title: Development of an equation to correct for hemolysis in direct bilirubin measurements.
abstract: BACKGROUND
  Direct bilirubin is measured for the investigation of pediatric and adult jaundice. Package inserts suggest that hemolysis decreases direct bilirubin measurements, but no published studies have adequately described the extent of interference.
  
  
  METHODS
  The influence of hemolysis on direct bilirubin quantification (Beckman AU680) was evaluated by titrating increasing amounts of hemoglobin into specimens with variable starting concentrations of direct bilirubin. An equation was derived to predict the nominal interference-free concentration of direct bilirubin as a function of measured concentration and hemolysis-index.
  
  
  RESULTS
  Hemolysis decreased the direct bilirubin concentration reported by the AU680. The extent of interference is a function of both the interference-free concentration of direct bilirubin and the degree of hemolysis.
  
  
  CONCLUSIONS
  The concentration of direct bilirubin in hemolyzed specimens can be predicted.
authors.affiliation: Kaiser Permanente, TPMG Northern California Regional Laboratory, Berkeley, CA, United States.
authors.forename: Dina N
authors.initials: DN
authors.lastname: Greene
authors.affiliation: University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, BC, Canada.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Holmes
authors.affiliation: Kaiser Permanente, TPMG Northern California Regional Laboratory, Berkeley, CA, United States.
authors.forename: Maun-Jan
authors.initials: MJ
authors.lastname: Lin
authors.affiliation: Kaiser Permanente, TPMG Northern California Regional Laboratory, Berkeley, CA, United States.
authors.forename: Joy Y
authors.initials: JY
authors.lastname: Liang
authors.affiliation: Kaiser Permanente, TPMG Northern California Regional Laboratory, Berkeley, CA, United States.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lorey
authors.affiliation: University of Utah School of Medicine, Department of Pathology, Salt Lake City, UT, United States. Electronic address: Robert.Schmidt@hsc.utah.edu.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D016477:Artifacts; D001663:Bilirubin / Q000096:biosynthesis*; D003627:Data Interpretation, Statistical; D006461:Hemolysis; D006801:Humans
chemical_list: D001663:Bilirubin
keywords: Bilirubin; Hemolysis; Interference; Neonatal hyperbilirubinemia; Screening