Effectiveness of transcutaneous bilirubin measurement in managing neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan

Hussain, Ali; Shah, M. H.; Lakhdir, Maryam Pyar Ali; Ariff, Shabina; Demas, Simon; Qaiser, Fatima; Ali, Safdar

doi:10.1136/bmjpo-2017-000065

Cited by 13 publications

(15 citation statements)

References 15 publications

(14 reference statements)

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“…Another method to detect the level of bilirubin in neonates is the use of transcutaneous bilirubinometer (TcB), a hand-held device that measures the amount of bilirubin in the skin by directing light into the skin of the newborn and evaluating the intensity of specific wave- there is conflicting evidence with regards to the sensitivity of TcB usage in pigmented neonates (7,8,11,12). BiliSpec is a low-cost reader and disposable lateral flow card that needs several drops of blood to determine the concentration of total bilirubin (4).…”

Section: Discussionmentioning

confidence: 99%

Detection of Neonatal Jaundice by Using an Android OS-Based Smartphone Application

Padidar¹,

Shaker²,

Amoozgar

et al. 2019

Iran J Pediatr

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Background: Neonatal jaundice resulting from raised blood bilirubin levels is one of the most common clinical conditions that needs medical attention. To initiate appropriate management that can both prevent and treat severe neonatal jaundice, screening methods that measure bilirubin level are warranted. Methods: In this study, we present an Android OS-based application for detecting neonatal jaundice. We used the application to detect jaundice in 113 neonates. Our smartphone-based estimation of bilirubin levels depends on a smartphone, a color calibration card, and a 100X zoom microscope clip. Our application was designed to acquire images of the newborn's forehead skin in a standardized manner, estimate the average R, G, B scores of the images that have been taken from the forehead skin and calibration card, and then convert them to hue, saturation, intensity (HSI) parameters. All these are performed offline; in this application, we used offline machine learning and regression techniques for analysis Results: Our smartphone-based estimation of bilirubin levels had a sensitivity of 68% and specificity of 92.3% for estimating the bilirubin levels of less than 10 mg/dL and sensitivity of 82.1% and specificity of 100% for estimating the bilirubin levels of less than 15 mg/dL. Our application-based estimation of bilirubin levels had the correlation of 0.479 with the total serum bilirubin values. Conclusions: Our results suggest that our smartphone-based application can serve as a promising screening tool for neonatal jaundice, and it can aid in determining neonates requiring a blood draw for measuring total serum bilirubin level.

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Section: Discussionmentioning

confidence: 99%

Detection of Neonatal Jaundice by Using an Android OS-Based Smartphone Application

Padidar¹,

Shaker²,

Amoozgar

et al. 2019

Iran J Pediatr

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“…If jaundice appears within 24 hours of birth, then TsBR is sent and the jaundice is managed according to AAP guidelines 19 which are followed in our unit. If jaundice appears after 24 hours, then risk assessment is performed and in low risk babies TcBR is checked and plotted on the TcBR nomogram for low risk babies (fig-1, Hussain et al 17 ). If TcBR level falls on or above red line, TsBR is sent, and phototherapy initiated.…”

Section: Methodsologymentioning

confidence: 99%

“…TcBR nomogram for low risk babies (fig-4), is already in use for our low risk babies and is made using American Academy of Pediatrics (AAP) guidelines for phototherapy threshold for low risk babies. It was incorporated into the hospitals guideline for the management of neonatal jaundice after we found a 70% reduction in the freq-uency of serum sampling for TsBR using this nomogram 17 . It is similar to the high risk nomogram and also has two color coded lines, a red line (phototherapy line) which shows the phototherapy thresholds for low risk babies and a blue line (TcBR line) drawn 2 mg/dL (34.2 µmol/ L) below the phototherapy line and is named as TcBR line because literature review reveals a variation of ± 1 mg/dL (17.1 µmol/L) in results of For all low risk babies, on appearance of clinical jaundice TcBR will be done and plotted on TcBR nomogram.…”

Section: Tcbr Nomogram and Process Flow For Low Risk Babiesmentioning

confidence: 99%

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Effectiveness of Transcutaneous Bilirubin (Tcbr) Measurement in High Risk Neonates and to Evaluate the Validity of Transcutaneous Bilirubin (Tcbr) With Total Serum Bilirubin (Tsbr) Levels in Both Low and High Risk Neonates at a Tertiary Care Center Of....

Shahwar

Ariff

Tariq

et al. 2021

PAFMJ

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Objective: To evaluate the utility of a Transcutaneous Bilirubin nomogram in high risk neonates and to evaluate the validity of Transcutaneous Bilirubin and Total serum bilirubin in both low and high-risk neonates. Study Design: Cross-sectional study. Place and Duration of Study: Postnatal Ward, Aga Khan University Hospital, Karachi, from May to Oct 2019. Methodology: The participants will include all neonates born and admitted in the well baby nursery withjaundice. All neonates with gestational age of <35 weeks, requiring admission in Neonatal intensive care unit, and neonates with conjugated hyperbilirubinemia will be excluded. We will stratify our neonates into high and low risk population based on predefined criteria. Eighty five neonates in low risk group and 122 neonates in high risk group will be included. Results: We aim to assess the effectiveness of Transcutaneous Bilirubin nomogram in high risk neonates asan effective and non-invasive tool in the management of neonatal jaundice in high risk neonates. We will alsoassess the sensitivity and specificity of Transcutaneous Bilirubin and Total serum bilirubin measurementsand the analysis would be performed separately for high risk and low risk neonates to evaluate the validity ofTranscutaneous Bilirubin independently in both groups. Conclusion: We hope to establish a validated phototherapy guideline based on the Transcutaneous Bilirubinnomogram, as a cost effective and noninvasive tool in the management of neonatal jaundice in both high and low risk groups in Pakistan.

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“…However, the mean contrasts among the hyperbilirubinemia level estimated by transcutaneous bilirubinometer and TSB are enormous when the bilirubin levels surpass 205 µmol/L (12 mg/dL) in newborn[18]. An additional drawback of transcutaneous meters is that their availability and accessibility in under-developing nations.Likewise, there is clashing proof concerning the affectability of TcB utilization in dark colour neonates[8][19][20][21]. In literature, many transcutaneous meters have been reported and have been used for experimentation.…”

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confidence: 99%

Development of Jaundice Detection Approaches in Neonates

Bhagat¹,

M²,

Singh³

et al. 2020

JUSST

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Jaundice is one of the most common diseases that have a significant impact in the first few days of newborn life. Detection and regular monitoring of bilirubin, which is responsible for Jaundice, is an essential phase during the hyperbilirubinemia. In the literature, various clinical assessment methods of Jaundice are available. It motivates us to present a review of these clinical assessment methods in practice, along with their advantages and limitations. In this paper, we have discussed three widely used methods, such as visual assessment, total serum bilirubin and transcutaneous bilirubinometer. From the comparative analysis of these methods, it is concluded that the visual assessment is very subjective in nature, whereas, the total serum bilirubin method is still a gold standard method. The detailed analysis of the methods depicts that the correlation between this two total serum bilirubin and transcutaneous bilirubinometer has enormous potential for improvement resulting in the enhancement in precision and accuracy of bilirubin measurement.

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Effectiveness of transcutaneous bilirubin measurement in managing neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan

Cited by 13 publications

References 15 publications

Detection of Neonatal Jaundice by Using an Android OS-Based Smartphone Application

Detection of Neonatal Jaundice by Using an Android OS-Based Smartphone Application

Effectiveness of Transcutaneous Bilirubin (Tcbr) Measurement in High Risk Neonates and to Evaluate the Validity of Transcutaneous Bilirubin (Tcbr) With Total Serum Bilirubin (Tsbr) Levels in Both Low and High Risk Neonates at a Tertiary Care Center Of....

Development of Jaundice Detection Approaches in Neonates

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