Transcutaneous bilirubin measurement during phototherapy in term neonates

Katayama, Yoshinori; Enomoto, Masahiro; Kikuchi, Shin; Takei, Atsuko; Ikegami, Hitoshi; Minami, Hirotaka; Lee, Yong Kye

doi:10.1111/ped.13248

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…Tan and Dong observed that the beginning of phototherapy reduced the correlation of TCB with TSB in skin exposed to light [19]. This fact has been confirmed by other authors [7,16,20,21]. A systematic review and metaanalysis conducted in 2016 exposes the dubious utility of TCB in skin exposed to phototherapy [4].…”

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confidence: 64%

Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer

et al. 2019

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Objective Determine the suitability of transcutaneous bilirubin (TCB) as a tool to assess the effectiveness of phototherapy on patched skin. Study design A prospective observational study was conducted. We covered a fragment of skin (sternum) with a photoopaque patch. Several simultaneous TCB and TSB measurements were performed with the JM-105 bilirubinometer. Bland and Altman test evaluated the agreement between bilirubin levels. Result A total of 217 patients were studied, 48.8% were preterm. The mean difference between TSB and TCB before the start of treatment was 1.07 mg/dL. During phototherapy, differences on covered skin were 0.52, 0.27, and 0.39 mg/dL at 24, 48, and 72 h of therapy respectively. The best correlation was observed at 48 h in preterm infants. Conclusion The measurement of TCB on patched skin (PTCB) is useful for monitoring the response to phototherapy in term and preterm infants. We use a patch with a removable flap that eases successive measures without disturbing the patients.

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confidence: 64%

Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer

et al. 2019

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“…Reyes et al [ 6 ] reported that TcB measured by BiliChek during phototherapy compared to TSB has a negative mean bias which worsened as TSB increased particularly at TSB levels > 238 μ mol/l. Katayama et al [ 13 ] reported moderate correlations between TSB and TcB before ( r = 0.56) and during ( r = 0.47) phototherapy. For TSB ≤ 306 μ mol/L during phototherapy, a TcB cut-off of 238 μ mol/l had a specificity of 100%.…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous Bilirubin Measurements Can Be Used to Measure Bilirubin Levels during Phototherapy

Al-Saedi

2018

International Journal of Pediatrics

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Objective To determine whether transcutaneous bilirubin measurements (TcB) before and during phototherapy taken from covered skin during phototherapy correlate with total serum bilirubin (TSB) levels. Study Design In this prospective observational study, healthy term newborns who required TSB measurements were included. TcB measurements were taken from the forehead before starting and during phototherapy using the BiliChek device. Before starting phototherapy, part of the forehead was covered. Blood for TSB measurement was collected within 5 minutes of TcB measurements. Correlations and mean differences between TcB and TSB before and during phototherapy were calculated. Result Paired TSB and TcB measurements before and during phototherapy in 151 newborns were performed. The mean gestational age was 38.8 weeks and birth weight was 3.1 kg; 53% were male. Before starting phototherapy, TSB and TcB were 183.8 ± 41.6 and 190.5 ± 43 μmol/l, respectively. During phototherapy, TSB and TcB were 191.8 ± 39.4 and 187.8 ± 45.3 μmol/l, respectively. Linear regression analysis showed a significant correlation between TcB and TSB before starting phototherapy and during phototherapy (r: 0.85; p < 0.001 and r: 80.0; p < 0.001), respectively. Before starting phototherapy, the mean difference between TSB and TcB was 6.2 ± 23.2 μmol/l, with a 95% CI of −39.3 to 51.7 μmol. During phototherapy, the mean difference was −2.8 ± 23.5 μmol/l, with a 95% CI of −48.9 to 43.3 μmol/l. Conclusion TcB measurements from covered skin in jaundiced term infants during phototherapy correlate with TSB and can be used to monitor bilirubin levels during phototherapy.

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“…In Nahar et al's study that compared TSB with TcB in late‐preterm and term infants, using a TcB cutoff value of 15 mg/dL to predict neonatal hyperbilirubinemia before phototherapy with AUC (0.87) in late‐preterm and term infants yielded a sensitivity of 77% and a specificity of 88% . Katayama et al mentioned that for TSB of ≤18 mg/dL during phototherapy, a TcB cutoff level of 14 mg/dL had a specificity of 1.0; thus, the avoidance of the TSB measurements would be 43% with this method …”

Section: Discussionmentioning

confidence: 99%

Comparison of transcutaneous and serum bilirubin before, under, and after phototherapy in term and late‐preterm infants

Yang

Liu

Chen

2019

The Kaohsiung J of Med Scie

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This study aimed to determine the correlation of transcutaneous bilirubin (TcB) with total serum bilirubin (TSB) in infants receiving phototherapy and the accuracy of TcB for deciding the time to discontinue phototherapy. Paired TcB and TSB levels were assessed in 52 term and 56 late-preterm infants receiving phototherapy. TcB was measured in the unexposed skin of the middle forehead using a noninvasive bilirubin analyzer, BiliChek. TSB was measured every morning, and TcB was measured 2 hours after TSB measurements. Bland-Altman plots, linear regression, multivariate pair wise correlation, and receiver operating characteristic curve (ROC) analyses were performed. Bland-Altman plots before, under, and 24 hours after phototherapy in term and late-preterm infants revealed that TcB and TSB have higher consistency. TcB and TSB showed positive linear correlation before, under, and after phototherapy in both infant groups. In the multivariate pair wise correlations, differences between TcB and TSB were negatively correlated with phototherapy duration in term (correlation coefficient = −0.233, P value = .001) and late-preterm (correlation coefficient = −0.198, P value = .002) infants. Cutoff levels of TcB for discontinuing phototherapy based on the ROC analysis were 13.8 (sensitivity of 90%, specificity of 84%, area under the curve [AUC] 0.94) and 11.8 mg/dL (sensitivity of 84%, specificity of 88%, AUC 0.92) in term and late-preterm infants, respectively. TcB and TSB before, under, and after phototherapy in both term and late-preterm infants showed good correlation and higher consistency with jaundice. To reduce repetitive blood sampling for TSB, TcB measurement may be a reliable method for term and latepreterm infants undergoing phototherapy.

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Transcutaneous bilirubin measurement during phototherapy in term neonates

Abstract: Direct measurement of TcB during phototherapy using a bed-type device is a reliable method to estimate TSB in term neonates and would contribute to a reduction in blood sampling. It cannot, however, be used as a substitute for TSB measurement.

Cited by 10 publications

References 24 publications

Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer

Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer

Transcutaneous Bilirubin Measurements Can Be Used to Measure Bilirubin Levels during Phototherapy

Comparison of transcutaneous and serum bilirubin before, under, and after phototherapy in term and late‐preterm infants

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