Jonathan
Requests for biblrubin assays from non neonatal wards are analysed on the
Roche Modular for total bilirubin and on the Roche Integra for direct
bilirubin. Approximately 175 uL of serum is required for both assays.
Best wishes
John Fry
> ----------
> From: Jonathan Kay[SMTP:[log in to unmask]]
> Reply To: ACB Point of Care Testing List
> Sent: 19 November 2002 16:23
> To: [log in to unmask]
> Subject: Re: Bilirubinometers
>
> Using the blood gas analysers is attractive. How do you handle the
> requests for bilirubin analysis that come from sources other than the
> neonatal unit? Have a blood gas analyser in the laboratory, or some
> other approach?
>
> Dr Jonathan Kay
>
>
> On Friday, November 15, 2002, at 05:43 PM, Fry, John wrote:
>
> > All samples on SCBU that are analysed for blood gases automatically
> > have a
> > bilirubin result. Yes, the problem was I believe in one of the
> > mathematical
> > formulae used to 'produce' a bilirubin result.
> >
> > Prior to purchasing this machine, we did look at a number of
> > 'bilirubinometers' but, since the blood gas machine on SCBU was
> > almost due
> > for replacement, combining the two instruments was the most cost and
> > clinically effective method of progress.
> >
> > John Fry
> >> ----------
> >> From: PETER HOWELL[SMTP:[log in to unmask]]
> >> Reply To: ACB Point of Care Testing List
> >> Sent: 15 November 2002 15:34
> >> To: [log in to unmask]
> >> Subject: Re: Bilirubinometers
> >>
> >> Hi John
> >>
> >> The potential 'controversy' was over the performance of bilirubin on
> >> the
> >> analyser, not the use of the analyser for one-off bilirubin
> >> measurements.
> >> This would not seem to be apparent from your experience, but I
> >> remember
> >> some doubts from somewhere. I'll search my 'memory banks' !
> >> Would your SCBU staff use the blood gas analyser to do JUST a
> >> bilirubin,
> >> or would they measure blood gases/electrolytes at the same time, even
> >> if
> >> the baby didnt require them ?
> >> Do you see what I mean ??
> >>
> >> Peter
> >>
> >>
> >>> -----Original Message-----
> >>> From: Fry, John [SMTP:[log in to unmask]]
> >>> Sent: 15 November 2002 15:30
> >>> To: [log in to unmask]
> >>> Subject: Re: Bilirubinometers
> >>>
> >>> As far as the analytical side goes, our NEQAS returns are good, as is
> >> the
> >>> correlation with the main analysers in the department. Neither the
> >> technical
> >>> staff or myself are aware of the controversy you have mentioned
> >> regarding
> >>> one off bilirubin in sick neonates.
> >>>
> >>> John Fry
> >>> Clinical Biochemist
> >>>
> >>>> ----------
> >>>> From: PETER HOWELL[SMTP:[log in to unmask]]
> >>>> Reply To: ACB Point of Care Testing List
> >>>> Sent: 15 November 2002 13:18
> >>>> To: [log in to unmask]
> >>>> Subject: Re: Bilirubinometers
> >>>>
> >>>> Isn't there some 'controversy' about how good these analysers are at
> >>>> measuring bilrubin ??
> >>>>
> >>>> And its OK if you are also measuring blood gases/ electrolytes at
> >>>> the
> >> same
> >>>> time, but not really for just a one-off bilirubin on a 'well' baby.
> >>>>
> >>>> Peter
> >>>>
> >>>> Peter Howell
> >>>> Head Biomedical Scientist
> >>>> Medical Biochemistry Department
> >>>> Wrexham Maelor Hospital
> >>>> Wrexham
> >>>>
> >>>>
> >>>>> -----Original Message-----
> >>>>> From: Fry, John [SMTP:[log in to unmask]]
> >>>>> Sent: 15 November 2002 13:16
> >>>>> To: [log in to unmask]
> >>>>> Subject: Re: Bilirubinometers
> >>>>>
> >>>>> One possible answer is to purchase one of the Radiometer 7 series
> >> blood
> >>>> gas
> >>>>> analysers which incorporates an analytical uniit for bilirubin
> >> assays on
> >>>> the
> >>>>> whole blood sample. Centrifugation of capillary samples is then a
> >> part
> >>>> of
> >>>>> history.
> >>>>>
> >>>>> John Fry
> >>>>> Worthing Hospital
> >>>>>
> >>>>>> ----------
> >>>>>> From: Evans, Francis -
> >>>> RCHT[SMTP:[log in to unmask]]
> >>>>>> Reply To: ACB Point of Care Testing List
> >>>>>> Sent: 15 November 2002 11:58
> >>>>>> To: [log in to unmask]
> >>>>>> Subject: Re: Bilirubinometers
> >>>>>>
> >>>>>> I have been concerned for 'ages' about the infection risk involved
> >> in
> >>>>>> spinning capillaries for bilirubins in our SCBU laboratory. We do
> >>>> have a
> >>>>>> separate lab to contain the gas analyser and bilirubinometer but
> >> the
> >>>>>> aerosol
> >>>>>> problem when capillaries leak and eject their contents is of
> >>>> considerable
> >>>>>> concern. I have not been able to get any manufacturer to supply a
> >>>>>> properly
> >>>>>> sealed rotor to contain spills.
> >>>>>>
> >>>>>> I would also be interested to hear other views on suitable
> >>>> alternatives.
> >>>>>>
> >>>>>> Francis Evans
> >>>>>> Chief BMS
> >>>>>> Clinical Chemistry
> >>>>>> Royal Cornwall Hospitals Trust
> >>>>>> Truro TR1 3LJ
> >>>>>>
> >>>>>>
> >>>>>>
> >>>>>> -----Original Message-----
> >>>>>> From: Paul Eldridge [mailto:[log in to unmask]]
> >>>>>> Sent: Friday, November 15, 2002 10:05
> >>>>>> To: [log in to unmask]
> >>>>>> Subject: Bilrubinometers
> >>>>>>
> >>>>>>
> >>>>>> I have sent this to both the POCT list and ACB clin chem list.
> >>>> Apologies
> >>>>>> to those who get it twice.
> >>>>>> Two problems/questions:
> >>>>>> 1. Infection in ward areas by centrifuges.
> >>>>>> It has been reported by a new paediatric doctor here that
> >>>>>> bilirubinometers have been removed from wards in 2 SW London
> >> hospitals
> >>>>>> because of infection risks from the centrifuges used to spin down
> >> the
> >>>>>> capillary tubes.
> >>>>>> Have others experienced this problem?
> >>>>>> Is there a centrifuge available that can be sealed?>
> >>>>>> Is there any good experience with non invasive bilirubin
> >> measurements?
> >>>>>>
> >>>>>> 2. We recently replaced our TIME ward bilirubinometer with the
> >> Digital
> >>>>>> Analogue Systems NEO BIL instrument distributed by Schuco in the
> >> UK.
> >>>> It
> >>>>>> very simple to operate by the ward staff but cannot be calibrated
> >> by
> >>>> the
> >>>>>> lab. It has a non linear response noted by positive bias below 300
> >> and
> >>>>>> negative above this level. This has been shown by studies on EQAS
> >>>>>> samples and our dilution studies.
> >>>>>> Do others have the problem and how do you overcome it ?
> >>>>>>
> >>>>>> Many thanks in advance.
> >>>>>>
> >>>>>>
> >>>>>> Dr Paul H Eldridge
> >>>>>> Clinical Biochemist
> >>>>>> University Hospital Lewisham
> >>>>>> London SE13 6LH
> >>>>>> UK
> >>>>>> Phone: (44) 020 8333 3255
> >>>>>> Fax: (44) 020 8690 8891
> >>>>>>
> >>>>>>
> >>>>>> [log in to unmask]
> >>>>>>
> >>>>>>
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