Bilirubin, total

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Test Name:

Bilirubin, total

Ordering Information:

Collection Device/Tube Type:

1. EDM Base Lab: 5 mL blood - GOLD SST (gel)
2. CGY DSC: 4.5 mL blood - MINT LIHEP PST (gel)
3. NOTE: The preferred tube type at each testing site is acceptable at the alternate site

Collection Instructions:

Neonatal bilirubin testing referred to Alberta Precision Laboratories

Submission Requirements:

1 mL serum or lithium heparin plasma
* Protect from light

North Zone, Edmonton Zone and Central Zone:
• Foil is not required for specimens with Total bilirubin only (i.e. Neonatal/Conjugated not performed as part of the biliary atresia protocol) but these specimens must still be protected from light during storage and transport (keep in closed box and/or dark fridge)

Calgary Zone and South Zone:
• For patients 5 months or younger, collection must be protected from light by using gold top amber colored microcollection tube or green top tube with amber sleeve color

Handling/Storage Comments:

South Zone Patient Service Centres and Rural South Alberta Precision Laboratories sites referring to DynaLIFE Calgary DSC must refrigerate and protect samples from light post collection.

Frequency of Testing:

Daily

Reference Range:

Test	Age	Reference Range (umol/L)
Bilirubin, total	0 to < 30 days	No reference interval
Bilirubin, total	≥ 30 days	< 20

Critical Values:

0 to <30 days: greater than 300 umol/L

Comments:

NOTES:
For children, aged 7 days to 5 months, with a total or neonatal bilirubin result greater than 20 umol/L, direct (conjugated) bilirubin and percentage of direct (conjugated) bilirubin are reported

The following comment is appended to the results when the percentage of conjugated bilirubin is greater than or equal to 20%:
"In infants direct (conjugated) hyperbilirubinemia (the direct [conjugated] bilirubin fraction of bilirubin greater than or equal to 20% of the total or neonatal bilirubin) is pathologic. Prompt evaluation is necessary especially to assess for Biliary Atresia. Consider referral to pediatric gastroenterologist."

Last Reviewed:

03 May 2023

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