The results of a serum bilirubin measurement from a newborn patient indicate a total bilirubin of 26 mg per deciliter. The sample was diluted using saline 1:2. Below are the results of the diluted sample what is the concentration of unconjugated bilirubin? Total bilirubin: 16 mg per deciliter direct bilirubin: 0.5 mg per deciliter

Unconjugated bilirubin can be calculated by subtracting direct bilirubin from total bilirubin. In this case, subtracting 0.5mg/dL from 16mg/dL results in 15.5mg/dL. However, the sample was diluted 1:2, hence the unconjugated bilirubin level would be 31mg/dL.

Explanation:

In serum bilirubin testing usually done in newborns, there are two types of bilirubin that we usually consider - total bilirubin and direct bilirubin. The difference between these two measures is known as unconjugated bilirubin, sometimes also referred to as indirect bilirubin. In this case, you gave a diluted total bilirubin of 16 mg per deciliter and direct bilirubin of 0.5 mg per deciliter. Therefore, to ascertain the unconjugated bilirubin, you should subtract the direct bilirubin from the total bilirubin. Hence, the concentration of unconjugated bilirubin in the sample is 16.0 mg/dL - 0.5 mg/dL, which equals 15.5 mg/dL. However, the sample was diluted 1:2 so you need to multiply by 2 which gives 31 mg/dL.

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