Assessment of neonatal hyperbilirubinemia using GEM premier 4000 total bilirubin assay: Impact on risk classification?

Shunyou Gong, Lois Schultz, Linda M. Sandhaus, Christine L. Schmotzer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The American Academy of Pediatrics recommends measurement of total bilirubin (TBili) in newborns to assess the risk of developing severe neonatal hyperbilirubinemia and bilirubin-induced neurologic dysfunction. In this study, we evaluated the correlation of whole blood TBili results measured on a blood gas analyzer to serum results obtained on an automated chemistry analyzer. In addition, we determined the concordance of hyperbilirubinemia risk classification between the 2 methods. Seventy-nine blood samples were collected. The TBili (mg/dL) was measured on whole blood using the Instrumentation Laboratories GEM 4000 (GEM) and on simultaneously collected serum samples on the Siemens Dimension Vista chemistry analyzer (Vista). Twenty-four infants, aged younger than 7 days, were classified into categories for risk of sequelae of severe hyperbilirubinemia using an established postnatal hour-specific nomogram. GEM results showed a mean bias of +0.55 mg/dL compared with Vista. Eight (33%) of 24 infants were assigned different risk grades by the GEM; 4 were assigned higher risk grades, and 4 had lower risk grades; only 1 infant?€™s risk status was changed by more than 1 grade. Therefore, although the GEM method shows good overall agreement with the Vista chemistry analyzer in measurement of TBili levels, assignment of clinical risk categories may differ by the 2 methods.

Original languageEnglish (US)
Pages (from-to)148-151
Number of pages4
JournalPoint of Care
Volume13
Issue number4
DOIs
StatePublished - Dec 12 2014

Keywords

  • GEM Premier 4000
  • Neonatal hyperbilirubinemia
  • Point-of-care testing
  • Risk stratification

ASJC Scopus subject areas

  • Nursing(all)

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