The challenge

Blood collection and laboratory testing in pediatric populations present multiple challenges (i.e., draw volume limitations, vein collapse and high hematocrit).

These result in low or insufficient serum or plasma volume available for testing and potentially no reportable laboratory results.

The solution

Our VITROS® MicroSlide technology are ideal for this challenge as it requires only 2.7 µL to 11 µL of sample.

Furthermore, to alleviate these issues is to reduce the sample volume required for laboratory testing. Now you can achieve this with VITROS® XT MicroSlides. Featuring dual-test capability, these innovative slides are designed to further reduce sample size while maintaining analytical performance versus a conventional single assay test element.

The total sample volume to run the 12 XT MicroSlides is 45.6 μL ranging from 2.7 μL for GLU to 5.0 μL for ALKP and decreasing the sample volume by 49% from the low 89.5 μL sample volume required for the current VITROS MicroSlide products.

^{Figure: Small sample volume with Multi-Test VITROS® XT Chemistry System slides supports difficult draws to enhance pediatric testing. RD-0095 Development of Novel Multi-Test VITROS® XT Chemistry Products Slides* to Enhance Pediatric Testing.}

The SMART metering feature automatically checks for bubbles and clots/debris every time the system aspirates or dispenses fluid. This acts as an analytical control process for each test, ensuring result integrity is maintained.

If the sample is insufficient, or if there are bubbles or a clot, the analyzer will return the precious sample to the tube ('Save the Sample' feature).

^{Figure: Patented pressure level-sensing technology}

The challenge

Typically, 13% of all draws in a pediatric trauma department are affected by hemolysis.¹

The methods used for pediatric testing should not be subject to interference by bilirubin or hemolysis, both of which are commonly present in pediatric specimens. In contrast with frequently repeated testing that can be done on adult samples, small pediatric samples may preclude repeated testing to confirm abnormal results.

Analytic interference occurs more in neonatal patients than in adults and represents a significant technical challenge. Specifically, high concentrations of bilirubin, lipids and fetal hemoglobin are present in many neonatal specimens. 

The Solution

VITROS^® Technologies enable results you can trust for over 160 clinical chemistry/immunoassay assays, with more in development. 

The unique MicroSlide design minimizes the impact of endogenous and exogenous interfering substances that could impact the quality of assay results. The unique Spread Layer filters out endogenous and exogenous interferents, and each processing step is optimized with the dry multi-layer Slide design. 

Additional safety checks are available on VITROS^® Systems, minimizing the impact of common interferences and giving you complete peace of mind.

_{¹Bush RA, Mueller T, Sumwalt B, Cox SA, Hilfiker ML. Assessing pediatric trauma specimen integrity. Clin Lab Sci. 2010;23(4):219-222. Accessed January 4, 2022. http://clsjournal.ascls.org/content/ascls/23/4/219.full.pdf} 

The challenge

Measurement of Bu and Bc in newborns is important in determining the causes of jaundice and is therefore helpful in limiting the effects of hyperbilirubinemia on the central nervous system.

ln the past, the potential for bilirubin to cause brain damage – kernicterus – in infants was assessed by calculating indirect bilirubin (IBIL).

Routinely used diazo methods exhibit considerable variation due to reaction time, reaction mixture pH or endogenous interferents.

Incorrect IBIL results increase the probability of unnecessary treatments. A more accurate method of measuring unconjugated bilirubin enables greater certainty in therapeutic interventions.

The Solution

The VITROS^® BuBc Slide assay provides true measurements of both conjugated and unconjugated bilirubin fractions. It shows greater specificity and increased robustness against interferences than traditional wet chemistry diazo bilirubin assays. Giving precise, accurate results that support better patient care.

Spreading layer

• Traps large molecules like DELB (Bc bound to albumin) which is not measured

Masking layer

• Optically blocks potentially interfering compounds trapped in the spreading layer, such as hemoglobin, preventing them from interfering with the measurement

^{_{Chan KM, Scott MG, Wu TW, et al. Inaccurate values for direct bilirubin with some commonly used direct bilirubin procedures. Clin Chem. 1985;31(9):1560-1563. Accessed January 4, 2022. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.493.9801&rep=rep1&type=pdf}}

The challenge

Pediatric labs must respond quickly to test requests, deliver specific training to testing personnel and understand the unique requirements of patients. The laboratory can provide additional value to clinicians through both quality results and interpretive support.

Pediatric patients can have unreliable clinical histories, and physical findings can underrepresent the severity of disease and their condition can rapidly change, particularly in premature infants. This makes shorter turnaround time (TAT) and high first-pass yields (FPY) invaluable.

The solution

VITROS^® Integrated Systems consolidate seven proven technologies designed to remove the obstacles to reducing TAT. So, you can provide meaningful results the first time thanks to frictionless operations and a full assay menu.