Hyperbilirubinemia and Transcutaneous Bilirubinometry

Abstract

BACKGROUND:Neonatal jaundice or hyperbilirubinemia is a common occurrence in newborns. Although most cases of neonatal jaundice have a benign course, severe hyperbilirubinemia can lead to kernicterus, which is preventable if the hyperbilirubinemia is identified early and treated appropriately.CONTENT: This review discusses neonatal jaundice and the use of transcutaneous bilirubin (TcB) measurements for identification of neonates at risk of severe hyperbilirubinemia. Such a practice requires appropriate serial testing and result interpretation according to risk level from a nomogram that provides bilirubin concentrations specific for the age of the neonate in hours. In this context, we have evaluated the potential impact on clinical outcome and limitations of TcB methods in current use.

Differences Between Transcutaneous and Serum Bilirubin Measurements in Black African Neonates

“…The algorithms and other technical features of the 2 devices are well described. 5,6,9 Infants whose bilirubin levels at screening exceeded 3 mg/dL below the recommended postnatal age threshold for phototherapy based on the American Academy of Pediatrics (AAP) guidelines were assessed for TSB within ∼1 hour. This criterion was adopted because of the high prevalence of G6PD deficiency in this population.…”

“…3 As a high-risk population, routine, predischarge bilirubin screening is warranted in this racial group to minimize the risk of kernicterus. 4 The excellent correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) tests 5,6 has made TcB a valuable screening tool for TSB in the management of hyperbilirubinemia worldwide. 4,7,8 However, TcB tends to underestimate TSB in whites or neonates with light or medium skin color and overestimate TSB in non-whites or neonates with dark skin color.…”

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

“…These devices work by directing light into the skin of the neonate and measuring the intensity of specific wavelengths returned. 8 The number of wavelengths varies depending on the TcB device. These devices have been shown to correlate well with serum bilirubin levels in term and near-term infants.…”

Transcutaneous Billirubinometry: A Useful Screening Tool for Neonatal Jaundice in Term and Near Term Babies - A Hospital Based Study

“…[12][13][14] Accuracy of transcutanuous bilirubinometry is not widely accepted in preterm newborn. 15,16 In preterm infant transcutaneous bilirubinometry is less accurate than in term infant as result are affected by immature skin and by different albumin to bilirubin binding. [16][17][18] In our country transcutaneous bilirubinometry has not been widely adopted due to concern of its validity and accuracy.…”

“…15,16 In preterm infant transcutaneous bilirubinometry is less accurate than in term infant as result are affected by immature skin and by different albumin to bilirubin binding. [16][17][18] In our country transcutaneous bilirubinometry has not been widely adopted due to concern of its validity and accuracy. In this context this study was performed with the objectives of estimating the relationship between transcutaneous bilirubin (TcB) and TSB and to evaluate whether transcutaneous billirubinometry could be a valid screening method for detecting jaundice in term and near term newborn.…”