Automated total and neonatal bilirubin values in newborns: Is a distinction clinically relevant?

M. E. Langbaum, S. J. Farber, P. Rosenthal

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Guidelines for managing hyperbilirubinemia in newborns were developed by using diazo methods that measure total and direct-reacting bilirubins and calculate an indirect fraction. The automated Kodak Ektachem system allows for measuring serum bilirubin by either of two dry-slide methods: TBIL, involving a modified diazo method, and NBIL, involving a dual-wavelength colorimetric method that fractionates and directly measures the unconjugated (Bu) and conjugated (Bc) bilirubins (Bu + Bc = neonatal bilirubin). The manufacturer recommends that NBIL be used in newborns <15 days old, which is impractical in a large, busy hospital laboratory. We compared NBIL and TBIL in 500 paired serum samples from infants <15 days old. We noted a statistically significant difference between TBIL and NBIL values (162.9, SD 70.4, vs 164.6, SD 69.2, μmol/L; P <0.0001), which was small and of no clinical significance. We conclude that TBIL values may be used with caution for newborn bilirubin screening. Furthermore, NBIL measurements are an acceptable alternative to diazo measurements for neonatal care, allowing the use of previously developed guidelines with NBIL values.

Original languageEnglish (US)
Pages (from-to)1690-1693
Number of pages4
JournalClinical chemistry
Issue number9
StatePublished - 1992
Externally publishedYes


  • multilayer analysis
  • pediatric chemistry

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical


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