PERIPHERAL BRAIN
Interpretation of Routine Chemistry Tests in Pediatrics
Theodore J. Pysher MD1
Phillip R. Bach PhD2
1 Director of Laboratories, Primary Children's Medical Center, Professor of Pathology and Pediatrics
2 Director of Clinical Chemistry, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City, UT.
Historical Perspective and Current Status of the Multitest Chemistry Profile
The development of a single instrument that could reproducibly sample a specimen, mix it with the required reagents at appropriate intervals, and analyze the resulting reaction revolutionized the chemical analysis of clinical specimens. Not long after its development, several of these Auto AnalyzersTM, each dedicated to measuring a different analyte, were linked, and the Sequential Multiple Analyzer (SMATM) was born. Because these systems were automated, they could perform the analyses for which they were designed at less expense, with greater precision, and in less time than when the tests were performed by hand. Moreover, it was claimed that the integration of the measurement of these chemical markers of disease into the routine health maintenance examination would lead to earlier detection of disease and improved patient care.
These early multitest analyzers had only limited application in pediatrics because they required so large a specimen. The SMA-12TM, for example, required 3 mL of serum for each 12-test panel. Two developments, however, made the multitest chemistry analyzer accessible to pediatric-sized samples-microcomputes and ever smaller components. The early multitest analyzers were marvels of creative plumbing in which each specimen ran the full course of the instrument and, therefore, the same amount had to be sampled whether one or all of the 6, 12, or 24 available tests were requested.
