Bilirubin Measurement for Neonates: Comparison of 9 Frequently Used Methods

Grohmann, Karina; Roser, Markus; Rolinski, Boris; Kadow, I.; Müller, Cornelia; Goerlach-Graw, Ada; Nauck, Matthias; Küster, Helmut

doi:10.1542/peds.2005-0590

Cited by 110 publications

(63 citation statements)

References 26 publications

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“…45,46 However, there is a lower threshold for the initiation of phototherapy for preterm infants, with certain guidelines providing specific cutoffs for each gestational week according to the postnatal age. 47 Thus, the information from this systematic review should be incorporated in clinical practice, taking into consideration the thresholds for phototherapy in preterm infants.…”

Section: Figurementioning

confidence: 99%

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

Nagar¹,

Vandermeer²,

Campbell

et al. 2013

Pediatrics

108

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BACKGROUND AND OBJECTIVE: Transcutaneous bilirubin (TcB) devices are widely used for the estimation of serum bilirubin levels in term and near-term infants. Our objective was to review the diagnostic accuracy of TcB devices in preterm infants.METHODS: Medline, Embase, Cochrane library, Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched (from database inception date until December 2012). Additional citations were identified by using the bibliographies of selected articles and from conference proceedings. The studies were included if they compared TcB with total serum bilirubin in preterm infants before phototherapy and presented data as correlation coefficients or as BlandAltman difference plots. Data were extracted by 1 reviewer and checked for accuracy by the second reviewer. An assessment tool (quality assessment of diagnostic accuracy studies) was used for risk of bias assessments. RESULTS:Twenty-two studies met the inclusion criteria; 21 studies reported results as correlation coefficients, with pooled estimates of r = 0.83 for each site of measurement. Pooled estimates in infants ,32 weeks' gestation were similar to the overall preterm population (r = 0.89 [95% confidence interval: 0.82-0.93]). For the 2 commonly used TcB devices (ie, JM103 and BiliCheck), the results were comparable at the forehead site, although the JM103 device exhibited better correlation at the sternum. Analysis of the BlandAltman plots (13 studies) revealed negligible bias in measurement at the forehead or sternum site by using either the JM-103 or BiliCheck device; however, the JM-103 device exhibited better precision than the BiliCheck (SD for TcB -total serum bilirubin differences: 24.3 and 31.98 mmol/L, respectively). CONCLUSIONS:The TcB devices reliably estimated bilirubin levels in preterm infants and could be used in clinical practice to reduce blood sampling.

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Section: Figurementioning

confidence: 99%

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

Nagar¹,

Vandermeer²,

Campbell

et al. 2013

Pediatrics

108

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“…Light-tissue interactions in the visible wavelength range are the basis of many experimental and routinely used diagnostic and therapeutic procedures at the neonatal intensive care, e.g., in transcutaneous bilirubinometry, 1 pulse oximetry, 2 and phototherapy during jaundice. 3 Knowledge of the optical properties of the tissue is essential when predicting or modeling light-tissue interactions, which in turn is invaluable for the development and improvement of these procedures.…”

Section: Introductionmentioning

confidence: 99%

Optical properties of neonatal skin measured in vivo as a function of age and skin pigmentation

Bosschaart¹,

Mentink²,

Kok³

et al. 2011

J. Biomed. Opt.

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“…2 Previously, investigators have found that TcB measurements have correlated well with TSB levels, with correlation coefficients ranging from ∼0.77 to 0.97. [3][4][5][6][7][8][9][10][11][12][13][14][15] However, in most of these previous studies, a single device was used in 1 hospital, or in a limited number of hospitals, presumably with frequent monitoring of the device's accuracy and with optimized training of the individuals performing the TcB measurement; all these conditions tend to optimize the accuracy of the measurement. 16 The applicability of these results to TcB use in routine clinical settings is unclear.…”

Section: What This Study Addsmentioning

confidence: 99%

Discrepancies Between Transcutaneous and Serum Bilirubin Measurements

2015

PEDIATRICS

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OBJECTIVE: To characterize discrepancies between transcutaneous bilirubin (TcB) measurements and total serum bilirubin (TSB) levels among newborns receiving care at multiple nursery sites across the United States.METHODS: Medical records were reviewed to obtain data on all TcB measurements collected during two 2-week periods on neonates admitted to participating newborn nurseries. Data on TSB levels obtained within 2 hours of a TcB measurement were also abstracted. TcB -TSB differences and correlations between the values were determined. Data on demographic information for individual newborns and TcB screening practices for each nursery were also collected. Multivariate regression analysis was used to identify characteristics independently associated with the TcB -TSB difference.RESULTS: Data on 8319 TcB measurements were collected at 27 nursery sites; 925 TSB levels were matched to a TcB value. The mean TcB -TSB difference was 0.84 6 1.78 mg/dL, and the correlation between paired measurements was 0.78. In the multivariate analysis, TcB -TSB differences were 0.67 mg/dL higher in African-American newborns than in neonates of other races (P , .001). The TcB -TSB difference also varied significantly based on brand of TcB meter used and hour of age of the infant. For 2.2% of paired measurements, the TcB measurement underestimated the TSB level by $3 mg/dL. CONCLUSIONS: During routine clinical care, TcB measurement provided a reasonable estimate of TSB levels in healthy newborns. Discrepancies between TcB and TSB levels were increased in African-American newborns and varied based on brand of meter used. WHAT'S KNOWN ON THIS SUBJECT:In most previous studies, transcutaneous bilirubin measurement has been found to provide an accurate estimate of total serum bilirubin levels. However, most of these studies were conducted in settings that optimized accuracy. WHAT THIS STUDY ADDS:This study provides a "real-world" assessment of the accuracy of transcutaneous bilirubin measurements in multiple clinical settings and identification of sources of discrepancy between transcutaneous and total serum bilirubin measurements.

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Bilirubin Measurement for Neonates: Comparison of 9 Frequently Used Methods

Cited by 110 publications

References 26 publications

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

Optical properties of neonatal skin measured in vivo as a function of age and skin pigmentation

Discrepancies Between Transcutaneous and Serum Bilirubin Measurements

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