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Capillary and venous bilirubin values. Are they really different?
G I Leslie1, J B Philips, G Cassady
1Department of Pediatrics, University of Alabama, Birmingham.
American Journal of Diseases of Children (1960)
|November 1, 1987
Summary
Capillary blood samples may underestimate total serum bilirubin levels in jaundiced newborns, especially when levels exceed 170 mumol/L. For accurate clinical decisions, venous bilirubin measurements are recommended for elevated levels.
Area of Science:
- Neonatal Medicine
- Clinical Chemistry
Background:
- Jaundice is common in newborns.
- Accurate measurement of total serum bilirubin (TSB) is crucial for diagnosing and managing neonatal jaundice.
- Capillary blood sampling is a common method for TSB measurement.
Purpose of the Study:
- To compare TSB values obtained from paired capillary and venous samples in jaundiced newborns.
- To determine if capillary samples underestimate venous samples at higher TSB levels.
Main Methods:
- Paired capillary and venous blood samples were collected from 79 untreated jaundiced infants and 29 infants receiving phototherapy.
- Total serum bilirubin levels were measured and compared between the two sample types.
Main Results:
- TSB values from capillary and venous samples correlated significantly.
- Capillary samples underestimated venous TSB values when levels exceeded 170 mumol/L (10 mg/dL).
- Underestimation by capillary samples was clinically significant (over 17 mumol/L or 1 mg/dL) in a notable proportion of infants with elevated TSB.
Conclusions:
- Capillary blood sampling may lead to underestimation of TSB in jaundiced newborns, particularly at levels above 170 mumol/L.
- Given the potential for significant underestimation, venous sampling is recommended for TSB measurement when levels exceed 170 mumol/L to guide clinical decisions.