Evaluation of the Kejian KJ‐8000 bilirubinometer in an Australian setting

Abstract

Aim To evaluate the accuracy of the Kejian 8000 (KJ‐8000) transcutaneous bilirubinometer in infants of differing ethnicity and gestational age. Methods This was a prospective study of infants in the Newborn Care Unit at Gold Coast University Hospital. Transcutaneous bilirubin (TcB) and serum bilirubin (SBR) results were compared using linear regression and a Bland–Altman plot. Predicted indices were calculated to assess the KJ‐8000 as a screening tool using local jaundice management guidelines. Results A total of 416 paired samples were collected from 201 infants. There was a strong correlation between TcB and SBR with a Pearson correlation coefficient of 0.8 (<0.00001). The bias was −5.9 μmol/L (95% confidence interval: −101, 89). The bias was not evenly spread, with the KJ‐8000 tending to underestimate at higher SBR levels. Infants <32 weeks' gestation had a poor correlation of 0.48. Non‐Caucasian infants were more likely to have TcB overestimation, and measurements were less precise. As a screening tool using local guidelines, the KJ‐8000 had a sensitivity, specificity, positive predictive value and negative predictive value of 83, 53, 20 and 96%, respectively, and is predicted to avoid blood tests in 48% of infants screened. Conclusions In this study, the correlation and agreement of TcB measurements using the KJ‐8000 were not as good as has been reported with other more studied devices but may still have value as a screening tool. The poor correlation in preterm infants suggests that use should be restricted to term infants. The overall results of this study are affected by an underrepresentation of term infants, and so, further clinical assessment of this device should be undertaken before it can be recommended for widespread use.

Utility of Direct Coomb’s test in a Tertiary Care Nursery

“…However, despite being a non-invasive method, the considerations of financial costs, lack of standardisation guidelines, inaccurate value in Asian and dark-skinned people, and high false-positive results are not yet adopted in our unit. 19 Therefore, despite the latest modalities, direct Coomb's test remains a cost-effective and readily accessible method of detecting neonates at risk of developing severe hyperbilirubinemia and its complications.…”

70 years of bilirubin sensing: towards the point-of-care bilirubin monitoring in cirrhosis and hyperbilirubinemia

“…These POCT techniques include implantable, wearable, and handheld devices and sensors. 52 Handheld -Jacques, et al 99 FOC-based -SpectRx BiliCheck 100 Handheld 2300 Bilistick 101 Fingerprick 1400 JM-103 102 Handheld 1500 JM-105 102 Handheld 2900 KJ-8000 Meter 103 Handheld 4800…”

Screening methods for neonatal hyperbilirubinemia: benefits, limitations, requirements, and novel developments

“…33,34,35 The accuracy of TcB in infants receiving PT (due to skin bleaching) and its use on preterm neonates has also been subject of discussion. 36,37 Hulzebos and colleagues concluded that PT enhances the well-known underestimation of TSB by TcB in preterm infants, even when measured on an unexposed area of skin in the diaper area. The underestimation of TSB before PT was significantly lower, 44 ± 36 μmol/L, than the underestimation during and after PT, 61 ± 29 and 63 ± 25 μmol/L, respectively.…”