Abstract Background Neonatal jaundice is a common condition characterized by elevated bilirubin levels in newborns. Since bilirubin is a photolabile analyte, delays in transporting blood samples can lead to inaccurate results. With a change in blood collection tube, from heparinized capillary tubes (SafeCap®, USA) to Microcuvette® 200 Lithium Heparin LH tubes (Sarstedt, Germany), blood samples for neonatal bilirubin were sent with blood tube labelled with specimen label only. A new in-house transport container, repurposed from urine dipstick container, was implemented to protect the sample from light. This study aims to assess whether the specimen label alone provides adequate protection from light, or if a transport container is required. Methods Twenty blood samples with neonatal bilirubin concentrations ranging from 63 to 390 µmol/L were collected in Lithium Heparin tubes (Becton Dickinson, USA). These were concurrently transferred into Microcuvette® 200 Lithium Heparin LH tubes. The samples were subjected to different transport conditions: with or without a transport container, and with tubes either fully or half-wrapped with specimen label. The samples were centrifuged at 2853 g for 5 minutes at 1-, 4- and 6-hours intervals, followed by plasma neonatal bilirubin measurements using Reichert® UNISTAT Bilirubinometer. Results Neonatal bilirubin measurements for samples at 1-, 4-, and 6-hours were compared against 0-hour samples. The average percentage difference in neonatal bilirubin concentration for samples sent with transport containers were 1.0%, 0.9%, and 1.1% respectively. For samples sent with specimen label but without transport containers, the percentage differences were -0.5%, -2.9%, and -3.8% respectively. For samples that were half-wrapped with a specimen label but without container, the percentage differences were 0.8%, -3.9%, and -4.4% respectively. All neonatal bilirubin differences calculated at different time intervals were within The Royal College of Pathologists of Australasia Quality Assurance Program Chemical Pathology Allowable Performance Specifications 2022 (± 8 = 80 µmol/L and ± 10% 80 µmol/L). Neonatal bilirubin levels in samples transported with containers remained stable for up to 6 hours. Samples sent without transport containers showed a greater degree of neonatal bilirubin degradation between 4 to 6 hours. Conclusion These results demonstrated that specimen labels alone were insufficient in protecting neonatal bilirubin samples from photodegradation, hence the use of transport containers is recommended. The use of this transport container can also be expanded to transporting other photolabile analytes to the laboratory.
Goh et al. (Wed,) studied this question.
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