Enhancing Pediatric Testing

Helping pediatric laboratories overcome challenges and change young lives.

Clinical laboratories servicing pediatric centers must navigate several unique challenges to provide optimized diagnostic testing for pediatric patients. These include dealing with small sample sizes, interferents, determination of proper reference intervals and performing multiple valid analyses on these limited sample volumes with a rapid turnaround time.

Enhancing Pediatric Testing

Helping pediatric laboratories overcome challenges and change young lives.

Clinical laboratories servicing pediatric centers must navigate several unique challenges to provide optimized diagnostic testing for pediatric patients. These include dealing with small sample sizes, interferents, determination of proper reference intervals and performing multiple valid analyses on these limited sample volumes with a rapid turnaround time.

01

Sample size

High quality results with precious hard to draw samples.

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).

Smart Metering

Figure: Patented pressure level-sensing technology

02

Analytic interference

Minimize doubt by managing interferences.

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 

03

Assessment of hyperbilirubinemia:

Preventing kernicterus in newborns

Better informed decision-making through accurate, reliable assessment of bilirubin.

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

04

The right results the first time

Helping your lab perform under pressure.

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. 

 

5. Antibiotic resistance

Seeing beyond fever to a more precise diagnosis and targeted treatment.

The challenge

When fever is the only symptom of ongoing infection in infants and young children, it can be difficult to correctly assess the source, type and severity of the infection. This can lead to an over-prescription of antibiotics, with the potential consequences of developing resistance. In that situation, biomarkers are a useful tool for early diagnosis as they are easy to measure and rapidly available for immediate clinical decision-making. 

The solution

Procalcitonin (PCT) is a reliable blood parameter that supports early diagnosis and clinical decision-making for systemic bacterial infections and therapy control. This enables a more judicious use of empiric antibiotics and a reduction of antibiotic exposure.

VITROS® B•R•A•H•M•S PCT (Procalcitonin) Assay

  • Available on lab-based VITROS Platforms
  • Fast increase after bacterial infection within 3-6 hours (faster than CRP)
  • High sensitivity and specificity for bacterial infection, improving the accuracy of clinical diagnosis
  • Recommended for antibiotic stewardship by the Surviving Sepsis campaign guideline
  • Experts at the European Medicines Agency (EMA) include PCT for neonatal and pediatric sepsis diagnosis

Request more information ->