Comparison of Skin Sites for Estimating Serum Total Bilirubin in In-Patients and Out-Patients: Chest Is Superior to Brow

Poland, Ronald L.; Hartenberger, Carol; McHenry, Helen; Hsi, Andrew

doi:10.1038/sj.jp.7211141

Cited by 17 publications

(19 citation statements)

References 7 publications

(13 reference statements)

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“…Maisels et al, using the JM-103 Jaundice Meter, performed measurements over the forehead and sternum in 475 infants and found a higher correlation for the values assessed over the sternum [16]. Because the forehead is exposed to ambient light, this can lead to underestimation of TSB values, while the sternum is nearly always covered [5,30]. Measurements over the sternum was therefore considered the better choice for our measurements in our study.…”

Section: Discussionmentioning

confidence: 97%

Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

2009

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BackgroundThe gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed®, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed® and serum bilirubin in preterm and term infants of different skin colours.MethodsThe transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis.ResultsA total of 117 measurement cycles were performed in 99 term infants (group1), further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2), and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3). The mean deviation and variability (+/- 2SD) of the transcutaneous from serum bilirubin were: -14 (+/- 144) μmol/l; -0.82 (+/- 8.4) mg/dl in group 1, +16 (+/- 91) μmol/l;+0.93(+/- 5.3) mg/dl in group 2 and -8 (+/- 76) μmol/l; -0.47 (+/- 4.4) mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values.ConclusionDespite its new technology the Bilimed® has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants.

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Section: Discussionmentioning

confidence: 97%

Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

2009

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“…TcB measurements were all performed by trained nurse–midwives. Based on the good correlation of TcB with TSB, we chose the midsternum for the site of TcB measurement . The mean of two TcB measurements was taken.…”

Section: Methodsmentioning

confidence: 99%

Transcutaneous bilirubin measurement during phototherapy in term neonates

Katayama

Enomoto

Kikuchi

et al. 2017

Pediatrics International

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“…19 Based on our experience with measurement at different body sites and using varying numbers of determination, we concluded that optimal performance was obtained with a single reading over the sternum (data available on request); preferential use of the sternum site is also in agreement with the results of Maisels et al (JM) 17 and Poland et al (BiliCheckt). 20 TcB was measured within 30 minutes of collection of blood for TSB determination.…”

Section: Description Of Jmmentioning

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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Comparison of Skin Sites for Estimating Serum Total Bilirubin in In-Patients and Out-Patients: Chest Is Superior to Brow

Abstract: In our inpatients, chest and brow readings approximated serum values. After discharge, brow readings were lower than serum values by almost 20%, while chest readings were underestimated by 5%. We recommend using the chest for transcutaneous bilirubin estimates.

Cited by 17 publications

References 7 publications

Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

Transcutaneous bilirubin measurement during phototherapy in term neonates

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

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