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Joy C, Collyer TA, McMahon K. Accuracy of transcutaneous bilirubinometry in term infants after phototherapy: a prospective observational study. J Matern Fetal Neonatal Med 2024; 37:2295808. [PMID: 38146169 DOI: 10.1080/14767058.2023.2295808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/12/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To test the accuracy of transcutaneous bilirubinometry (TcB) in neonates 12 h after discontinuing phototherapy. STUDY DESIGN In a prospective study of 91 neonates at ≥35 weeks of gestation, paired measurements of total serum bilirubin (TSB) and TcB were obtained 12 h after discontinuation of phototherapy. TcB measurements were obtained on the uncovered skin of the sternum and the covered skin of the lower abdomen. Bland-Altman plots were used to evaluate agreement between TSB and TcB. RESULTS TcB was found to systematically underestimate TSB on both covered and uncovered skin. The smallest but statistically significant difference between TSB and TcB was found on the covered lower abdomen (-1.03, p < .0001) compared with the uncovered skin of the sternum (-1.44, p < .0001). The correlation between TSB and TcB was excellent on both covered (r = 0.86, p < .001) and uncovered skin (r = 0.90, p < .001). Bland and Altman plots showed poor agreement between TcB and TSB. CONCLUSIONS This study demonstrated excellent correlation between TcB and TSB 12 h after phototherapy but poor TcB-TSB agreement. TcB cannot be reliably used in neonates exposed to phototherapy.
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Affiliation(s)
- Charissa Joy
- Department of Paediatrics, Peninsula Health, Frankston, Australia
| | - Taya A Collyer
- Biostatistics, Monash University, Peninsula Clinical School, Frankston, Australia
- National Centre for Healthy Ageing, Frankston Hospital, Frankston, Australia
| | - Kathryn McMahon
- Department of Paediatrics, Werribee Mercy Hospital, Werribee, Australia
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Candel-Pau J, Maya-Enero S, Garcia-Garcia J, Duran-Jordà X, López-Vílchez MÁ. Transcutaneous bilirubin reliability during and after phototherapy depending on skin color. Eur J Pediatr 2024; 183:2819-2830. [PMID: 38581462 PMCID: PMC11192662 DOI: 10.1007/s00431-024-05516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024]
Abstract
Measurement of transcutaneous bilirubin (TcB) is a non-invasive, widely used technique to estimate serum bilirubin (SB). However, its reliability in multiethnic populations during and after phototherapy is still controversial even in covered skin. The aim of this study was to determine the reliability of TcB in covered (cTcB) and exposed (eTcB) skin during and after phototherapy in a multiethnic population of term and preterm neonates according to Neomar's neonatal skin color scale. Prospective, observational study comparing SB and TcB. We determined SB when clinically indicated and, at the same time, measured cTcB under a photo-opaque patch and eTcB next to it with a jaundice meter (Dräger JM-105TM). All dyads TcB-SB were compared, both globally and according to skin color. We obtained data from 200 newborns (color1: 44, color2: 111, color3: 41, color4: 4) and compared 296 dyads TcB/SB. Correlation between cTcB and SB is strong during (0.74-0.83) and after (0.79-0.88) phototherapy, both globally and by color group. The SB-cTcB bias depends on gestational age during phototherapy and on skin color following phototherapy. The correlation between eTcB and SB during phototherapy is not strong (0.54), but becomes so 12 h after discontinuing phototherapy (0.78). Conclusions: Our study supports the reliability of cTcB to assess SB during and after phototherapy, with differences among skin tones after the treatment. The use of cTcB and Neomar's scale during and mainly after phototherapy may help reduce the number of blood samples required. What is Known: • Controversies exist on the reliability of jaundice meters during and after phototherapy in covered skin. Only a few studies have analyzed their accuracy in multiethnic populations, but none has used a validated neonatal skin color scale. What is New: • We verified correlation between serum and transcutaneous bilirubin in covered skin in a multiethnic population depending on skin color based on our own validated neonatal skin color scale during and after phototherapy.
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Affiliation(s)
- Júlia Candel-Pau
- Department of Neonatology, Service of Pediatrics, Hospital del Mar, Universitat Pompeu Fabra, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
| | - Silvia Maya-Enero
- Department of Neonatology, Service of Pediatrics, Hospital del Mar, Universitat Pompeu Fabra, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Jordi Garcia-Garcia
- Department of Neonatology, Service of Pediatrics, Hospital del Mar, Universitat Pompeu Fabra, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Xavier Duran-Jordà
- AMIB (Methodological and Biostatistical Consultancy), IMIM (Hospital del Mar Institute for Medical Research), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - María Ángeles López-Vílchez
- Department of Neonatology, Service of Pediatrics, Hospital del Mar, Universitat Pompeu Fabra, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
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Eken S, Ilhan O, Hakan N. Comparison of Transcutaneous and Total Serum Bilirubin Measurements at Five Different Sites in Newborns before and after Phototherapy. KLINISCHE PADIATRIE 2024; 236:31-38. [PMID: 37647914 DOI: 10.1055/a-2135-3367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE This study aims to examine the accuracy of transcutaneous bilirubin (TcB) in estimating the total serum bilirubin (TSB) level at five different sites before and immediately after phototherapy. METHODS This study prospectively enrolled infants with a gestational age of 34 to 416/7 weeks who were clinically diagnosed with neonatal jaundice and required phototherapy within 28 days after birth. TcB levels were measured on the uncovered four areas (forehead, mid-sternum, abdomen, and interscapular site) and covered hipbone by using the Dräger JM-103 Jaundice Meter before phototherapy and at 0 min after discontinuing phototherapy. Correlation and agreement between TcB and TSB levels were assessed before and after phototherapy. RESULTS We included 108 infants with a mean gestational age of 37.6±1.5 weeks and birth weight of 3108±548 g. A strong significant correlation was found between TSB and TcB measurements at all five sites before phototherapy with the strongest correlation at the interscapular site (r=0.768, p=0.001). The correlation was weakened between TSB and TcB at all five sites after phototherapy; however, the strongest correlation was at the covered hipbone (r=0.619, p=0.001). TcB measurements at all five sites tended to underestimate TSB levels before and after phototherapy. The difference (TcB - TSB) tended to increase with increasing TSB levels. CONCLUSIONS TcB levels were most accurately measured at the interscapular site and covered hipbone before and immediately after phototherapy, respectively.
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Affiliation(s)
- Seda Eken
- Department of Pediatrics, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Ozkan Ilhan
- Division of Neonatology, Mugla Sitki Kocman University School of Medicine, Department of Pediatrics, Mugla, Turkey
| | - Nilay Hakan
- Division of Neonatology, Mugla Sitki Kocman University School of Medicine, Department of Pediatrics, Mugla, Turkey
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Abiha U, Banerjee DS, Mandal S. Demystifying non-invasive approaches for screening jaundice in low resource settings: a review. Front Pediatr 2023; 11:1292678. [PMID: 38054187 PMCID: PMC10694303 DOI: 10.3389/fped.2023.1292678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/18/2023] [Indexed: 12/07/2023] Open
Abstract
All national and international pediatric guidelines universally prescribe meticulous bilirubin screening for neonates as a critical measure to mitigate the incidence of acute bilirubin encephalopathy (ABE) and Kernicterus. The prevailing gold standard for jaundice detection in neonates necessitates invasive blood collection, followed by subsequent biochemical testing. While the invasive procedure provides dependable bilirubin measurements and continues to be the sole gold standard diagnostic method for assessing bilirubin concentration. There exists a pressing need to innovate non-invasive screening tools that alleviate the sampling stress endured by newborns, mitigate iatrogenic anemia, and expedite the turnaround time for obtaining results. The exploration of non-invasive modalities for bilirubin measurements is gaining momentum, driven by the overarching goal of minimizing the number of pricks inflicted upon neonates, thereby rendering screening a swift, efficient, comfortable, and dependable process. This comprehensive review article delves extensively into the array of non-invasive approaches and digital solutions that have been proposed, implemented, and utilized for neonatal bilirubin screening, with a particular emphasis on their application in low-resource settings. Within this context, the review sheds light on the existing methodologies and their practical applications, with a specific focus on transcutaneous bilirubin meters. Moreover, it underscores the prevailing open challenges in this domain and outlines potential directions for future research endeavors. Notably, the review underscores the imperative need for robust educational programs targeted at both families and healthcare personnel to expedite the process of seeking timely care for neonatal jaundice. Additionally, it underscores the necessity for the development of enhanced screening and diagnostic tools that can offer greater accuracy in clinical practice.
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Affiliation(s)
- Umme Abiha
- Department of Smart Healthcare, Indian Institute of Technology, Jodhpur, India
- All India Institute of Medical Science, Jodhpur, India
| | - Dip Sankar Banerjee
- Computer Science and Engineering, Indian Institute of Technology, Jodhpur, India
| | - Saptarshi Mandal
- Transfusion Medicine and Blood Bank, All India Institute of Medical Science, Jodhpur, India
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İşleyen F, Çelik İH, Demirel N, Erçel NÖ, Işık DU, Baş AY. Transcutaneous bilirubin measured on protected skin during phototherapy in term and preterm neonates. Early Hum Dev 2023; 185:105858. [PMID: 37722208 DOI: 10.1016/j.earlhumdev.2023.105858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/07/2023] [Accepted: 09/10/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Transcutaneous bilirubin (TCB) measurement is a simple, painless, and time-saving alternative for the assessment of TSB (total serum bilirubin) levels. However, TCB measurements obtained during phototherapy can yield inaccurate results. We evaluated the effectiveness of TCB measurements obtained from protected skin areas in patients who underwent phototherapy. METHODS This prospective study included neonates delivered at a gestational age of ≥340/7 weeks. TCB measurements were performed at the forehead and the lower end of the sternum using a JM-105 device. Simultaneously, blood samples were collected to determine TSB levels. During phototherapy, the forehead was covered with a photo-opaque patch. TSB and TCB were measured before, during, at the end of, and after phototherapy. RESULTS In total, 200 neonates, including 110 (55 %) term and 90 (45 %) late preterm infants, were enrolled. Of these neonates, 162 (81 %) were Turkish while 38 (19 %) were refugees from Syria and Iraq. Notably, no statistically significant differences were observed in the TSB and TCB values between the Turkish and refugee groups (p > 0.05). Bland-Altman analysis was conducted between the TCB values obtained from the covered forehead area and TSB values; the analysis revealed moderate, high, and excellent agreements for the first bilirubin measurement and at the end of phototherapy, before phototherapy, and for the second and rebound bilirubin measurements, respectively. Regarding intraclass correlation coefficients, values >0.95, 0.94-0.85, 0.84-0.70, and < 0.7 indicated perfect, high, moderate, and unacceptable compatibilities, respectively. Although a significant association was observed between pre-phototherapy TCB obtained from the sternum and TSB levels, no significant associations were observed during phototherapy. CONCLUSIONS Our findings indicate that the consistency observed between TCB measurements obtained from the protected skin areas and TSB values can be used to monitor phototherapy effectiveness, particularly in late preterm/term infants and those with darker skin tones. Furthermore, this approach can aid in guiding decisions related to treatment termination, evaluating rebound bilirubin levels, minimizing costs, and providing a less invasive testing option.
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Affiliation(s)
- Fatih İşleyen
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, 06010 Ankara, Turkey.
| | - İstemi Han Çelik
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, 06010 Ankara, Turkey
| | - Nihal Demirel
- Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey; Department of Pediatrics and Neonatology, University of Health Sciences Turkey, Bilkent City Hospital, 06010 Ankara, Turkey
| | - Nihan Özel Erçel
- Mersin University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin, Turkey
| | - Dilek Ulubaş Işık
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, 06010 Ankara, Turkey
| | - Ahmet Yağmur Baş
- Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey; Department of Pediatrics and Neonatology, University of Health Sciences Turkey, Etlik City Hospital, 06010 Ankara, Turkey
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Casnocha Lucanova L, Zibolenova J, Matasova K, Matasova K, Zibolen M. The use of transcutaneous bilirubin nomograms for the prevention of bilirubin neurotoxicity in the neonates. Front Public Health 2023; 11:1212667. [PMID: 37538268 PMCID: PMC10395091 DOI: 10.3389/fpubh.2023.1212667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Purpose Although neonatal jaundice is a ubiquitous and predominantly benign phenomenon, the risk of neurotoxicity exists in a number of infants with unconjugated hyperbilirubinemia. Plotting bilirubin values on nomograms enables clinicians to employ an anticipatory and individualized approach with the goal of avoiding excessive hyperbilirubinemia and preventing acute bilirubin encephalopathy and its progression to kernicterus. We aimed to construct nomograms for White term infants based on transcutaneous bilirubin (TcB) measurements using a JM-105 device. Methods TcB measurements were taken in infants at ages ranging from 0 to 96 postnatal hours. We then constructed hour-specific TcB nomograms from forehead and sternum measurements in infants who did not require subsequent phototherapy. Results We included 2,981 TcB measurements taken on the forehead and 2,977 measurements taken on the sternum in 301 White term newborn infants. We assessed the predictive abilities of the nomograms at six postnatal time intervals using receiver operating characteristic curves. The areas under the curves indicated reasonable prediction of hyperbilirubinemia requiring phototherapy, except for the forehead measurement taken within the first 12 h of life. Sensitivity tended to rise as postnatal age increased. Conclusion The nomograms illustrate dermal bilirubin dynamics in White term neonates during the first 4 days of life. They may be useful tools to predict individualized risk of hyperbilirubinemia requiring treatment, and to plan optimal follow-up of infants at risk of bilirubin neurotoxicity.
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Affiliation(s)
- Lucia Casnocha Lucanova
- Neonatology Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia
| | - Jana Zibolenova
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Katarina Matasova
- Neonatology Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia
| | - Katarina Matasova
- Neonatology Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia
| | - Mirko Zibolen
- Neonatology Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia
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Ho SR, Lin YC, Chen CN. The Impact of Phototherapy on the Accuracy of Transcutaneous Bilirubin Measurements in Neonates: Optimal Measurement Site and Timing. Diagnostics (Basel) 2021; 11:diagnostics11091729. [PMID: 34574069 PMCID: PMC8466921 DOI: 10.3390/diagnostics11091729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 11/21/2022] Open
Abstract
Transcutaneous bilirubinometer devices are widely applied to assess neonatal hyperbilirubinemia. However, the optimal skin site and timing of transcutaneous bilirubin (TCB) measurements for the strongest correlation with total serum bilirubin (TSB) levels after phototherapy are still unclear. We conducted a retrospective observational study evaluating the correlation of TCB and TSB levels in neonates postphototherapy. The TCB measurements on the forehead and mid-sternum at 0 and 30 min postphototherapy were assessed by using a JM-103 bilirubinometer. Paired TCB and TSB measurements were assessed by Pearson correlation and Bland–Altman plots. We analyzed 40 neonates with 96 TSB and 384 TCB measurements. The TSB level correlated moderately with the forehead TCB level at 30 min postphototherapy (r = 0.65) and less strongly with the midsternum TCB level at 0 min postphototherapy (r = 0.52). The forehead at 30 min after cessation of phototherapy was the best time point and location of TCB measurement for the assessment of neonatal jaundice status. The reliability of TCB measurements varied across skin sites and durations after phototherapy. The effectiveness of TCB measurement to assess neonatal hyperbilirubinemia is much better on covered skin areas (foreheads) 30 min postphototherapy. The appropriate application of transcutaneous bilirubinometers could aid in clinical practice and avoid unnecessary management.
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Affiliation(s)
- Shau-Ru Ho
- Department of Pediatrics, National Taiwan University Hospital Hsin-chu Branch, Hsin-chu 30059, Taiwan; (S.-R.H.); (Y.-C.L.)
- Department of Pediatrics, National Taiwan University Children’s Hospital, Taipei 10041, Taiwan
| | - Yu-Chen Lin
- Department of Pediatrics, National Taiwan University Hospital Hsin-chu Branch, Hsin-chu 30059, Taiwan; (S.-R.H.); (Y.-C.L.)
- Department of Pediatrics, National Taiwan University Children’s Hospital, Taipei 10041, Taiwan
| | - Chi-Nien Chen
- Department of Pediatrics, National Taiwan University Hospital Hsin-chu Branch, Hsin-chu 30059, Taiwan; (S.-R.H.); (Y.-C.L.)
- Department of Pediatrics, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- Correspondence: ; Tel.: +886-3-532-6151 (ext. 2304)
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Efficacy of transcutaneous bilirubinometry as compared to serum bilirubin in preterm newborn during phototherapy. Eur J Pediatr 2021; 180:2629-2636. [PMID: 34120212 DOI: 10.1007/s00431-021-04148-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Transcutaneous measurement of bilirubin is being used for neonatal jaundice. Its utility during phototherapy in preterm babies is not established. The objective of our study was to assess the efficacy of transcutaneous bilirubin (TcB) measurement in comparison to total serum bilirubin in preterm newborns at admission and during phototherapy at the covered skin area (glabella). It was a prospective observational study and conducted at the neonatal intensive care unit of a tertiary care hospital from January 2017 to January 2019. One hundred eligible preterm neonates were enrolled. Babies who were very sick, with poor peripheral circulation, edematous, having conjugated hyperbilirubinemia, with major congenital malformations, already received phototherapy or exchange transfusion were excluded. Paired total serum bilirubin and transcutaneous bilirubin were measured at admission and 6 h and 24 h during phototherapy. TcB was measured from the area (glabella) covered by an eye protector during phototherapy. The sample for TsB was taken within 10 min of TcB measurement. The mean differences between TsB and TcB values at admission and 6 h and 24 h of phototherapy were - 0.005 (0.353) mg/dl, - 0.350 (0.611) mg/dl, and - 0.592 (0.353) mg/dl, respectively. At admission or before starting of phototherapy, the difference (TsB-TcB) was statistically not significant (p = .125), while the difference in these values was statistically significant at 6 h and 24 h of phototherapy.Conclusion: TcB measurements from the covered skin area in jaundiced preterm infants during phototherapy were not correlated with TsB and cannot be used as an alternate of serum bilirubin testing. What is known • HPLC bilirubin measurement is a gold standard test for bilirubin measurement but impractical for day to day use. Serum total bilirubin is used for clinical testing.. • There is evidence for use of transcutaneous bilirubinometry for assessment of bilirubin in term newborn. What is new • TcB measurements from a covered skin area in jaundiced preterm newborns under phototherapy were not correlated significantly at 6 h and 24 h of phototherapy, but correlated before phototherapy. • TcB cannot be used as an alternate of serum bilirubin testing in preterm infants during phototherapy.
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Evaluation of the Relationship Between Transcutaneous Bilirubin Measurement and Total Serum Bilirubin in Neonatal Patients Followed for Jaundice. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:262-267. [PMID: 34349605 PMCID: PMC8298076 DOI: 10.14744/semb.2020.79837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/13/2020] [Indexed: 11/25/2022]
Abstract
Objectives: Jaundice is a physiological condition caused by hyperbilirubinemia, which is common in neonatal period. However, severe hyperbilirubinemia can cause kernicterus, which is a serious condition that leads to neurological problems. In this study, we aimed to investigate whether it is safe to use transcutaneous bilirubin (TcB) instead of blood for the evaluation of jaundice by comparing TcB measurement with standard total serum bilirubin (TSB) measurement values. Methods: A total of 105 term and early term infants with gestational ages between 37 and 42 weeks were included in the study. MBJ20 TcB measuring device was used for TcB measurement. TcB was measured from the forehead and sternum. To evaluate the relationship between TcB measurements and TSB measurements, we performed Pearson correlation, Spearman correlation, linear regression analysis, and Bland-Altman analysis in which we evaluated the scatter plot of the differences between the average values of the measurements. Results: There was a positive and statistically significant correlation between TcB forehead and TSB measurements and TcB sternum and TSB measurements (p<0.001). Linear regression analysis showed a positive directional correlation between TcB forehead and TSB measurements (R²=0.85) and TcB sternum and TSB measurements (R²=0.87). Bland-Altman analysis showed a good consistency between TSB and TcB forehead measurement methods (mean difference: 0.39±1.46, 95% CI: [−2.47]–[3.26]), and between TSB and TcB sternum measurement methods (mean difference: 0.49±1.32 95% CI: [−2.1]–[3.07]). Conclusion: As a result of our study, we found that TcB measurement can be reliable instead of taking blood for jaundice evaluation.
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Reliability of transcutaneous bilirubin determination based on skin color determined by a neonatal skin color scale of our own. Eur J Pediatr 2021; 180:607-616. [PMID: 33409587 DOI: 10.1007/s00431-020-03885-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
Measurement of transcutaneous bilirubin (TcB) is widely used to estimate serum bilirubin (SB). However, its reliability depending on skin tone is still controversial. Ethnic classification does not correlate well with skin tone. We aimed to determine the reliability of transcutaneous bilirubin in a multiethnic population based on skin color according to our neonatal skin color scale. We conducted a prospective, observational study comparing SB and TcB among different skin colors. With the blood sample routinely obtained at 48-72 h for the screening of inborn errors of metabolism, we determined SB and TcB with a jaundice meter. We obtained data from 1359 newborns (color 1 337, color 2 750, color 3 249, color 4 23) and analyzed 1549 dyads SB/TcB. Correlation between TcB and serum bilirubin was very good (R2 = 0.908-0.956), globally and by color group, with slight differences between darker and lighter skin colors. Bland-Altman plots showed different mean bias depending on skin color. Conclusions: Our study not only supports the reliability of TcB to assess SB regardless of skin color, but also supports the fact that TcB tends to overestimate SB in a higher degree in dark-skinned neonates. This may help reduce the number of blood samples for newborns. What is Known: • Jaundice meters are extensively used to diagnose neonatal hyperbilirubinemia, although controversies exist on their reliability depending on skin color. • Only a few studies have analyzed their accuracy in multiethnic populations, but none has used a validated neonatal skin color scale. What is New: • We verified correlation between serum and transcutaneous bilirubin in a multiethnic population depending on skin color after classifying our neonates into color groups with our own validated neonatal skin color scale.
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Accuracy of enhanced transcutaneous bilirubinometry according to various measurement sites. Turk Arch Pediatr 2021; 56:15-21. [PMID: 34013224 DOI: 10.14744/turkpediatriars.2020.54514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/21/2020] [Indexed: 11/20/2022]
Abstract
Objective The goal of the study was to provide missing data on the accuracy of enhanced transcutaneous bilirubinometry in a monoracial population of term neonates, considering three different measurement sites. Material and Methods Transcutaneous bilirubin was measured using the JM-105 device on the forehead, chest, and abdomen. Blood sampling for total serum bilirubin concentration has been performed within 10 minutes of transcutaneous measurements. Paired transcutaneous bilirubin and total serum bilirubin measurements were statistically analyzed. Results The study group consisted of 102 healthy term Slovak infants. The correlation between total serum bilirubin and transcutaneous bilirubin was significant (coefficient of determination R2: 0.9045 forehead, 0.8808 sternum, 0.8467 abdomen). Transcutaneous measurements underestimated serum bilirubin levels significantly when total serum bilirubin values were higher than 15 mg/dL, irrespective of the site of transcutaneous measurements. The lowest mean difference between total serum bilirubin and transcutaneous bilirubin was identified on the sternum (median: -1.1 mg/dL). The area under the curve was >0.97 and >0.93 for detecting total serum bilirubin levels >10 mg/dL and >13 mg/dL, respectively, for all measurement sites. Transcutaneous measurements on the forehead and sternum provided very high sensitivity, with the best performance at the forehead. Conclusion Transcutaneous bilirubinometry using an enhanced device is an accurate, sensitive, and convenient screening method in term Caucasian neonates. Transcutaneous bilirubin measurements on the forehead, sternum, and abdomen are reliable, with the best performance on the forehead. It is necessary to confirm higher transcutaneous bilirubin values with a total serum bilirubin measurement.
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Anand P, S. (Chairperson) M, C. A, Gopalakrishnan S, Sachdeva A, Sahoo T, Sivanandan S. Screening, Prevention, and Management of Neonatal Hyperbilirubinemia. ACTA ACUST UNITED AC 2020. [DOI: 10.1177/0973217920974163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Jeon J, Lim G, Oh KW, Lee NM, Park HW, Chung ML. The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants. BMC Pediatr 2020; 20:548. [PMID: 33278875 PMCID: PMC7718678 DOI: 10.1186/s12887-020-02450-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022] Open
Abstract
Background To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. Methods We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). Results There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value (r = 0.925 and 0.915, respectively). With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead (r = 0.751) was a better match to the TSB than was TcB at the sternum (r = 0.668). Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. Conclusions TcB was more accurate in infants not receiving phototherapy. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum.
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Affiliation(s)
- Jaesung Jeon
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, 44033, Ulsan, South Korea
| | - Gina Lim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, 44033, Ulsan, South Korea.
| | - Ki Won Oh
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, 44033, Ulsan, South Korea
| | - Na Mi Lee
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Hye Won Park
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Mi Lim Chung
- Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Pusan, South Korea
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Ying Q, You X, You J, Wang J. The accuracy of transcutaneous bilirubin to identify hyperbilirubinemia in jaundiced neonates. J Matern Fetal Neonatal Med 2020; 35:4318-4325. [PMID: 33213255 DOI: 10.1080/14767058.2020.1849112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare transcutaneous bilirubin (TcB) to total serum bilirubin (TSB) in jaundiced neonates by using a JM-103 bilirubinometer. METHODS We conducted a retrospective study in jaundiced infants ≥35 weeks' gestation. Infants' and maternal information, TcB measurements, and TSB levels were collected. The correlation and consistency between TcB and TSB were analyzed by Pearson's correlation analysis and the Bland-Altman plot. Multivariate regression analysis was used to identify characteristics associated with the difference between TcB and TSB, underestimation by TcB and overestimation by TcB. RESULTS A total of 787 paired samples were collected. There was a strong correlation between TcB and TSB with a Pearson correlation coefficient of 0.708 (p < .001). In preterm infants, outpatients and infants with high TSB levels, the TcB measurements were less precise. The TcB-TSB difference was significantly associated with gender, maternal hypertension disease, ABO hemolytic disease, and outpatient setting (p < .05). Only the outpatient setting had statistical significance in the underestimation of TSB ≥2 mg/dL. CONCLUSIONS Generally, TcB by a JM-103 bilirubinometer had a good correlation and consistency with the TSB values. However, small for gestational age, postnatal age of hour, ABO hemolytic disease, and outpatient setting may lead to inconsistencies between the TcB and TSB.
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Affiliation(s)
- Qian Ying
- Obstetrics & Gynecology Hospital Affiliated to Fudan University, Shanghai, China
| | - Xueqin You
- Obstetrics & Gynecology Hospital Affiliated to Fudan University, Shanghai, China
| | - Jingye You
- Obstetrics & Gynecology Hospital Affiliated to Fudan University, Shanghai, China
| | - Jimei Wang
- Obstetrics & Gynecology Hospital Affiliated to Fudan University, Shanghai, China
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Large scale validation of a new non-invasive and non-contact bilirubinometer in neonates with risk factors. Sci Rep 2020; 10:11149. [PMID: 32636410 PMCID: PMC7341797 DOI: 10.1038/s41598-020-67981-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/11/2020] [Indexed: 11/08/2022] Open
Abstract
The study was aimed to evaluate the performance of a newly developed non-invasive and non-contact bilirubin measurement device (AJO-Neo) as an alternative to the conventional invasive biochemical method of total serum bilirubin (TSB) estimation in preterm and term neonates suffering from hyperbilirubinemia associated with risk factors, and/or undergoing phototherapy. The safety and efficacy of the device were assessed in 1968 neonates with gestational ages ranging from 28 to 41 weeks and suffering from incidences of hyperbilirubinemia. Linear regression analysis showed a good correlation between AJO-Neo and the conventional method of TSB (Pearson’s coefficient, r = 0.79). The small bias (0.27 mg/dL) and limits of agreements (− 3.44 to 3.99 mg/dL) were within the range of clinical acceptance. The device was also precise in the measurement of bilirubin levels in all subgroups of the study. The receiver operator curve (ROC), that takes account of both sensitivity and specificity of a device showed high efficacy of the device (area under the curve, AUC = 0.83) in the detection of bilirubin. While monitoring the bilirubin level during phototherapy, the device indicated promising results showing good agreement with TSB. Specificities and sensitivities of the device indicated a much higher accuracy in neonates with associated risk factors for hyperbilirubinemia. Hence, the newly developed device (AJO-Neo) is reliable in measuring bilirubin level in preterm, and term neonates irrespective of gestational or postnatal age, sex, risk factors, feeding behavior or skin color.
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Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer. J Perinatol 2020; 40:226-231. [PMID: 31767979 PMCID: PMC6985020 DOI: 10.1038/s41372-019-0557-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/07/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Determine the suitability of transcutaneous bilirubin (TCB) as a tool to assess the effectiveness of phototherapy on patched skin. STUDY DESIGN A prospective observational study was conducted. We covered a fragment of skin (sternum) with a photo-opaque patch. Several simultaneous TCB and TSB measurements were performed with the JM-105 bilirubinometer. Bland and Altman test evaluated the agreement between bilirubin levels. RESULT A total of 217 patients were studied, 48.8% were preterm. The mean difference between TSB and TCB before the start of treatment was 1.07 mg/dL. During phototherapy, differences on covered skin were 0.52, 0.27, and 0.39 mg/dL at 24, 48, and 72 h of therapy respectively. The best correlation was observed at 48 h in preterm infants. CONCLUSION The measurement of TCB on patched skin (PTCB) is useful for monitoring the response to phototherapy in term and preterm infants. We use a patch with a removable flap that eases successive measures without disturbing the patients.
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Yang ST, Liu FC, Chen HL. Comparison of transcutaneous and serum bilirubin before, under, and after phototherapy in term and late-preterm infants. Kaohsiung J Med Sci 2019; 35:715-724. [PMID: 31436020 DOI: 10.1002/kjm2.12121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/17/2019] [Indexed: 11/08/2022] Open
Abstract
This study aimed to determine the correlation of transcutaneous bilirubin (TcB) with total serum bilirubin (TSB) in infants receiving phototherapy and the accuracy of TcB for deciding the time to discontinue phototherapy. Paired TcB and TSB levels were assessed in 52 term and 56 late-preterm infants receiving phototherapy. TcB was measured in the unexposed skin of the middle forehead using a noninvasive bilirubin analyzer, BiliChek. TSB was measured every morning, and TcB was measured 2 hours after TSB measurements. Bland-Altman plots, linear regression, multivariate pair wise correlation, and receiver operating characteristic curve (ROC) analyses were performed. Bland-Altman plots before, under, and 24 hours after phototherapy in term and late-preterm infants revealed that TcB and TSB have higher consistency. TcB and TSB showed positive linear correlation before, under, and after phototherapy in both infant groups. In the multivariate pair wise correlations, differences between TcB and TSB were negatively correlated with phototherapy duration in term (correlation coefficient = -0.233, P value = .001) and late-preterm (correlation coefficient = -0.198, P value = .002) infants. Cutoff levels of TcB for discontinuing phototherapy based on the ROC analysis were 13.8 (sensitivity of 90%, specificity of 84%, area under the curve [AUC] 0.94) and 11.8 mg/dL (sensitivity of 84%, specificity of 88%, AUC 0.92) in term and late-preterm infants, respectively. TcB and TSB before, under, and after phototherapy in both term and late-preterm infants showed good correlation and higher consistency with jaundice. To reduce repetitive blood sampling for TSB, TcB measurement may be a reliable method for term and late-preterm infants undergoing phototherapy.
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Affiliation(s)
- Shu-Ting Yang
- Division of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fen-Chen Liu
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Lin Chen
- Division of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Hulzebos CV, Vader-van Imhoff DE, Bos AF, Dijk PH. Should transcutaneous bilirubin be measured in preterm infants receiving phototherapy? The relationship between transcutaneous and total serum bilirubin in preterm infants with and without phototherapy. PLoS One 2019; 14:e0218131. [PMID: 31199817 PMCID: PMC6568417 DOI: 10.1371/journal.pone.0218131] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/25/2019] [Indexed: 01/22/2023] Open
Abstract
Our objective was to analyze the relationship between transcutaneous bilirubin (TcB) measured on an unexposed area of skin and total serum bilirubin (TSB) in preterm infants before, during, and after phototherapy (PT). For this purpose paired TSB and TcB levels were measured daily during the first ten days after birth in preterm infants of less than 32 weeks’ gestation. TcB was measured with a Dräger Jaundice Meter JM-103 on the covered hipbone. Agreement between TSB and TcB levels was assessed before, during, and after PT. True negative and corresponding false negative percentages were calculated using different TcB cut-off levels. Data are presented as mean (±SD). We obtained 856 paired TcB and TSB levels in 109 preterm infants (66 boys, gestational age 29.4 ± 1.6 weeks and birth weight 1282 g ± 316 g). We found that the difference between TSB and TcB before PT was significantly lower, 44 (±36) μmol/L, than the difference during and after PT, 61 (±29) μmol/L and 63 (±25) μmol/L, respectively; P < 0.01. Blood sampling could be reduced by 42%, with 2% false negatives, when 50 μmol/L was added to the TcB level at 70% of the PT threshold. Our conclusion is that phototherapy enhances underestimation of TSB by TcB in preterms, even if measured on unexposed skin. The use of specific TcB cut-off levels substantially reduces the need for TSB measurements.
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Affiliation(s)
- Christian V. Hulzebos
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, the Netherlands
- * E-mail:
| | - Deirdre E. Vader-van Imhoff
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, the Netherlands
| | - Arend F. Bos
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, the Netherlands
| | - Peter H. Dijk
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, the Netherlands
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Abstract
Abstract
Phototherapy represents the most common therapeutic intervention at neonatology departments in the first days of life. The beneficial effects of light on the decrease of the serum bilirubin level were first described by Cremer et al. in 1950’s (1). Since then phototherapy has been successfully used to treat severe hyperbilirubinaemia and has almost completely replaced exchange transfusion. Phototherapy is a relatively non-invasive method. However, along with decreasing bilirubin level, it can also influence some other functions: perfusion of organs, predominantly skin; peripheral vascular resistance; distribution of blood flow; heart activity and, thus, also systemic blood pressure along with breathing. A side component of applied light is a certain amount of heat which warms the body surface up and, therefore, the risk of exogenous overheating and increased water loss through the skin arise. Maternal-infant separation, modification of calcium homeostasis, disturbed circadian rhythm, or changes of the hemodynamics of various organ systems are only a few of the undesired effects which prove phototherapy not to be a treatment without any side effects. Careful indication of phototherapy is essential, particularly in premature infants.
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Akin A, Sarici SU, Ozcan M, Akpinar M, Altun D, Yasartekin Y, Serdar MA, Sarici D. Transcutaneous bilirubinometry should be carried out in newborn infants at least seven hours after phototherapy finishes. Acta Paediatr 2018; 107:1100-1101. [PMID: 29432663 DOI: 10.1111/apa.14272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Agah Akin
- Division of Neonatology; Department of Pediatrics; Faculty of Medicine; Ufuk University; Ankara Turkey
| | - Serdar Umit Sarici
- Division of Neonatology; Department of Pediatrics; Faculty of Medicine; Ufuk University; Ankara Turkey
| | - Murat Ozcan
- Department of Pediatrics; State Hospital; Haymana, Ankara Turkey
| | - Melis Akpinar
- Division of Neonatology; Department of Pediatrics; Faculty of Medicine; Ufuk University; Ankara Turkey
| | - Demet Altun
- Division of Neonatology; Department of Pediatrics; Faculty of Medicine; Ufuk University; Ankara Turkey
| | - Yuksel Yasartekin
- Division of Neonatology; Department of Pediatrics; Faculty of Medicine; Ufuk University; Ankara Turkey
| | - Muhittin A. Serdar
- Department of Biochemistry; Faculty of Medicine; Acibadem University; Ankara Turkey
| | - Dilek Sarici
- Division of Neonatology; Department of Pediatrics; Kecioren Education and Research Hospital; Ankara Turkey
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Comparison of Transcutaneous and Serum Bilirubin Measurements in Neonates 30 to 34 Weeks' Gestation Before, During, and After Phototherapy. Adv Neonatal Care 2018; 18:144-153. [PMID: 29498944 DOI: 10.1097/anc.0000000000000469] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of noninvasive, transcutaneous bilirubin monitoring (TcB) as a jaundice screen in full-term infants is well established; however, there is a paucity of research evaluating the use of TcB in premature infants. PURPOSE To compare agreement and consistency of transcutaneous and serum bilirubin measurements in a multiracial premature infant population ranging from 30 to 34(Equation is included in full-text article.)weeks' gestation before, during, and after phototherapy. METHODS Forty-five neonates, 30 to 34(Equation is included in full-text article.)weeks' gestation, were enrolled in this prospective, correlational study over a 12-month period. One set of paired transcutaneous and serum bilirubin measurements, per neonate, was obtained before phototherapy, during therapy, and after phototherapy. Exclusion criteria included neonates with positive direct coombs test or evidence of hemolytic disease, major congenital anomalies, hydrops fetalis, and those not expected to survive. RESULTS There was a strong, positive correlation between TcB and total serum monitoring (TSB) measurements obtained pretherapy (r = 0.797, P < .001). A moderate correlation was noted between TcB and TSB measurements obtained during therapy (r = 0.588, P < .001). A strong correlation was noted between TcB and TSB measurements obtained posttherapy (r = 0.869, P < .001). There were no significant differences between paired samples across time (F = 0.891, P = .41, partial η = 0.01). The TSB measurements were consistently lower than TcB pretherapy, during, and posttherapy. IMPLICATIONS FOR PRACTICE The TcB measurements provide a reliable estimation, generally within 2 to 3 mg/dL of TSB levels, in premature infants 30 to 34(Equation is included in full-text article.)weeks' gestation. IMPLICATIONS FOR RESEARCH Investigation of consumption of time and nursing personnel required to perform TcB testing, compared with TSB testing, is indicated. Cost analyses comparing TcB-driven screening protocols and interval TSB measurements, among premature infants, are indicated. As newer generations of TcB devices are approved for use, additional studies using mixed-race populations of premature infants will be necessary to continue to evaluate the reliability and validity of this screening tool within the everyday neonatal intensive care unit.
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Comparison between Bilistick System and transcutaneous bilirubin in assessing total bilirubin serum concentration in jaundiced newborns. J Perinatol 2017; 37:1028-1031. [PMID: 28617429 DOI: 10.1038/jp.2017.94] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To compare the performance and accuracy of the JM-103 transcutaneous bilirubinometer and Bilistick System in measuring total serum bilirubin for the early identification of neonatal hyperbilirubinemia. STUDY DESIGN The study was performed on 126 consecutive term and near-term (⩾36 weeks' gestational age) jaundiced newborns in Cairo University Children Hospital NICU, Egypt. Total serum bilirubin was assayed concurrently by the clinical laboratory and Bilistick System and estimated using the JM-103 transcutaneous bilirubin instrument. Bland-Altman analysis was used to evaluate the agreement between determinations. RESULT The limits of agreement of the Bilistick System (-5.8 to 3.3 mg dl-1) and JM-103 system (-5.4 to 6.0 mg dl-1) versus the clinical laboratory results were similar. CONCLUSION The Bilistick System is an accurate alternative to transcutaneous (TcB) determination for early diagnosis and proper management of the neonatal jaundice.
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