digoxin and Jaundice

To better define the reported increased digitalis-like immunoreactive substances (DLIS) in neonatal plasma, we studied the relation among plasma DLIS level, blank intensity (BLK-I) value at FPIA measurement and plasma total bilirubin level.. The DLIS levels were measured in 10 neonates with or without jaundice and 10 infants in good health, using fluorescence polarization immunoassay (FPIA) and microparticle enzyme immunoassay (MEIA). BLK-I value and plasma total bilirubin level were also measured simultaneously.. In neonates with jaundice, DLIS using FPIA, BLK-I and total bilirubin level were 0.58 +/-0.13 ng/mL, 2598 +/- 408, and 17.98 +/- 1.13 mg/dL, respectively, before phototherapy, and 0.33 +/-0.06 ng/mL, 1886 +/- 237, and 15.16 +/- 2.07 mg/dL after phototherapy. Corresponding values in neonates without jaundice were (DLIS: 0.34 +/-0.04 ng/mL; BLK-I: 1,764 +/- 278; total bilirubin: 10.37 +/- 4.54 mg/dL); in healthy infants (0.12 +/-0.06 ng/mL, 400.7 +/- 4.6 and 0.42 +/- 0.13 mg/dL, respectively) and in healthy volunteers (0.10 +/-0.07 ng/mL, 403.1 +/- 8.4, and 0.58 +/- 0.30 mg/dL, respectively). Using MEIA, DLIS was not detected in 10 neonates, 10 infants and 20 healthy volunteers.. A fluorescent compound related to bilirubin increased the BLK-I value in the measurement of neonatal plasma using FPIA. The fluorescence was not the result of endogenous digitalis-like factors.

Topics: Bilirubin; Cardenolides; Cardiovascular Agents; Child, Preschool; Digoxin; Female; Fluorescence Polarization Immunoassay; Heart Diseases; Humans; Infant; Infant, Newborn; Jaundice; Male; Phototherapy; Reference Values; Saponins

We applied the Enzyme Multiplied Immunoassay Technique (EMIT; Syva Corp., Palo Alto, CA) for determination of serum digoxin to the ABA-100 bichromatic analyzer. Assay conditions were almost exactly as prescribed for the manual procedure, but the ABA-100 offers high automation, smaller reagent volumes, and shorter reaction time. Precision studies gave CV's of less than 10%. Sixty patients' samples, analyzed for digoxin by radioimmunoassay and this enzyme immunoassay, gave a correlation (r) of 0.941. Results obtained with the ABA-100 were apparently slightly higher. One kit provides reagents for 250 assays, as compared to 70 assays with the manual procedure. In an emergency situation a result will be available about 60 min after the patient's sample is received; one operator can analyze about 120 samples in 8 h.

Topics: Digoxin; Hemolysis; Humans; Hyperlipidemias; Immunoenzyme Techniques; Jaundice; Radioimmunoassay; Reagent Kits, Diagnostic

We present a comparative evaluation of two commercial kits, the "Quantitope" and "GammaCoat," for radioimmunoassay of digoxin in serum. These kits, in which iodine-125 is used as a label, proved to suitable for digoxin assay as determined by their reproducibility, sensitivity, precision, and a regression analysis. Hemolysis, lipemia, and icterus did not affect results. However, in some cases hypoalbuminemia falsely lowered the assayed digoxin concentration. Recovery of pure digoxin added to native patients' sera having low albumin concentration (24-28 g/liter) ranged from 67-105% with the Quantitope kit and 70-110% with the GammaCoat kit. Low serum albumin concentration did not always decrease the recovery of digoxin; this effect varied from serum to serum, which may indicate that there are factors other than albumin that affect the assay of digoxin.

Topics: Digoxin; Evaluation Studies as Topic; Hemolysis; Humans; Iodine Radioisotopes; Jaundice; Radioimmunoassay; Serum Albumin; Triglycerides

Topics: Blood Pressure; Carbon Dioxide; Cardiac Catheterization; Cardiac Output; Cryosurgery; Digoxin; Epinephrine; Female; Furosemide; Halothane; Heart; Heart Arrest, Induced; Heart Defects, Congenital; Hemodynamics; Hemoglobins; Humans; Hydrogen-Ion Concentration; Infant; Infant, Newborn; Isoproterenol; Jaundice; Male; Myocardium; Oxygen; Oxygen Consumption; Postoperative Care; Postoperative Complications; Pulmonary Veins; Regression Analysis

Topics: Adenocarcinoma; Aged; Blood Glucose; Carbutamide; Diabetes Mellitus; Diethylstilbestrol; Digoxin; Drug Interactions; Heart Diseases; Humans; Jaundice; Lipids; Liver Cirrhosis; Liver Function Tests; Male; Nitroglycerin; Prostatic Neoplasms; Triglycerides