Kramer’s scale or transcutaneous bilirubinometry: the ideal choice of a pediatrician? can we trust our eyes?

Varughese, Pearl Mary

doi:10.18203/2349-3291.ijcp20193702

Cited by 8 publications

(5 citation statements)

References 14 publications

(14 reference statements)

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“…We found a strong correlation between TCB and TSB in accordance with previous studies [10]. Two recent studies from Indonesia and India, respectively, reported higher correlations between TCB and TSB in (late) preterm infants [17,19]. TCB overestimated TSB with 26 µmol/L at 24 h and 21 µmol/L at 48 h [19].…”

Section: Discussionsupporting

confidence: 91%

“…Two recent studies from Indonesia and India, respectively, reported higher correlations between TCB and TSB in (late) preterm infants [17,19]. TCB overestimated TSB with 26 µmol/L at 24 h and 21 µmol/L at 48 h [19]. Greco et al [16] reported that TCB measured before or during PT with the JM-103 overestimated TSB with an MD of 5 (±50) µmol/L and corresponding LoA from −92 to 103 µmol/L.…”

Section: Discussionmentioning

confidence: 96%

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Diagnostic Properties of a Portable Point-of-Care Method to Measure Bilirubin and a Transcutaneous Bilirubinometer

et al. 2021

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Background: Recently, the Bilistick®, a point-of-care instrument to measure bilirubin levels, has been developed. It is fast and cheaper than transcutaneous bilirubin (TCB)-measuring devices, but data on diagnostic properties are scarce. Objective: This study aimed to compare the performance of the Bilistick® (BM-BS 1.0 – FW version 2.0.1) and the JM-105 bilirubinometer for measuring bilirubin. Method: This is a prospective study in infants born after ≥32 weeks’ gestation, and/or a birth weight of ≥1,500 g, and a postnatal age ≤14 days in Surabaya, Indonesia. Bilirubin was measured with the Bilistick® System (BM-BS 1.0 – FW version 2.0.1), transcutaneously (TCB) with the JM-105 bilirubinometer, and in serum (TSB) with a routine laboratory technique. Mean differences and 95% limits of agreement (LOA) and correlations were calculated. Result: We enrolled 149 neonates and 126 had paired measurements of Bilistick® bilirubin, TCB, and TSB. Bilistick® failed in 16 (10.7%) infants. Mean Bilistick® bilirubin-TSB difference was −11 µmol/L (95% LOA: −101 to 79 µmol/L) and r = 0.738 (p < 0.001). Mean TCB-TSB difference was 26 μmol/L (95% LOA: −33 to 88) and r = 0.785 (p < 0.001). The sensitivity, specificity, PPV, and NPV for Bilistick® bilirubin for a TSB above treatment thresholds were 0.74, 0.84, 0.67, and 0.88, respectively, and for TCB 0.92, 0.64, 0.54, and 0.95, respectively. Conclusion: The Bilistick® System (BM-BS 1.0 – FW version 2.0.1) underestimates TSB, whereas TCB overestimates TSB in jaundiced Indonesian infants. Further improvement of Bilistick®’s diagnostic accuracy with less false-negative readings is essential to increase its use.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%

Diagnostic Properties of a Portable Point-of-Care Method to Measure Bilirubin and a Transcutaneous Bilirubinometer

et al. 2021

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“…In Varughese study, the males were 54.4% while female babies were 45.6%. Out of 450 babies, 65.1% babies were delivered by vaginal delivery, 5.1% by instrumental delivery and 29.8% were delivered by Caesarean section [16].…”

Section: Discussionmentioning

confidence: 99%

Validity of Kramer Scale in Neonatal Hyperbilirubinemia

Shaikh,

Das,

Kumar

et al. 2023

AustinJGastroenterol

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Introduction: Jaundice refers to the yellow discoloration of sclera, skin and mucous membranes. It is a common problem that is faced during the first week of life by nearly every neonate. It is important to determine whether the clinical examination can be used reliably as a clinical screening tool for the diagnosis of neonatal jaundice. The diagnostic accuracy of Kramer’s rule was compared to venous method in this study in order to provide less invasive, time consuming and less painful method of measuring neonatal hyperbilirubinemia. Objective: To determine the diagnostic accuracy of Kramer’s rule of assessing neonatal hyperbilirubinemia taking serum bilirubin as “Gold standard”. Setting: New-born nursery at Paediatric Unit, Liaquat University Hospital, Hyderabad, Sindh. Design: Cross sectional validation study. Subject and Methods: A total of 317 neonates coming under inclusion criteria presenting at new-born nursery were examined. First, baby is undressed and clinical assessment of jaundice done. Then the venous blood sample was collected for serum bilirubin level and sent to diagnostic lab. Data was collected on predetermined pro-forma. Results: The average age of the neonate was 3.51±1.55 days. Sensitivity, specificity, positive predicted value, negative predicted value and accuracy of Kramer’s Rule in detection of neonatal hyperbilirubinemia was 90.7%, 80.5%, 88%, 84.6% and 86.75% respectively. Conclusion: Our study demonstrated that the Kramer’s scale could be better choice for detection and screening of neonatal hyperbilirubinemia. It is a non-invasive and quick method that can avoid babies from getting a skin infection or other complications related to blood sampling.

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“…Second, there are considerable difficulties in establishing gestational age [31,32] and time of birth of neonates admitted to hospitals serving rural areas in sub-Saharan Africa, where most deliveries occur at home, and neonates are admitted after the onset of NNJ in the community. Moreover, there is considerable debate about the criteria for a safe level of bilirubin in sick neonates [33][34][35].…”

Section: Participantsmentioning

confidence: 99%

Long-term neurocognitive and educational outcomes of neonatal insults in Kilifi, Kenya

et al. 2020

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Background There is little data on the long-term neurocognitive and educational outcomes among school-aged survivors of neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) in Africa. This study investigates the long-term neurocognitive and educational outcomes and the correlates of these outcomes in school-aged survivors of NNJ or HIE in Kilifi, Kenya. Methods We conducted a cross-sectional study on neurocognitive and educational outcomes among school-aged survivors (6–12 years) of NNJ (n = 134) and HIE (n = 107) and compared them to a community comparison group (n = 134). We assessed nonverbal intelligence, planning, working memory, attention, syntax, pragmatics, word-finding, memory, perceptual-motor, mathematical, and reading abilities. We also collected information on medical history, caregivers’ mental health, and family environment. Results The survivors of NNJ had lower mean total scores in word-finding [F (1, 250) = 3.89, p = 0.050] and memory [F (1, 248) = 6.74, p = 0.010] than the comparison group. The survivors of HIE had lower mean scores in pragmatics [F (1, 230) = 6.61, p = 0.011] and higher scores higher scores in non-verbal reasoning [F (1, 225) =4.10, p = 0.044] than the comparison group. Stunted growth was associated with almost all the outcomes in HIE. Conclusion Survivors of NNJ and HIE present with impairment in the multiple domains, which need to be taken into consideration in the planning of educational and rehabilitative services.

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Kramer’s scale or transcutaneous bilirubinometry: the ideal choice of a pediatrician? can we trust our eyes?

Cited by 8 publications

References 14 publications

Diagnostic Properties of a Portable Point-of-Care Method to Measure Bilirubin and a Transcutaneous Bilirubinometer

Diagnostic Properties of a Portable Point-of-Care Method to Measure Bilirubin and a Transcutaneous Bilirubinometer

Validity of Kramer Scale in Neonatal Hyperbilirubinemia

Long-term neurocognitive and educational outcomes of neonatal insults in Kilifi, Kenya

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