scholarly journals Transcutaneous versus Total Serum Bilirubin Measurements in Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Thivia Jegathesan ◽  
Douglas M. Campbell ◽  
Joel G. Ray ◽  
Vibhuti Shah ◽  
Howard Berger ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Clinical Decision Making ◽  
Serum Bilirubin ◽  
Clinical Decision ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Treatment Thresholds ◽  
Before And After ◽  
The Mean

<b><i>Introduction:</i></b> Transcutaneous bilirubin (TcB) measurement offers a noninvasive approach for bilirubin screening; however, its accuracy in preterm infants is unclear. This study determined the agreement between TcB and total serum bilirubin (TSB) among preterm infants. <b><i>Methods:</i></b> A multisite prospective cohort study was conducted at 3 NICUs in Ontario, Canada, September 2016 to June 2018. Among 296 preterm infants born at 24<sup>0/7</sup> to 35<sup>6/7</sup> weeks, 856 TcB levels were taken at the forehead, sternum, and before and after the initiation of phototherapy with TSB measurements. Bland-Altman plots and 95% limits of agreement (LOA) expressed agreement between TcB and TSB. <b><i>Results:</i></b> The overall mean TcB-TSB difference was −24.5 μmol/L (95% LOA −103.3 to 54.3), 1.6 μmol/L (95% LOA −73.4 to 76.5) before phototherapy, and −31.1 μmol/L (95% LOA −105.5 to 43.4) after the initiation of phototherapy. The overall mean TcB-TSB difference was −15.2 μmol/L (95% LOA −86.8 to 56.3) at the forehead and −24.4 μmol/L (95% LOA −112.9 to 64.0) at the sternum. The mean TcB-TSB difference was −31.4 μmol/L (95% LOA −95.3 to 32.4) among infants born 24–28 weeks, −25.5 μmol/L (95% LOA −102.7 to 51.8) at 29–32 weeks, and −15.9 μmol/L (95% LOA −107.4 to 75.6) at 33–35 weeks. Measures did not differ by maternal ethnicity. <b><i>Conclusion:</i></b> Among preterm infants, TcB may offer a noninvasive, immediate approach to screening for hyperbilirubinemia with more careful use in preterm infants born at &#x3c;33 weeks’ gestation, as TcB approaches treatment thresholds. Its underestimation of TSB after the initiation of phototherapy warrants the use of TSB for clinical decision-making after the initiation of phototherapy.

scholarly journals A Comparison between Transcutaneous and Total Serum Bilirubin in Healthy-term Greek Neonates with Clinical Jaundice

2014 ◽  
Vol 115 (1-2) ◽  
pp. 33-42 ◽  
Author(s):  
Charalambos Neocleous ◽  
Alkistis Adramerina ◽  
Stefanos Limnaios ◽  
Symeon Symeonidis ◽  
Chrysoula Spanou ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Care Plan ◽  
Total Serum ◽  
Limited Data ◽  
Transcutaneous Bilirubin ◽  
Appropriate Care ◽  
The Mean ◽  
Level Of Agreement

The accuracy of transcutaneous bilirubin meters has been assessed in newborns from various ethnic backgrounds. However, there are limited data on Greek newborns. Our study examined the accuracy of transcutaneous bilirubin measurements in clinically jaundiced healthy-term Greek newborns, using total serum bilirubin as the reference standard, in order to re-evaluate our local guidelines about neonatal jaundice. Clinically jaundiced newborns requiring total serum bilirubin level estimation were recruited prospectively. 368 pairs of total serum bilirubin/transcutaneous bilirubin measurements were taken in 222 newborns, using a direct spectrophotometric device and the BiliCheck device, respectively. The level of agreement between the obtained transcutaneous bilirubin and total serum bilirubin values was assessed. Our data were analysed using the Stata/SE 12.0 (StataCorp LP, USA) statistical programme. The mean (± SD) TSB was 225.4 ± 25.4 μmol/l and the mean (± SD) TcB was 237.9 ± 21.0 μmol/l. The correlation between the values was poor (Pearson’s correlation coefficient 0.439; Lin’s concordance coefficient 0.377 [95% CI 0.301 to 0.453]; P<0.001). The Bland-Altman analysis demonstrated that transcutaneous bilirubin measurements tended to overestimate the total serum bilirubin value (mean difference 12.5 ± 24.9 μmol/l), with wide 95% limits of agreement (–36.2 μmol/l to 61.3 μmol/l). Transcutaneous bilirubin values did not correlate well with total serum bilirubin values, being often imprecise in predicting the actual total serum bilirubin levels. This permits us to continue estimating total serum bilirubin in clinically jaundiced newborns according to our local guidelines, in order to safely decide the appropriate care plan.

scholarly journals Evaluation of Jaundice meter in the assessment of jaundice among Nigerian preterm neonates

1970 ◽  
Vol 42 (3) ◽  
pp. 194-198
Author(s):  
BO Kayode-Adedeji ◽  
JA Owa ◽  
GO Akpede ◽  
SO Alikah
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Objective Assessment ◽  
Total Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
The Mean ◽  
Transcutaneous Bilirubinometry

Background: The objective assessment of the severity of neonatal jaundice is Total Serum Bilirubin (TSB) determination, which requires multiple blood sampling. This has inherent problems, including risks of anaemia and infection. Transcutaneous Bilirubinometry (TcB) is a reliable, non-invasive alternative, however there is paucity of data on its performance in black preterm neonates.Objectives: To evaluate the correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) among Nigerian preterm neonates, and to determine the parameters affecting the relationship.Method: Jaundiced preterm neonates delivered between 28 and 36 weeks of gestation admitted at the Irrua Specialist Teaching Hospital (ISTH), Nigeria were recruited . The TSB levels were determined by spectrophotometry while the corresponding TcB levels were obtained using Jaundice Meter (JM-103). The neonates were stratified into gestational age and birth weight groups.Results: A total of 189 paired TcB and TSB levels were obtained from 60 neonates. The Mean (sd) TcB level of 11.4 (3.1) mg/dl was significantly higher than the mean TSB level of 10.2 (2.8)mg/dl (p= 0.028). The overall correlation coefficient between TcB and TSB was 0.98 and it was not significantly affected by the gestational age, birth weight and bilirubin levels.Conc lusion: Transcutneous bilirubin strongly correlates with total serum bilirubin levels among Nigerian preterm neonates, irrespective of gestational age, birth weight and the degree of jaundice.Keywords: hyperbiliruinaemia, jaundice meter, Nigerian, preterm, neonates, transcutaneous bilirubinometry

scholarly journals Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

2017 ◽  
Vol 57 (1) ◽  
pp. 8 ◽  
Author(s):  
Andra Kurnianto ◽  
Herman Bermawi ◽  
Afifa Darmawanti ◽  
Erial Bahar
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Subcutaneous Tissue ◽  
Correlation Coefficients ◽  
Total Serum Bilirubin ◽  
Blood Sampling ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometry

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

scholarly journals Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

2011 ◽  
Vol 51 (5) ◽  
pp. 256 ◽  
Author(s):  
Ari Kurniasih ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Pertin Sianturi
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Low Cost ◽  
Total Serum Bilirubin ◽  
Spectral Irradiance ◽  
Total Serum ◽  
Control Group ◽  
Study Group ◽  
Term Newborns ◽  
The Mean

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

scholarly journals Cognitive Oucome of Preterm Infants is Related to Maximal Total Serum Bilirubin

2011 ◽  
Vol 70 ◽  
pp. 348-348
Author(s):  
A B Schreuder ◽  
D E Van Imhoff ◽  
P H Dijk ◽  
M Schaaf ◽  
A F Bos ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum

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

2017 ◽  
Vol 39 (3) ◽  
pp. 116-122 ◽  
Author(s):  
Nargis Ara Begum ◽  
Khorshed Alam ◽  
Anamika Shaha ◽  
Md Sohel Showmik ◽  
Runa Laila ◽  
...  
Keyword(s):  
Screening Tool ◽  
Serum Bilirubin ◽  
Screening Method ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
P Value ◽  
Cross Sectional ◽  
Transcutaneous Bilirubin ◽  
Severe Hyperbilirubinemia ◽  
Transcutaneous Bilirubinometry

Background: Hyperbilirubinemia is a common problem in newborn. Most of the cases are benign but severe hyperbilirubinemia can lead to kernicterus and brain damage which is preventable. The gold standard to asses neonatal hyperbilirubinaemia is serum bilirubin measurement. Unfortunately, this procedure is invasive, painful and time consuming. As the consequence of missing severe hyperbilirubinemia is serious, there is a constant search to find out a safe method to detect jaundice. Transcutaneous bilirubinometry offers objective method of assessing degree of jaundice reducing subjectivity of clinical assessment.Objective: To evaluate the relationship between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) and assess whether transcutaneous bilirubinometry can be used as a valid screening method for detecting jaundice in term and late preterm babies.Method: A prospective cross-sectional study was performed in well baby nursery of United Hospital Limited, Dhaka from January 2013 to December 2013. Healthy term and late pre term newborn of ?35 wk gestation with clinical evidence of jaundice were included in the study. Total serum bilirubin was measured by Dichlorophenyl Diazonin method and transcutaneous bilirubinometer (JM-103) was used to measure transcutaneous bilirubin (TcB) level.Result: A total of 116 paired samples were analyzed and found strong correlation between TcB and TSB (correlation coefficient 0.8, mean difference 0.83, SD± 1.96 and 95% CI 0.6 to 1.06). Post natal age has significant association with TcB (p value 0.01) and TSB (p value 0.031). Requirement of phototherapy in both group were also significant (p value <0.001). TcB value of 11 mg/dl was chosen as cut off point corresponding TSB level 13 mg/dl with sensitivity 90% and specificity 71%. Above this level indicate need for blood sampling to take appropriate therapeutic measure.Conclusion: Transcutaneous billirubinometry is a non-invasive and valid screening tool for assessing jaundice in newborn.Bangladesh J Child Health 2015; VOL 39 (3) :116-122

Sign in / Sign up

Export Citation Format

Share Document