Bilirubin is a product of the hemoglobin catabolism that occurs principally in the spleen where red cells (that contain hemoglobin) are sequestered at the end of their approximate 120-day life. Bilirubin is transported in blood from the spleen to the liver where it is eliminated from the body in bile. Serum bilirubin...

Phototherapy, the standard treatment for neonatal jaundice, is guided by age-related serum bilirubin concentration; the older the baby, the higher is the recommended triggering serum bilirubin concentration. So that for example, UK guidelines state that for a full-term baby who is 12 hours old, phototherapy should be ...

Bilirubin is a waste product of hemoglobin catabolism that is excreted via the liver in bile.  Abnormal accumulation of this yellow pigment in blood results in jaundice. For adults and children, increased serum bilirubin and resulting jaundice is most commonly a signal of liver or biliary-tract disease; whilst for...

Emergency Department (ED) overcrowding is becoming an increasingly international issue.  Although the problem is not only resolved by ED change management (but rather requires a system-wide solution recognizing the complex interdependencies of consumer expectations, human resources, information systems immaturity and...

Serum bilirubin estimation, which has for some years now been available on point-of-care analyzers, including blood gas analyzers, is probably the most frequently requested blood test in neonatal medicine.  This is because increased serum/plasma bilirubin concentration (hyperbilirubinemia) and consequent jaundice is...

Increased serum bilirubin, clinically manifest as jaundice, is very common during the first week of life, affecting around 60 % of full-term babies and 85 % of babies born prematurely. For the vast majority this neonatal jaundice is a mild transitory phenomenon with no long-term consequences. The greatest fear...

The process of patient sample testing, whether performed in the clinical laboratory or at the point of care, is the sum of three distinct phases. The first is the preanalytical phase, which includes test selection as well as sample collection and handling.  The second is the analytical or measuring phase that...

Critical values are those associated with imminent danger unless acted upon promptly. Critical value menus often include results that do not fit this definition, leading to highly variable practice in adult and pediatric laboratories. Existing menus may be subdivided into more uniform tiers of severity: the highly...

Neonatal jaundice is the subject of two recent studies and an accompanying editorial, all published in the October issue of Archives of Disease in Childhood (Neonatal Edition). The aim of the first study was to determine if visual assessment of jaundice on day 2-3 of life is accurate in estimating serum bilirubin and...

All newborn babies have, by comparison with adults, a raised serum concentration of unconjugated (and therefore total) bilirubin, due principally to the transient increase in red cell destruction associated with the move from intrauterine support to physiological independence.  In close to half of all newborns the...