BILIRUBIN TOTAL&DIRECT

Stability of total bilirubin: Bilirubin Total: y = 1.091 x - 0.087 mg/dl

Cat. No. Pack Name Packaging (Content) 1 day at 1525C r = 0.992
7 days at 28C Bilirubin Direct: y = 1.029x + 0.037 mg/dl
BLT00011 BIL T&D 200 R1: 2x50 ml (BIT), R2: 2x50 ml (BID), R3: 1x6 ml 3 month at -20C r = 1.000
Stability of direct bilirubin: INTERFERENCES
EN IVD 2 days at 1525C Following substances do not interfere:
7 days at 28C Bilirubin Total: haemoglobin up to 7.5 g/l, triglycerides up to 1500 mg/dl.
INTENDED USE 3 month at -20C Bilirubin Direct: haemoglobin up to 10 g/l, triglycerides up to 1000 mg/dl.
Diagnostic reagent for quantitative in vitro determination of Total & Direct Bilirubin in human In case of immediate freezing.
serum and plasma. Freeze only once! WARNING AND PRECAUTIONS
Discard contaminated specimens. For in vitro diagnostic use. To be handled by entitled and professionally educated person.
CLINICAL SIGNIFICANCE Reagent 3 contains 1% sodium nitrite.
Bilirubin is a breakdown product of haemoglobin. Bilirubin formed in the reticulo endothelial sys- CALIBRATION Risk phrases (R): R 22 Harmful if swallowed.
tem is transported bound by albumin to the liver. This bilirubin is water insoluble and is known Xi
Calibration with the factor (see ASSAY PARAMETERS table) or with calibrator XL MULTICAL, Safety phrases (S): S 29 Do not empty into drains.
as indirect or unconjugated bilirubin. In the liver, bilirubin is conjugated to glucuronic acid to form Cat. No. XSYS0034 is recommended. S 36 Wear suitable protective clothing.
direct bilirubin. Conjugated bilirubin is excreted via the biliary system into the intestine. Here it is S 46 If swallowed seek medical advice immediately
metabolised by bacteria to urobilinogen and stercobilinogen. QUALITY CONTROL
For quality control ERBA NORM, Cat. No. BLT00080 and ERBA PATH, Cat. No. BLT00081 are and show this container or label.
TOTAL BILIRUBIN = INDIRECT BILIRUBIN + DIRECT BILIRUBIN
Total Bilirubin is elevated in obstructive conditions of the bile duct, hepatitis, cirrhosis, in haemoly- recommended. Harmful
tic disorders and several inherited enzyme deficiencies. UNIT CONVERSION WASTE MANAGEMENT
Indirect Bilirubin is elevated by pre-hepatic causes such as haemolytic disorders or liver diseases mg/dl x 16.95 = mol/l Please refer to local legal requirements.
resulting in impaired entry transport or conjugation within the liver. Monitoring of indirect bilirubin
in neonates is of special importance as it is the indirect (or free) bilirubin bound to albumin that EXPECTED VALUES 3 ASSAY PROCEDURE
is able to cross the blood brain barrier more easily increasing the danger of cerebral damage. TOTAL BILIRUBIN: Wavelength 546/630 (670) nm
Adults: 0 2.0 mg/dl Cuvette 1 cm
PRINCIPLE
Cord < 2 mg/dl
Modified method of Pearlman & Lee in which a surfactant is used as a solubilizer. Reagent blank Standard (Cal.) Sample
Newborns, premature:
Bilirubin glucuronate reacts directly with sulphodiazonium salt and forms coloured derivative
0 1 d 1.0 8.0 mg/dl Working reagent 0.500 ml 0.500 ml 0.500 ml
azobilirubin. The colour intensity of formed azobilirubin measured at 540 - 550 nm is proportio-
1 2 d 6.0 12.0 mg/dl Sample - - 0.025 ml
nal to direct bilirubin concentration in the sample.
3 5 d 10.0 14.0 mg/dl
REAGENT COMPOSITION Newborns, full term: Standard (Cal.) - 0.025 ml -
R1 0 1 d 2.0 6.0 mg/dl Distilled water 0.025 ml - -
Sulphanilic Acid 4.62 mmol/l 1 2 d 6.0 10.0 mg/dl Mix and incubate 5 min. at 37 C. Measure absorbance of the sample Asam and standard Ast
HCl 117.6 mmol/l 3 5 d 4.0 8.0 mg/dl against reagent blank.
Cetrimide 27.44 mmol/l
DIRECT BILIRUBIN:
R2 CALCULATION
Adults and infants: 0 0.2 mg/dl
Sulphanilic Acid 14.61 mmol/l Asam
It is recommended that each laboratory verify this range or derives reference interval for
HCl 117.6 mmol/l 1. Total & Direct Bilirubin (mg/dl) = x Ccal Ccal = calibrator concentration
the population it serves.
R3 Ast
Sodium Nitrite 145 mmol/l PERFORMANCE DATA 2. Using factor:
REAGENT PREPARATION Data contained within this section is representative of performance on ERBA XL systems. Data Total & Direct Bilirubin (mg/dl) = f x A
obtained in your laboratory may differ from these values. f = factor (see ASSAY PARAMETERS table)
Volume of working Add Measuring range Bilirubin Total: 0.08 23 mg/dl Applications for automatic analysers are available on request.
Test
Reagent Reagent 1 Reagent 2 Reagent 3
Intra-assay precision Mean SD CV ASSAY PARAMETERS FOR PHOTOMETERS
10 ml 10 ml 0.2 ml Within run (n=20) (mg/dl) (mg/dl) (%)
Parameter Bilirubin Total Bilirubin Direct
Bilirubin 25 ml 25 ml 0.5 ml Sample 1 1.58 0.015 0.93
Mode End Point End Point
Total 50 ml 50 ml 1.0 ml Sample 2 3.90 0.035 0.90
Wavelength 1 (nm) 546 546
100 ml 100 ml 2.0 ml
Inter-assay precision Mean SD CV Wavelength 2 (nm) 630 (670) 630 (670)
Volume of working Add Run to run (n=20) (mg/dl) (mg/dl) (%) Sample Volume (l) 25/50 25/50
Test
Reagent Reagent 1 Reagent 2 Reagent 3 Sample 1 1.36 0.023 1.67 Working Reagent Volume (l) 500/1000 500/1000
10 ml 10 ml 0.1 ml Sample 2 5.23 0.068 1.31 Incubation time (min.) 5 5
Bilirubin 25 ml 25 ml 0.25 ml Incubation temp. (C) 37 37
Measuring range Bilirubin Direct: 0.18 23 mg/dl
Direct 50 ml 50 ml 0.5 ml Normal Low 0 0
Intra-assay precision Mean SD CV
100 ml 100 ml 1.0 ml Normal High 2 0.2
Within run (n=20) (mg/dl) (mg/dl) (%)
Linearity Low 0 0
WORKING REAGENT STABILITY Sample 1 9.18 0.23 2.45
Linearity High 20 20
The working Total & Direct Bilirubin reagents are stable for 7 days at 28C, when protected Sample 2 15.12 0.32 2.10
from contamination and light. It is recommended to prepare fresh working solution before assay Factor 23 (21)* 17 (14)*
is performed. Inter-assay precision Mean SD CV Blank with Reagent Reagent
STABILITY AND STORAGE Run to run (n=20) (mg/dl) (mg/dl) (%)
Absorbance limit (max.) 0.2 0.2
The unopened reagents are stable till the expiry date stated on the bottle and kit label when Sample 1 2.54 0.10 3.78
Units QUALITY
mg/dl SYSTEM CERTIFIED
mg/dl
stored at 28C. Sample 2 0.78 0.03 3.37 * 23 at 546ISO 9001 ISO
/ 630 * 17 13485
at 546 / 630
SPECIMEN COLLECTION AND HANDLING COMPARISON 21 at 546 / 670 14 at 546 / 670
Use unheamolytic serum or plasma (heparin, EDTA). A comparison between XL-Systems Bilirubin Total & Direct (y) and a commercially available
It is recommended to follow NCCLS procedures (or similar standardized conditions). test (x) using 40 samples gave following results: Erba Lachema s.r.o., Karsek 1d, 621 00 Brno, CZ
e-mail: diagnostics@erbalachema.com, www.erbamannheim.com
12000035

N/59/13/A/INT Date of revision: 2. 12. 2013

REFERENCES
1. Pearlman, P.C. & Lee, R.T. Clin. Chem. (1974), 20: 447.
2. Henry, R. J. (Ed), Clinical Chemistry: Principles and Techniques (2nd Ed.) Harper and Row (1974). P. 1042.
3. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis, C.A., Ashwood, E.R., Bruns, D.E.; 5th edition,
WB Saunders Comp., 2012.

SYMBOLS USED ON LABELS

REF
Catalogue Number Manufacturer
i See Instruction for Use

Lot Number CE Mark - Storage Temperature

Device comply with
the Directive 98/79/EC

Expiry Date In Vitro Diagnostics Content

IVD CONT

QUALITY SYSTEM CERTIFIED Erba Lachema s.r.o., Karsek 1d, 621 00 Brno, CZ
ISO 9001 ISO 13485 e-mail: diagnostics@erbalachema.com, www.erbamannheim.com