Differences Between Transcutaneous and Serum Bilirubin Measurements in Black African Neonates

Olusanya, Bolajoko O.; Imosemi, Donald; Emokpae, Abieyuwa A.

doi:10.1542/peds.2016-0907

Cited by 66 publications

(51 citation statements)

References 32 publications

(39 reference statements)

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“…However, as previously reported [13] and displayed in Figure 2, TSB is frequently overestimated by TcB in black neonates by clinically significant margins. This finding should not be surprising as TcB reflects the yellowish coloration of the blanched skin and subcutaneous tissue rather than intravascular plasma/serum bilirubin concentration.…”

Section: Discussionsupporting

confidence: 82%

“…Some 45.1% of the infants were female, 2.4% weighed <2.5 kg, and 16.5% had a gestational age <38 weeks. The infants were predominantly from the Yoruba tribe (70.5%); had light or medium brown skin (91.3%), as previously defined [13]; and were exclusively breast-fed (73.2%). TcB was recorded by BiliChek in 22.7% of the infants.…”

Section: Resultsmentioning

confidence: 99%

“…With appropriate follow-up, the likelihood of a bad outcome resulting from exaggerated TcB measurements seems negligible compared to the immense benefits of rapid and noninvasive TSB estimation for the infant, parents, and care providers [27]. However, as previously demonstrated [13], it is important to recognize the possible impact of different models of TcB device in decision-making for phototherapy or even confirmatory TSB determination where possible.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have also shown that TcB significantly overestimates TSB among African neonates, in sharp contrast to the more commonly reported underestimation among white neonates [13,14]. However, limited evidence exists on the use of TcB as proxy for TSB in initiating phototherapy, particularly in resource-limited countries where timely and routine TSB determination is not readily available but the burden of severe hyperbilirubinemia is high [15,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings

Olusanya

Emokpae²

2017

Neonatology

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Background: Routine and timely determination of total serum bilirubin (TSB) remains a challenge in many resource-limited countries with substantial burden of severe neonatal hyperbilirubinemia. Limited evidence exists on the potential usefulness of transcutaneous bilirubin (TcB) to identify infants who may require phototherapy based on possible treatment criteria in such settings. Objective: To compare the number of infants requiring phototherapy across different TSB criteria and determine the predictive performance of TcB under each criterion. Methods: Infants with paired TcB and TSB measurements in a maternity hospital in Lagos, Nigeria, were assessed for phototherapy based on TSB criteria by the American Academy of Pediatrics (AAP), National Institute for Health and Clinical Excellence (NICE) UK, and World Health Organization (WHO), and an absolute threshold of ≥12 mg/dL. The predictive performance of TcB across treatment criteria was evaluated with receiver operating curve analysis. Results: A total of 1,011 infants with a mean TcB of 10.54 ± 3.19 (range: 2.7-19.9) mg/dL and TSB of 9.63 ± 2.61 (range: 0.3-19.5) mg/dL were assessed. Some 60 (5.9%) infants required phototherapy by 1 or more TSB criteria, with TSB ≥12 mg/dL identifying 55 (91.7%) and AAP 27 (45%) of these infants. All infants identified by the NICE and WHO criteria were equally detected by the AAP criterion. TcB showed negative predictive values of 99.0-99.9%, and positive predictive values of 7.7-15.5% across all criteria. Conclusions: The number of infants requiring phototherapy varies significantly across treatment criteria. TcB may be useful in identifying infants who do not require phototherapy, but may also identify a high proportion of false positives that is burdensome in resource-limited settings.

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Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings

Olusanya

Emokpae²

2017

Neonatology

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“…Depending on the device and target populations, TcB may either overestimate or underestimate bilirubin level in jaundiced neonates. 12,14,15 TcB screening in early hours of life may be a useful marker to foretell the possibility of hyperbilirubinemia in later days of life. 12,[16][17][18][19] In the present study, we showed that TSB and sternum TcB levels were plausibly correlated with each other in full term and near term infants with hyperbilirubinemia.…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous Bilirubin Assessment for Screening of Hyperbilirubinemia in Term and Near-Term Neonates with Jaundice, a Comparative Study

Kalvandi¹,

Shahramian²,

Delaramnasab³

et al. 2017

Int J Basic Sci Med

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Introduction: Hyperbilirubinemia is a common condition in neonates. In this study, we aimed to investigate the association of total serum bilirubin (TSB) with sternum transcutaneous bilirubin (TcB) level obtained by KJ-8000 Transcutaneous bilirubin meter (KEJIAN medical apparatus). Methods: Eighty newborns were enrolled in the present prospective cross-sectional study. At first, blood sampling was performed for determination of TSB, and immediately after that, TcB levels were recorded at the sternum skin by KJ-8000 device. Data was analyzed by statistical software SPSS version 21.0. Results: The mean gestational age of the infants was 38.2 ± 1.5 weeks. The mean level of TSB was 13.52 ± 4 mg/dL, while the mean value of TcB was 13.71 ± 3.53 mg/dL. Pearson correlation analysis showed a correlation coefficient of r = 0.770 between sternum TcB recorded by KJ-8000 device and TSB. Conclusion: Given a strong correlation between TcB and TSB levels, it is advised the transcutaneous bilirubinometery be considered as the screening method in infant jaundice.

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Reliability of transcutaneous bilirubin determination based on skin color determined by a neonatal skin color scale of our own

et al. 2021

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Differences Between Transcutaneous and Serum Bilirubin Measurements in Black African Neonates

Cited by 66 publications

References 32 publications

Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings

Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings

Transcutaneous Bilirubin Assessment for Screening of Hyperbilirubinemia in Term and Near-Term Neonates with Jaundice, a Comparative Study

Reliability of transcutaneous bilirubin determination based on skin color determined by a neonatal skin color scale of our own

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