Comparison of neonatal reference intervals for 23 biochemical analytes in the cord blood-A single center study in South Korea.

Choi SJ, Lee S, Lee B, Jang JY, Cho J, Uh Y. Comparison of neonatal reference intervals for 23 biochemical analytes in the cord blood-A single center study in South Korea. Turk J Pediatr 2019; 61: 337-344. Reference intervals for laboratory tests are important in the diagnosis and treatment of disease. However, due to difficulty in recruiting sufficient numbers of reference subjects, studies regarding reference intervals for biochemical analytes in neonates is lacking. The aim of this study was to compare and validate the reference intervals for 23 biochemical analytes in the cord blood of neonates. From August to December 2017, 79 consecutive neonates born at the Wonju Severance Christian Hospital (Wonju, Korea) with C-reactive protein concentration less than 0.05 mg/dL were included in this study. All of 23 biochemical analytes were measured by the cobas 8000 c702 (Roche Diagnostics, Switzerland). Mean ± 2 standard deviations (SD) were calculated if the values were normally distributed, and median and the range of 2.5-97.5 percentile were described when the values were not normally distributed. We compared the neonatal reference intervals for 23 biochemical analytes. Alkaline phosphatase and gamma glutamyl transferase showed significant differences according to sex, and direct bilirubin revealed significant differences depending on the delivery mode. These compared reference intervals of 23 biochemical analytes will be useful for clinical decision-making in the management of neonates.

Development of an integrated reporting system for verifying hemolysis, icterus, and lipemia in clinical chemistry results.

BACKGROUND: Hemolysis, icterus, and lipemia (HIL) cause preanalytical interference and vary unpredictably with different analytical equipments and measurement methods. We developed an integrated reporting system for verifying HIL status in order to identify the extent of interference by HIL on clinical chemistry results. METHODS: HIL interference data from 30 chemical analytes were provided by the manufacturers and were used to generate a table of clinically relevant interference values that indicated the extent of bias at specific index values (alert index values). The HIL results generated by the Vista 1500 system (Siemens Healthcare Diagnostics, USA), Advia 2400 system (Siemens Healthcare Diagnostics), and Modular DPE system (Roche Diagnostics, Switzerland) were analyzed and displayed on physicians' personal computers. RESULTS: Analytes 11 and 29 among the 30 chemical analytes were affected by interference due to hemolysis, when measured using the Vista and Modular systems, respectively. The hemolysis alert indices for the Vista and Modular systems were 0.1-25.8% and 0.1-64.7%, respectively. The alert indices for icterus and lipemia were <1.4% and 0.7% in the Vista system and 0.7% and 1.0% in the Modular system, respectively. CONCLUSIONS: The HIL alert index values for chemical analytes varied depending on the chemistry analyzer. This integrated HIL reporting system provides an effective screening tool for verifying specimen quality with regard to HIL and simplifies the laboratory workflow.