Theoretical constraints in the measurement of serum bilirubin binding capacity

Ryall, Rosemary L.; Peake, M J

doi:10.1016/s0009-9120(82)90595-1

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Measuring B f directly proved elusive, however, and the early tests measuring plasma "saturation" with UCB (i.e., plasma UCB-binding capacity) ultimately proved unsuitable for routine clinical laboratory use (39,40 ). Ironically, by the time the peroxidase method for measuring B f finally arrived on the scene in 1974 (2 ), ABE had become a rare event in the newborn populations at greatest risk.…”

Section: Where's the B F ? A Brief Clinical History Of Abe B T Andmentioning

confidence: 99%

“…The test has been automated (60,61 ), requires small sample volumes (Ͻ100 L of serum or plasma), and is quantitative, rapid (2-3 min), and inexpensive. Because the method directly assays B f , the lower-affinity UCB-binding sites will not obscure test endpoints as they do with the binding tests that attempt to measure serum or plasma UCB binding capacity (29,39,40 ). A US Food and Drug Administration (FDA)-approved commercial spectrophotometer (UB-A1 Analyzer, Arrows Co Ltd) (62 ) provides automated readouts of B T (mg/dL) and B f (g/dL).…”

Section: The Peroxidase Test For Measuring B Fmentioning

confidence: 99%

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Unbound (Free) Bilirubin: Improving the Paradigm for Evaluating Neonatal Jaundice

et al. 2009

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Background: The serum or plasma total bilirubin concentration (BT) has long been the standard clinical laboratory test for evaluating neonatal jaundice, despite studies showing that BT correlates poorly with acute bilirubin encephalopathy (ABE) and its sequelae including death, classical kernicterus, or bilirubin-induced neurological dysfunction (BIND). The poor correlation between BT and ABE is commonly attributed to the confounding effects of comorbidities such as hemolytic diseases, prematurity, asphyxia, or infection. Mounting evidence suggests, however, that BT inherently performs poorly because it is the plasma non–protein-bound (unbound or free) bilirubin concentration (Bf), rather than BT, that is more closely associated with central nervous system bilirubin concentrations and therefore ABE and its sequelae. Content: This article reviews (a) the complex relationship between serum or plasma bilirubin measurements and ABE, (b) the history underlying the limited use of Bf in the clinical setting, (c) the peroxidase method for measuring Bf and technical and other issues involved in adapting the measurement to routine clinical use, (d) clinical experience using Bf in the management of newborn jaundice, and (e) the value of Bf measurements in research investigating bilirubin pathochemistry. Summary: Increasing evidence from clinical studies, clinical experience, and basic research investigating bilirubin neurotoxicity supports efforts to incorporate Bf expeditiously into the routine evaluation of newborn jaundice. .

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Section: Where's the B F ? A Brief Clinical History Of Abe B T Andmentioning

confidence: 99%