Evaluation of lithium determination in three analyzers: flame emission, flame atomic absorption spectroscopy and ion selective electrode.
BACKGROUND
Lithium carbonate salt has become an increasingly important substance in the treatment of manic depressive disorders, and its relatively narrow therapeutic range has caused laboratories to monitor the serum concentration carefully. In the present work we evaluated lithium measurement in 3 different analyzers.  METHODS #ENTITYSTARTX00026;


METHODS
Three different analyzers including Flame Emission (FES), Flame Atomic Absorption Spectroscopy (FAAS), and Ion Selective Electrode (ISE) were used. All chemicals had a grade suitable for trace metal analysis.


RESULTS
Within-day precision of CV was ≤ 1.5% for FES & FAAS, except for ISE (1.9% CV). Between-days precision of CV was less for FES than for FAAS and ISE (1.3% versus 2.2% & 2.3%). The percent recovery of added lithium in pooled patients' serum was higher for ISE than for FASS and FES (103.4% versus 96.2% and 94.6%). We also obtained a higher average lithium concentration for patients' serum samples (n=16) measured by ISE than for FAAS and FES (0.825±0.30 versus 0.704±0.26 & 0.735±0.19). Paired t-test results revealed a significant difference (p< 0.001) for patient sera analyzed with FAAS and ISE.


CONCLUSIONS
We report higher results for ISE than the other two analyzers and conclude that the choice between the two flame methods for patients' serum lithium determination is arbitrary and that FES analyzer is a more attractive routine alternative for lithium determination than FAAS because of its cost and ease of performance. In addition, the results obtained by ISE are precise. However, its accuracy may depend on other interfering factors.
Department of Biochemistry, National Reference Laboratory, Ministry of Health and Medical Education of Iran, Tehran, Iran.
Mehri
M
Aliasgharpour
Hamid
H
Hagani