Transcutaneous bilirubinometry in Chinese, Malay and Indian infants

Abstract

The objective of this study was to investigate the correlation of transcutaneous bilirubinometry (TcB) and plasma bilirubin concentrations in full-term Chinese, Malay and Indian infants. TcB was performed with the Minolta Airshields bilirubinometer on Chinese, Malay and Indian fullterm infants. The readings were taken on the chest (sternum) and forehead (glabella) when capillary blood was sampled for bilirubin determination. Five hundred and forty TcB indices in 253 Chinese infants, 282 in 169 Malay infants, and 182 in 120 Indian infants were obtained over the sternum and forehead. A good correlation between the TcB indices and the bilirubin concentrations was observed in Chinese, Malay and Indian infants: r = 0.78 (chest), r = 0.73 (forehead); r = 0.86 (chest), r = 0.84 (forehead); and r = 0.84 (chest), r = 0.82 (forehead). The correlation was just as good when the combined values were evaluated together: r = 0.80 (chest) r = 0.75 (forehead). In Chinese infants, correlation at values below 250 mumol l-1 was significantly better than that at values over 250 mumol l-1 r = 0.80 versus r = -0.20, p < 0.00001 (chest), and r = 0.74 versus r = 0.07, p < 0.00001 (forehead). However, a safer cut-off point clinically would be 200 mumol l-1, since only relatively few higher bilirubin values were encountered when TcB indices were below 200 mumol l-1. The same pattern was noticed with the other two groups, and the combined group. Thus, TcB provides a non-invasive, cost-effective screening method for significant neonatal jaundice, sparing infants and parents physical and emotional stress, and medical and nursing personnel extra work and inconvenience.

Transcutaneous bilirubinometry in preterm infants

“…The accuracy of transcutaneous bilirubin readings may differ when comparing different ethnic groups (6). Most of our newborns were Caucasians, in whom the BS-BTc correlations were better than those in the small group of seven Asians.…”

“…A good correlation between transcutaneous and conventionally determined serum bilirubin values was shown in full-term babies (4)(5)(6)(7). In contrast, other investigators conclude that BTc measurements cannot accurately predict BS (3).…”

“…The most widespread transcutaneous bilirubin analyser is the Minolta AirShields Jaundice Meter (1)(2)(3)(4), but the Ingram Icterometer (4) is also often used. Several studies have shown good correlation when comparing BTc values with conventionally determined BS levels (4)(5)(6)(7). However, in most studies, full-term and healthy newborns were examined (4-7), whereas there is still a dearth of knowledge about the accuracy of BTc measurement in preterm infants (1,2).…”

Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

“…The accuracy of TcB readings may also differ when comparing different ethnic groups and the hope that TcB measurements would be independent of both race and pigmentation has not been fulfilled yet [5,8,9,17]. In one study by Bhutani and co-workers the correlation between BiliCheck ® TcB and high performance liquid chromatography (HPLC) measurements of the total serum bilirubin (TSB) in African-American infants was as good as in Caucasian infants, whereas TcB measurements by the Minolta JM-103 tended to overestimate the TSB measurements in African-American [2,16].…”

Point-of-care testing: where is the evidence? A systematic survey

“…This advantage does not always mean better patient outcomes, the medical unit that would like to perform POCT should be interested in the real impact of results in clinical practice, besides the accuracy of devices. Kendal et al [1] [13] 2000 Prospective USA 1788 NR Borgard [14] 2006 Prospective France 473 NR Engle [15] 2002 Prospective USA 404 NR Ho [16] 2006 Prospective China 4689 SN, SP, PPV, NPV Kazmierczak [17] 2004 Prospective USA Unclear NR Lam [18] 2008 Prospective China 113 SN, SP Maisels [19] 2004 Prospective USA 849 NR Mielsch [20] 2010 Prospective Germany 240 NR Robertson [21] 2002 Prospective USA 101 NR Rolinski [22] 2001 Prospective Germany 142 NR Rubaltelli [23] 2001 Prospective Italy NR NR Schmidt [24] 2009 Cohort USA 94 SN, SP, NPV Schumacher [25] 1995 Prospective USA NR NR Tan [26] 1996 Prospective Singapore 540 NR Tayaba [27] 1998 Prospective USA 900 NR Wong [28] 2002 Prospective UK 64 PPV Yamanouchi [29] 1980 Prospective Japan NR NR Yamauchi [30] 1988 Prospective Japan 576 NR Procalcitonin Bektas [31] 2011 Prospective Turkey 141 SN, SP, LR+, LRGaletto-Lacour [32] 2003 Prospective Switzerland 99 SN, SP, PPV, NPV Hesselink [33] 2009 Prospective Netherlands 101 NR Meisner [34] 2000 Prospective Germany 237 NR PTH Agarwal [35] 2001 Prospective Australia 88 NR Chou [36] 2002 Case series Taiwan NR NR Garner [37] 1999 Prospective NC 130 NR Johnson [38] 2001 Prospective USA 104 NR Mace [39] 2008 Prospective UK 20 NR Sokoll [40] 2000 Prospective USA 200 NR Troponin Apple [41] 2000 Prospective USA 1550 SN, SP Apple [42] 2006 Observational retrospective USA 545 NR Birkhahn [43] 2010 Prospective USA 151 SN, SP, PPV, NPV Bock [44] 2008 Prospective US...…”