Effects of Lipofundin® on the Measurement of Total Bilirubin by Spectrophotometry

Background: Jaundice occurs frequently in neonates and can cause severe neurological complications; hence, hyperbilirubinemia is usually monitored by direct spectrophotometry. However, lipemia, resulting from inborn disorders or parenteral feeding of preterm neonates with lipid emulsion, may interfere with certain laboratory assessments. Here, we evaluated whether artificial lipemia also interferes with bilirubin measurement by direct spectrophotometry. Methods: Total bilirubin levels were assessed by the spectrophotometry when serial concentrations of Lipofundin®, medium-chain triglycerides, or a stabilizer solution, were added to cord blood samples from five full-term and five preterm newborn infants. Results: In blood specimens from ten neonates, spectrophotometry-determined bilirubin levels proportionally and significantly increased in the presence of Lipofundin® at least 1% v/v or 10% medium-chain triglycerides at least 10% v/v in all pre-term and full-term infants. The stabilizer solution caused no interference. Conclusion: Lipofundin® in the cord blood interferes with spectrophotometric measurement of total bilirubin; this effect is mainly related to triglyceride levels and has implications for management of neonates with jaundice.