Comparison of assays for measuring plasma paracetamol

BMJ 1998; 316 doi: http://dx.doi.org/10.1136/bmj.316.7129.475a (Published 07 February 1998) Cite this as: BMJ 1998;316:475

Possibility of calibration error needs evaluation

  1. A L Jones, Deputy directora,
  2. D R Jarvie, Senior clinical scientistb,
  3. D Simpson, Senior lecturerb,
  4. L F Prescott, Professor of clinical pharmacologyc
  1. a Scottish Poisons Information Bureau, Edinburgh Royal Infirmary, Edinburgh EH3 9YW
  2. b University Department of Clinical Biochemistry, Edinburgh Royal Infirmary
  3. c Western General Hospital Clinical Pharmacology Unit, Edinburgh EH4 2XU
  4. d Leicester Royal Infirmary NHS Trust, Leicester LE1 5WW

    Editor—Egleston et al report a significant difference in plasma paracetamol concentrations assayed with the AcetaSite bench assay and a standard laboratory assay.1 Rapid and accurate determinations of plasma paracetamol concentrations are crucial in the expeditious and appropriate administration of antidotal treatment, which prevents severe liver damage if given sufficiently early in the course of poisoning.2

    We compared two methods for estimating plasma paracetamol (Cobas paracetamol assay kit (Cambridge Life Sciences, Ely) and AcetaSite blood acetaminophen (paracetamol) test (Cambridge Life Sciences)) with a standard high performance liquid chromatographic method.3 We used the methods on 35 samples from 23 patients presenting between 5 and 50 hours after a paracetamol overdose who claimed to have taken a mean of 22.0 g (range 5–50 (SD 13.1) g) of paracetamol alone. Samples were taken and stored at −40°C, and all assays were performed in our laboratory.

    The 1 shows the results obtained with the three methods. Compared with high performance liquid chromatography, the AcetaSite …

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