Affiliation:
1. Department of Neonatology with Intensive Care, University Hospital Merkur, Zagreb, Croatia
2. Department of Medical Biochemistry and Laboratory Medicine, University Hospital Merkur, Zagreb, Croatia
Abstract
Graphical abstract
Highlights
• Referent persons were selected using the direct a posteriori sampling method
• Nineteen most commonly used biochemical assays on Beckman Coulter AU680
• Harmonized reference intervals are suitable for most assays
• De novo reference intervals for potassium, magnesium and direct bilirubin were determined
IntroductionThis study aimed to examine whether the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) reference intervals for 19 commonly used biochemical assays (potassium, sodium, chloride, calcium, magnesium, inorganic phosphorous, glucose, urea, creatinine, direct and total bilirubin, C-reactive protein (CRP), total protein, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and lactate dehydrogenase (LD)) could be applied to the newborn population of one Croatian clinical hospital.
Materials and methodsReference interval verification was performed according to the CLSI EP28-A3c guidelines. Samples of healthy newborns were selected using the direct a posteriori sampling method and analyzed on the Beckman Coulter AU680 biochemical analyzer. If verification wasn’t satisfactory, further procedure included de novo determination of own reference intervals by analyzing 120 samples of healthy newborns.
ResultsAfter the first set of measurements, 14/19 tested reference intervals were adopted for use: calcium, inorganic phosphorous, glucose, urea, creatinine, total bilirubin, CRP, total protein, albumin, AST, ALT, GGT, ALP and LD. A second set of samples was tested for 5 analytes: potassium, sodium, chloride, magnesium and direct bilirubin. The verification results of the additional samples for sodium and chloride were satisfactory, while the results for potassium, magnesium and direct bilirubin remained unsatisfactory and new reference intervals were determined.
ConclusionsThe CALIPER reference intervals can be implemented into routine laboratory and clinical practice for the tested newborn population for most of the analyzed assays, while own reference intervals for potassium, magnesium and direct bilirubin have been determined.
Publisher
Croatian Society for Medical Biochemistry and Laboratory Medicine
Reference16 articles.
1. Reference intervals: current status, recent developments and future considerations.;Ozarda;Biochem Med (Zagreb),2016
2. Reference intervals: past, present, and future.;Doyle;Crit Rev Clin Lab Sci,2023
3. Pediatric reference intervals for biochemical markers: gaps and challenges, recent national initiatives and future perspectives.;Tahmasebi;EJIFCC,2017
4. The Canadian laboratory initiative on pediatric reference intervals a CALIPER white paper.;Adeli;Crit Rev Clin Lab Sci,2017