements in neonates: uniform neonatal treatment can only be achieved by improved standardization.
Publication year
2024Source
Clinical Chemistry and Laboratory Medicine, 62, 10, (2024), pp. 1892-1903ISSN
Publication type
Article / Letter to editor
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Organization
Laboratory Medicine
Journal title
Clinical Chemistry and Laboratory Medicine
Volume
vol. 62
Issue
iss. 10
Page start
p. 1892
Page end
p. 1903
Subject
Laboratory Medicine - Radboud University Medical CenterAbstract
Measurement of total bilirubin (TBil) concentration in serum is the gold standard approach for diagnosing neonatal unconjugated hyperbilirubinemia. It is of utmost importance that the measured TBil concentration is sufficiently accurate to prevent under treatment, unnecessary escalation of care, or overtreatment. However, it is widely recognized that TBil measurements urgently require improvement in neonatal clinical chemistry. External quality assessment (EQA) programs for TBil assess for differences between laboratories and provide supporting evidence of significant differences between various methods, manufacturers and measurement platforms. At the same time, many countries have adopted or only slightly adapted the neonatal hyperbilirubinemia management guidelines from the USA or UK, often without addressing differences in the methodology of TBil measurements. In this report, we provide an overview of the components of bilirubin that are measured by laboratory platforms, the availability of current reference measurement procedures and reference materials, and the role of EQA surveys in this context. Furthermore, the current status of agreement in neonatal bilirubin against clinical decision thresholds is reviewed. We advocate for enhancements in accuracy and comparability of neonatal TBil measurements, propose a path forward to accomplish this, and reflect on the position of the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Working Group Neonatal Bilirubin (WG-NB) in this matter.
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- Academic publications [243859]
- Electronic publications [130593]
- Faculty of Medical Sciences [92795]
- Open Access publications [104904]
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