Cephalocaudal Progression of Jaundice in Newborns Admitted to Neonatal Intensive Care Units

Knudsen, Aage; Ebbesen, Finn

doi:10.1159/000244436

Cited by 16 publications

(8 citation statements)

References 7 publications

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“…In uence of gender on transcutaneous bilirubin measured on the forehead The female NICU infants had a TcB(h) which was on average 10 mmol l ¡1 greater than the male NICU infants (p = 0.003) ( Table 2). This is in agreement with the nding that the cephalocaudal gradient of jaundice in NICU infants is greater in females than in males (24). It is also in accordance with females having a slightly lower albumin concentration than males, and the reserve albumin concentration for binding of bilirubin possibly being slightly lower in females than in males, as has been found for other ligands bound to albumin (25).…”

Section: Effect Of Illness On Transcutaneous Bilirubinsupporting

confidence: 91%

A new transcutaneous bilirubinometer, BiliCheck, used in the neonatal intensive care unit and the maternity ward

2002

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Section: Effect Of Illness On Transcutaneous Bilirubinsupporting

confidence: 91%

A new transcutaneous bilirubinometer, BiliCheck, used in the neonatal intensive care unit and the maternity ward

2002

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“…Our study also demonstrated slightly increases in sensitivity of Kramer's method when detecting jaundice among term (75.3%) and normal birthweight (80%) neonates and specificity in neonates with low birthweight (89. 4%).The findings are comparable to what reported in Denmark and Switzerland where sex, birthweight and gestational age were demonstrated to be the determinants of the diagnostic accuracy of the visual assessment technique (14,15). These findings suggest the consideration of gestational age and birthweights when using Kramer's method in screening and diagnosis of NJ.…”

Section: Discussionsupporting

confidence: 82%

Reliability of Visual Assessment for Diagnosis of Neonatal Jaundice Among Neonates of Black Descent: A Cross-Sectional Study From Tanzania.

Dionis

Chillo

Bwire

et al. 2021

Preprint

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Background: Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing of jaundice in neonates using Kramer’s method (visual assessment) is considered user friendly in resource limited areas. However, there are conflicting finding on reliability of the Kramer’s method in diagnosis of neonatal jaundice (NJ) particularly of black descent. Therefore, this study aimed to determine diagnostic accuracy of Kramer’s method in comparison with total serum bilirubin (TSB) test in diagnosis of NJ among neonates of black descent in Tanzania. Methods: A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonates’ jaundice was assessed by using Kramer’s method and TSB test. A 2 X 2 table was created for determination of sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/-LR) and diagnostic accuracy (effectiveness). Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using chi-square test and the p ˂ 0.05 was considered to be statistical significance. Results: The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of the Kramer’s method were 70.5%, 86.1%, 88.8%, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34 respectively. The diagnostic accuracy of the Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ= 0.524, P˂0.001). No significance relationship between the independent variables and presence of NJ. Conclusion: Kramer’s method was found to be inefficient in detecting NJ among neonates of black descent. However, it can be used as a predictor of NJ and whenever available invasive techniques should be applied.

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“…The clinical assessment of jaundice is best undertaken in a well-lit room to maximize the ability to determine true skin color [21]. Jaundice in term and preterm infants follows a cephalocaudal progression [25]. Visual estimation of the severity of jaundice is unpredictably and imprecisely related to the actual serum bilirubin level, especially in infants with dark skin pigmentation and once the jaundice has extended to the lower legs and feet [5,9,[26][27][28].…”

Section: Clinical Presentationmentioning

confidence: 99%

An Emergency Medicine Approach to Neonatal Hyperbilirubinemia

Colletti

Kothari

Jackson

et al. 2007

Emergency Medicine Clinics of North America

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Jaundice (also known as hyperbilirubinemia) is a yellowish-greenish pigmentation of the sclera and skin caused by an increase in bilirubin production or a defect in bilirubin elimination. Management of hyperbilirubinemia is one of the most common reasons for readmission of a newborn. Prolonged unconjugated hyperbilirubinemia can result in acute bilirubin encephalopathy and eventually develop into chronic bilirubin encephalopathy (kernicterus). Kernicterus, the feared complication of hyperbilirubinemia, was considered almost extinct but has recently re-emerged despite virtual elimination of Rh disease. This review provides a systematic approach to the presentation, evaluation, and management of the jaundiced newborn.

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Cephalocaudal Progression of Jaundice in Newborns Admitted to Neonatal Intensive Care Units

Cited by 16 publications

References 7 publications

A new transcutaneous bilirubinometer, BiliCheck, used in the neonatal intensive care unit and the maternity ward

A new transcutaneous bilirubinometer, BiliCheck, used in the neonatal intensive care unit and the maternity ward

Reliability of Visual Assessment for Diagnosis of Neonatal Jaundice Among Neonates of Black Descent: A Cross-Sectional Study From Tanzania.

An Emergency Medicine Approach to Neonatal Hyperbilirubinemia

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