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

Engle, William D.; Jackson, Gregory L.; Stehel, Elizabeth K.; Sendelbach, Dorothy; Manning, M. Denise

doi:10.1038/sj.jp.7211333

Cited by 65 publications

(68 citation statements)

References 21 publications

(33 reference statements)

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“…Overall, our results are similar to those of a large study evaluating the JM-103 in neonates X35 weeks, 3 and similar to or better than our experience using the JM-103 in larger, more mature neonates. 2 We found excellent precision between TcB results obtained by two independent observers. Means and s.d.…”

Section: Discussionmentioning

confidence: 61%

“…As in an earlier study using the JM-103 in our institution, there was a tendency for the TcB result to underestimate the corresponding TSB value. 2 In the current study, particularly in Groups 1 and 2, the regression lines drawn through individual group Bland-Altman data points indicated a tendency for the underestimation to be less at higher bilirubin values. In light of this trend, the clinician may be reassured as therapeutic intervention is, of course, more likely to be initiated at higher TSB values.…”

Section: Discussionmentioning

confidence: 89%

“…Furthermore, the use of transcutaneous bilirubin (TcB) values is more convenient and is less invasive than determination of TSB. 1 The majority of earlier studies have examined the use of TcB in term and near-term neonates, [2][3][4][5][6][7] whereas studies that have been carried out in preterm neonates have yielded varying results. [8][9][10][11][12][13][14][15][16] Yasuda et al 17 reported that the correlation between TcB and TSB was similar in both preterm and term neonates.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of transcutaneous bilirubinometry in preterm neonates

et al. 2009

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Objective: To determine the accuracy and precision of transcutaneous bilirubin (TcB) measurements in preterm neonates.Study Design: Neonates were stratified into three groups on the basis of gestational age: 24 to 28 weeks (Group 1, n ¼ 30), 29 to 31 weeks (Group 2, n ¼ 29) and 32 to 34 weeks (Group 3, n ¼ 31). TcB was measured using the Draeger Air Shields JM-103, and when possible, measurements were made by two observers. TcB and total serum bilirubin (TSB) measurements were compared, and interobserver precision for TcB measurements was assessed.Result: Correlations between TcB and TSB ranged from 0.79 to 0.92. Most of the differences between TcB and TSB were ±2 mg per 100 ml, and there was no trend for the difference to increase with increasing bilirubin values. Sensitivity, specificity and negative predictive values ranged from 0.67 to 1.0, 0.29 to 0.81 and 0.60 to 1.0, respectively. Intraclass correlations were 0.87 to 0.92. Conclusion:TcB correlates significantly with TSB in preterm neonates, and interobserver precision is significant. Routine measurement of TcB in preterm neonates may provide enhanced clinical monitoring for hyperbilirubinemia.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Evaluation of transcutaneous bilirubinometry in preterm neonates

et al. 2009

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“…29 Infants below standard TcB or TSB cut-offs may still develop hyperbilirubinemia, so even infants who have low pre-discharge screening levels should receive postnatal follow-up. 31 Studies have shown that the use of TcB and TSB in outpatient settings are also reliable 32,33 and can reduce readmissions for phototherapy. 34 The results of this study could be used by hospital postnatal discharge programs to ensure the most at-risk infants receive adequate information or screening before discharge and follow-up at home.…”

Section: Figurementioning

confidence: 99%

Early Discharge of Infants and Risk of Readmission for Jaundice

et al. 2015

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OBJECTIVES: To examine the association between early discharge from hospital after birth and readmission to hospital for jaundice among term infants, and among infants discharged early, to investigate the perinatal risk factors for readmission for jaundice.METHODS: Birth data for 781 074 term live-born infants born in New South Wales, Australia from 2001 to 2010 were linked to hospital admission data. Logistic regression models were used to investigate the association between postnatal length of stay (LOS), gestational age (GA), and readmission for jaundice in the first 14 days of life. Other significant perinatal risk factors associated with readmission for jaundice were examined for infants discharged in the first 2 days after birth.RESULTS: Eight per 1000 term infants were readmitted for jaundice. Infants born at 37 weeks' GA with an LOS at birth of 0 to 2 days were over 9 times (adjusted odds ratio [aOR] 9.43; 95% CI, and at 38 weeks' GA were 4 times (aOR 4.05; 95% CI, 3.62-4.54) more likely to be readmitted for jaundice compared with infants born at 39 weeks' GA with an LOS of 3 to 4 days. Other significant risk factors for readmission for jaundice for infants discharged 0 to 2 days after birth included vaginal birth, born to mothers from an Asian country, born to first-time mothers, or being breastfed at discharge.CONCLUSIONS: This study can inform guidelines or policy about identifying infants at risk for readmission for jaundice and ensure that appropriate post-discharge follow-up is received.WHAT'S KNOWN ON THIS SUBJECT: Studies examining early postnatal discharge and readmission for jaundice report conflicting results. Infants born 37 to 38 weeks' gestation have an increased risk for readmission for jaundice; however, the impact of early discharge on this group has not been investigated. WHAT THIS STUDY ADDS:Early postnatal discharge was significantly associated with readmission for jaundice. Of the infants discharged early, those born 37 to 38 weeks' gestation, born via vaginal delivery, born to Asian mothers, or were breastfed had the greatest risk for readmission. Dr Lain participated in the study design, took primary responsibility of the data analysis, and drafted the initial manuscript; Associate Professor Roberts participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; Dr Bowen participated in interpretation of the data and revision of manuscript for important clinical content; Associate Professor Nassar participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; and all authors approved the final manuscript as submitted. The length of stay (LOS) in hospital after the birth of a child has been a controversial topic over the past few decades. A Cochrane Review found early postnatal discharge, defined as earlier than standard care, to have no adverse effects on breastfeeding and maternal depression when accompanied by a policy of nursing/midwifery home visits. However, they reported more re...

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“…Transcutaneous bilirubin was measured within 30 min of blood sampling using the Konica Minolta/Dräger AirShields JM-103t Jaundice Metert (JM). 14,16 A single reading over the sternum was recorded; one investigator (HAB) performed all U/TSB and JM measurements.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a point-of-care direct spectrophotometric method for measurement of total serum bilirubin in term and near-term neonates

2006

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Objective: To evaluate point-of-care (POC) measurement of total serum bilirubin (TSB) in the management of neonatal jaundice.Study design: TSB was measured by a POC direct spectrophotometric bilirubin method (Unistatt (U/TSB)) and a standard diazo clinical laboratory method (Olympus AU640E analyzer (diazo/TSB)). Agreement between U/TSB and diazo/TSB was assessed by correlation coefficient and Bland-Altman analysis. Transcutaneous bilirubin (TcB) was measured using JM-103t (JM).Results: Correlation between U/TSB and diazo/TSB was 0.99 (n ¼ 120). Maximum difference (U/TSB minus diazo/TSB) was À2.9 mg/dl, and 79% were ±1 mg/dl; the average difference was À0.37±0.70 mg/dl and the average absolute difference was 0.60±0.52 mg/dl. Median time to determine U/TSB was 5 min. Correlation between U/TSB and JM was 0.92 (n ¼ 113). Maximum difference (U/TSB minus JM) was 6.3 mg/dl, and 45% were ±1 mg/dl; the average difference was 0.7±1.8 mg/dl and the average absolute difference was 1.4±1.2 mg/dl.Conclusion: Measurement of TSB using Unistatt provides excellent agreement with diazo/TSB and rapid turnaround time. This technique may provide reliable POC confirmation of TcB results that are above a screening cutoff value.

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

Cited by 65 publications

References 21 publications

Evaluation of transcutaneous bilirubinometry in preterm neonates

Evaluation of transcutaneous bilirubinometry in preterm neonates

Early Discharge of Infants and Risk of Readmission for Jaundice

Evaluation of a point-of-care direct spectrophotometric method for measurement of total serum bilirubin in term and near-term neonates

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