Assessment of a Transcutaneous Device in the Evaluation of Neonatal Hyperbilirubinemia in a Primarily Hispanic Population

Engle, William D.; Jackson, Gregory L.; Sendelbach, Dorothy; Manning, Denise; Frawley, William H.

doi:10.1542/peds.110.1.61

Cited by 91 publications

(86 citation statements)

References 32 publications

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“…However, in infants with non-white skin, the BiliCheck instrument showed a significantly lower performance (Fig. 3), with wider CI and underestimation of serum bilirubin by 25±35 lmol/l, a finding similar to that already reported by Engle et al [9]. Until this finding has been confirmed or refuted in a larger patient sample, BiliCheck values should be interpreted with caution in non-white infants.…”

Section: Bilichecksupporting

confidence: 81%

Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?

et al. 2004

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The aim of this study was to compare predictions of hyperbilirubinaemia by eye, performed by trained physicians and nurses, with predictions obtained using two commercial bilirubinometers. Jaundice was assessed in 92 white and 48 non-white healthy full-term neonates using three non-invasive methods and by total serum bilirubin as the reference method. Clinical assessment of cephalocaudal progression of jaundice was carried out independently by a physician and by nurses. Simultaneously, the Minolta Airshields JM-102 was applied on the sternum, the BiliCheck on both the forehead and the sternum, and finally, serum bilirubin concentrations were determined. The Minolta JM-102 showed the best performance with r 2 =0.90, an intraclass correlation coefficient (ICC) of 0.93, and a 95% confidence interval (CI) of ±4 units (approx. 56 lmol/l). The BiliCheck performed slightly better on the forehead than over the sternum with r 2 =0.90, an ICC of 0.88, and a CI of ±62 lmol/l. Assessment of jaundice by eye was least accurate with r 2 =0.74, an ICC of 0.67, and a CI of ±1.5 zones (corresponding to ±75 lmol/l). Skin pigmentation and ambient light both adversely affected noninvasive bilirubin estimation. Conclusion: All three non-invasive methods are well suited for estimation of serum bilirubin but show large confidence intervals. In healthy term newborns, hyperbilirubinaemia (>250 lmol/l) can be safely ruled out by eye if jaundice does not reach the abdomen or the extremities (Kramer zones 1 and 2), with <22 units (<230 lmol/l) for the Minolta JM-102, or with a cut-off of 190 lmol/l for the BiliCheck. If these respective thresholds are exceeded, serum bilirubin concentrations should be measured.

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Section: Bilichecksupporting

confidence: 81%

Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?

et al. 2004

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“…Six hours after stopping PHT, TcB-C and TSB were again the same, but TcB-E remained significantly lower than TSB. Engle et al 9 found that BiliCheck TcB underestimated bilirubin in term Hispanic infants with relatively high TSB (>15 mg per 100 ml). The authors further suggested that the predominant Hispanic population could be responsible for the unreliable results.…”

Section: Or Number (%)mentioning

confidence: 99%

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

et al. 2011

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Objective: To determine whether transcutaneous bilirubin (TcB) from covered skin (TcB-C) during and after discontinuing phototherapy (PHT) is reliable in treating neonatal jaundice.Study Design: In this prospective observational study, before starting PHT, part of the forehead was covered. TcB-C and TcB from exposed skin (TcB-E) to PHT were measured before starting PHT, on a 12-hourly basis while receiving PHT and 6 h after stopping PHT. We used ANOVA (analysis of variance) and Bonferroni's t-tests.Result: A total of 39 infants were enrolled (mean gestation 39 weeks, 51% males and 80% Hispanic).

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“…Others have questioned the accuracy of transcutaneous bilirubin (TcB) measurements, particularly in neonates with relatively high TSB. [12][13][14][15][16] The majority of studies of TcB have focused on hospitalized neonates prior to peak TSB values. If reliable TcB results could be demonstrated following discharge, when higher TSB values would be anticipated, this rapid, noninvasive, pointof-care technique would be attractive to parents and useful for providers who are implementing the AAP guidelines.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Transcutaneous Jaundice Meter Following Hospital Discharge in Term and Near-Term Neonates

et al. 2005

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OBJECTIVES:To evaluate performance of the Minolta JM-103 Jaundice Meter (JM) as a predictor of total serum bilirubin (TSB) in outpatient neonates during the first week postnatal, and to estimate the number of TSB determinations that might be avoided in clinical use. STUDY DESIGN:In neonates evaluated posthospital discharge, JM and TSB results were compared using linear regression and a Bland-Altman plot, and predictive indices were calculated for various JM cutoff values. Utilizing the 2004 American Academy of Pediatrics (AAP) guidelines, the ability of JM to predict risk zone status was determined. RESULTS:Overall correlation between JM and TSB was 0.77 (p<0.001; n ¼ 121). When TSB was >17 mg/dl, a cutoff value for JM of 13 mg/dl had a sensitivity of 1.0, and 50% of TSB determinations would be avoided. CONCLUSIONS:JM may facilitate outpatient management of hyperbilirubinemia by reducing the number of TSB determinations required; however, it does not provide a reliable substitute for laboratory measurement of TSB.

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Assessment of a Transcutaneous Device in the Evaluation of Neonatal Hyperbilirubinemia in a Primarily Hispanic Population

Cited by 91 publications

References 32 publications

Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?

Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

Evaluation of a Transcutaneous Jaundice Meter Following Hospital Discharge in Term and Near-Term Neonates

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