Can transcutaneous bilirubinometry reduce the need for blood tests in jaundiced full term babies?

Briscoe, Lesley; Clark, Simon J.; Yoxall, C W

doi:10.1136/fn.86.3.f190

Cited by 50 publications

(35 citation statements)

References 8 publications

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“…These instruments have been shown to give results that correlate well with serum bilirubin values, but exhibit large scattering [1]. Consequently, with the application of non-invasive bilirubinometers, the number of serum measurements could be reduced and painful heel pricks avoided but not completely abolished [5,15]. Warnings have been published for the use of bilirubinometers in newborns with dark and yellow skin and in bright sunlight [23].…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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

et al. 2004

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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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“…6,7 In the former study, the researchers have mentioned that TcB is as accurate as SBR and can replace it. 7 Karon et al showed that TcB is a sensitive but nonspecific method for predicting the risk of neonatal icterus.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Transcutaneous Billirubin with Serum Billirubin in Neonates with Jaundice

Arora

Singla

Sharma

et al. 2017

Int J Contemp Pediatr

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INTRODUCTIONNeonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the hospitals in the newborn period. Clinically it becomes apparent when the serum bilirubin exceeds 7 mg/dl in neonates.2 In most of the cases, it is benign and no intervention is required. Approximately 5-10 % of them have clinically significant hyperbilirubinemia mandating the use of phototherapy. 3,4 In recent decades, noninvasive bilirubin measurements have been presented for reducing patients stress, laboratory expenses, and the need for blood sampling. One of these noninvasive methods is transcutaneous bilirubinometry (TcB).Studies comparing the correlation between total serum bilirubin (SBR) and TcB have yielded different results. So, we planned this study to find out relationship between TcB and SBR values. ABSTRACTBackground: Neonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the hospitals in the newborn period. Studies comparing the correlation between total serum bilirubin (SBR) and transcutaneous bilirubin (TcB) have yielded different results. So, we planned this study to find out relationship between TcB and SBR values. Methods: A hospital based prospective study was done during March 2016 to September 2016, in which a total of 120 newborns including term and preterm who were admitted with neonatal jaundice in NICU, Maharana Bhupal Hospital, Udaipur, Rajasthan were assessed in terms of age, sex and weight and investigated for both TcB and SBR. The sample size was calculated at a confidence interval of 90% and allowable error of 15%. Results: Out of total 120 study subjects, 59 (49%) were males and 61 (51%) were females, out of which 53 (44%) were preterm and 67 (56%) were term neonates. Mean TcB and SBR values at the time of admission has a mean difference of 2.52 mg/dl with a p-value <0.001 (significant) on the other hand TcB and SBR at 24 hr of admission has a mean difference of 1.57 with a p-value >0.001, which is non-significant. TcB and SBR at 48 and 72 hr of admission also has a mean difference which is also non-significant (p >0.001). Conclusions: From present study, we conclude that there is no significant difference between TcB and SBR values at 24, 48 and 72 hrs after starting phototherapy. The values of TcB are equally reliable as SBR values.

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Can transcutaneous bilirubinometry reduce the need for blood tests in jaundiced full term babies?

Cited by 50 publications

References 8 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?

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

Relationship of Transcutaneous Billirubin with Serum Billirubin in Neonates with Jaundice

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