Transcutaneous Bilirubinometry and Diagnostic Tests: "The Right Job for the Tool"
Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-0254, USA. PEDIATRICS
(Impact Factor: 5.47).
09/2002; 110(2 Pt 1):407-8. DOI: 10.1542/peds.110.2.407
Available from: Glenn R Gourley
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ABSTRACT: A prospective observational study was conducted on 212 neonates born between 24 and 42 weeks of gestation who required blood sampling to determine total serum bilirubin (TSB) in the first week of life, prior to phototherapy. The transcutaneous bilirubin (TcB) measurements were performed on the infant's forehead using BiliCheck within +/-30 min of a blood sample being drawn. There was significant (r = 0.78) correlation between bilirubin levels obtained transcutaneously and those measured in the infant's blood. The correlation was not affected by birth weight and was dependent on the bilirubin levels. The negative nonsignificant correlation appears when TSB levels are greater than 11 mg/dl. Thus, TcB measurements can accurately predict TSB values lower than 11 mg/dl in a multiracial preterm and term neonatal population.
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ABSTRACT: Objective: 1) To compare estimates of serum bilirubin determined by a transcutaneous device BiliCheck with laboratory measured total serum bilirubin obtained by spectrophotometry (Bilitron) and high performance liquid chromatography (gold standard). 2) To precise cut off values of BiliCheck measurements whose sensibility and specificity are maximized. 3) To precise if skin tone, birth weigh, gestational age and postnatal age interfere with the transcutaneous measurement of bilirubin in the newborn. Study population: Newborn ≥ 35 weeks of gestation, < 60 days of life do not requiring phototherapy. Newborn with skin injuries were excluded. Transcutaneous measurement were performed within 30 minutes of blood sampling for total serum bilirubin. Results: 244 newborns were enrolled, total serum bilirubin > 15 mg/dL was founded in 35% of the sample. The correlations were very good. There was high coincidence between spectrophotometry and BilliCheck, mean error was 0,82 mg/dL (-4.03, 2.38) and between gold standard and BiliCheck, mean error was 1.056 mg/dL (-3.66, 5.77) increasing above 10 mg/dL Between gold standard and spectrophotometry, the mean error was 1.88 mg/dL (1.53, 5.29) increasing above 13-14 mg/dL. ROC curves shows a good accuracy of the BiliCheck comparing it with spectrophotometry, at gold standard levels of >13,>15 and >17 mg/dL. Analysis of covariance demonstrated that BiliCheck accuracy was independent of birth weight, gestational age, sex and skin tone. Conclusion: The transcutaneous measurements of bilirubin BiliCheck could be an useful device for screening and follow up newborn jaundice.
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