Comparison of the Predictive Accuracy of Stool Color for Triage of Infants for Phototherapy (STrIP) Score With Transcutaneous Bilirubinometer in Predicting Serum Bilirubin in Neonates

2021 ◽  
Vol 58 (10) ◽  
pp. 936-939
Author(s):  
Sushma Krishnegowda ◽  
Basil John Thomas ◽  
Deepti Thandaveshwara ◽  
Srinivasa Murthy Doreswamy
Keyword(s):  
Serum Bilirubin ◽  
Predictive Accuracy ◽  
Transcutaneous Bilirubinometer

scholarly journals Development of Jaundice Detection Approaches in Neonates

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Priti Bhagat V ◽  
◽  
Dr Mukesh Raghuwanshi M ◽  
Dr. Kavita Singh ◽  
Dr Sachin Damke ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Serum Bilirubin ◽  
Visual Assessment ◽  
Assessment Methods ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Gold Standard Method ◽  
Life Detection ◽  
Precision And Accuracy ◽  
Transcutaneous Bilirubinometer

Jaundice is one of the most common diseases that have a significant impact in the first few days of newborn life. Detection and regular monitoring of bilirubin, which is responsible for Jaundice, is an essential phase during the hyperbilirubinemia. In the literature, various clinical assessment methods of Jaundice are available. It motivates us to present a review of these clinical assessment methods in practice, along with their advantages and limitations. In this paper, we have discussed three widely used methods, such as visual assessment, total serum bilirubin and transcutaneous bilirubinometer. From the comparative analysis of these methods, it is concluded that the visual assessment is very subjective in nature, whereas, the total serum bilirubin method is still a gold standard method. The detailed analysis of the methods depicts that the correlation between this two total serum bilirubin and transcutaneous bilirubinometer has enormous potential for improvement resulting in the enhancement in precision and accuracy of bilirubin measurement.

scholarly journals Utility of Transcutaneous Bilirubinometer in Tertiary Care Hospital

2017 ◽  
Vol 37 (1) ◽  
pp. 72-78
Author(s):  
Vijay Kumar ◽  
Pardeep Singh Kahlon ◽  
Palwinder Singh ◽  
Kamail Singh ◽  
Anubha Sharma
Keyword(s):  
Birth Weight ◽  
Correlation Coefficient ◽  
Bilirubin Level ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Mean Value ◽  
Pearson’S Correlation Coefficient ◽  
Pearson's Correlation ◽  
Pearson's Correlation Coefficient ◽  
Transcutaneous Bilirubinometer

Introduction: Hyperbilirubinemia is one of the most vexing problems that may occur in 60% of term and 80% of preterm neonates. In order to reduce the risk of developing serious hyperbilirubinemia, it is vital to identify jaundiced infants who are in need of treatment as soon as possible. The objectives of this study were to find whether transcutaneous bilirubin (TcB) measurement correlates with total serum bilirubin (TSB) levels, measured with standard laboratory method and to analyse the effect of gestational age, birth weight and postnatal life on TcB and TSB.Material and Methods: A prospective study was conducted in the Department of Paediatrics, Government Medical College, Amritsar on 300 neonates with visible jaundice. These neonates were divided into various groups depending upon gestational age, birth weight and day of life. TcB readings were recorded at forehead and sternum and serum bilirubin level was measured within 30 minutes. Test of significance applied was unpaired T-test; mean value, p-value, standard deviation and Pearson's correlation coefficient 'r' were calculated.Results: Overall Mean value TcB at forehead was 15.32 with SD ± 2.75, mean TcB at sternum was 14.94 with SD ±2.51, mean value of TSB was 13.80 with SD ±2.15. Pearson’s correlation coefficient r was 0.895 for TcB forehead vs TSB, 0.903 for TcB sternum vs TSB and 0.966 between TcB forehead vs TcB sternum.Conclusion: TcB levels correlates well with the gold standard measurement of TSB. Gestational age, birth weight and day of life had no effect on TcB and TSB correlation. Transcutaneous bilirubinometer can thus be used to measure bilirubin level as a screening method for neonatal hyperbilirubinemia.

scholarly journals Transcutaneous bilirubin level to predict hyperbilirubinemia in preterm neonates

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 300
Author(s):  
Dewi Rahmawati ◽  
Mahendra Tri Arif Sampurna ◽  
Risa Etika ◽  
Martono Tri Utomo ◽  
Arend F. Bos
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Close Monitoring ◽  
Transcutaneous Bilirubin ◽  
Group I ◽  
Group Ii ◽  
Severe Hyperbilirubinemia ◽  
Transcutaneous Bilirubinometer

Background: Hyperbilirubinemia is common in neonates, with higher prevalence among preterm neonates, which can lead to severe hyperbilirubinemia. Assessment of total serum bilirubin (TSB) and use of a transcutaneous bilirubinometer (TcB) are existing methods to identify and predict hyperbilirubinemia. This study aimed to determine TcB cut-off values during the first day for preterm neonates to predict hyperbilirubinemia at 48 and 72 hours. Methods: A total of 90 neonates born ≤35 weeks were included in the study. They were divided into two groups (Group I: 1000-1500 grams; Group II: 1501-2000 grams). The bilirubin level was measured on the sternum using TcB at the ages of 12, 24, and 72 h. TSB measurements were taken on the third day or if TcB level reached ± 1.24 mg/dL phototherapy threshold and if TcB showed abnormal results (Group I: 5.76-8.24 mg/dL; Group II: 8.76-11.24 mg/dL). Hyperbilirubinemia was defined as TSB ≥7 mg/dL for group I and >10 mg/dL for group II. Results: In total, 38 group I neonates and 48 group II neonates were observed. Almost half of neonates in group I (44.7%) were suffering from hyperbilirubinemia at the age of 48 hours, with 45.8% of group II at the age of 72 hours. To predict hyperbilirubinemia at the age of 48 hours, the best 24-hour-age TcB cut-off values were calculated to be 4.5 mg/dL for group I and 5.8 mg/dL for group II. To predict hyperbilirubinemia at the age of 72 hours, we determined 24-hour-age TcB value of 5.15 mg/dL for group II. Conclusion: TcB values in the early days of life can be used as hyperbilirubinemia predictors on the following days for preterm neonates. Close monitoring should be managed for those with TcB values higher than the calculated cut-off values.

scholarly journals Can we Rely on Transcutaneous Bilirbinometry during Phototherapy?

2020 ◽  
pp. 5-12
Author(s):  
Dr. Pearl Mary Varughese
Keyword(s):  
Serum Bilirubin ◽  
Late Preterm ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Neonatal Septicemia ◽  
New Born ◽  
Prolonged Hospitalization ◽  
Preterm Babies ◽  
Screening Device ◽  
Transcutaneous Bilirubinometer

Background:Neonatal jaundiceis one of the main reasons for prolonged hospitalization in newborns, and its progress and treatment depends on serum bilirubin values. Phototherapy remains the mainstay of treatment of pathological jaundice in newborn babies. Though, transcutaneous bilirubinometer has been used as a screening device for measuring bilirubin, its role during phototherapy has always been questioned. Objective: To study the correlation between Transcutaneous bilirubinometer (TcB) values with serum bilirubin levels (TSB) in infants during phototherapy in term and late preterm babies. Materials and Methods: The study was conducted in a tertiary new-born center from November 2014 to June 2016. The inclusion criteria included all babies above 34 weeks gestation and exclusion criteria included babies with established direct hyperbilirubinemia, neonatal septicemia, major congenital/ gastrointestinal malformations, and those on phototherapy.

scholarly journals Clinical utility of hand held, non invasive transcutaneous bilirubinometer in neonatal jaundice: a prospective observational study

2021 ◽  
Author(s):  
Bibhudatta Mishra ◽  
Bishwajit Mishra ◽  
Guruveera Jeyasingh Malini ◽  
Arjit Mohapatra ◽  
Prafulla Kumar Biswal ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Neonatal Jaundice ◽  
Prospective Observational Study ◽  
Screening Tool ◽  
Serum Bilirubin ◽  
Blood Sampling ◽  
Viable Option ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometer

Background: Neonatal Jaundice is the most common morbidity in the first week of life, occurring in 60% of term and 80% of preterm newborn. However, visual inspection, being subjective, usually inaccurate and unreliable and will result in a number of unnecessary blood sampling. Taking all these in to considerations, transcutaneous bilirubinometer (TCB) may provide a solution which is an objective, noninvasive, fast and painless method of bilirubin estimation.Methods: Transcutaneous bilirubinometer levels were measured at forehead and sternum and blood samples for TSB were collected by venepuncture within 30 minutes and sent to biochemistry lab. After getting serum bilirubin reports, TCB and TSB values were compared by using Bhutani’s hour specific nomogram. Results: The correlation between serum bilirubin and transcutaneous bilirubin measured at forehead and sternum is very good at serum bilirubin <15 mg/dl, r value (Karl Pearson’s Correlation co-efficient) is 0.93 and 0.94 respectively.Conclusions: The findings of the present study indicate that the TCB is a reliable screening tool for hyperbilirubinemia in newborns >35 weeks of gestation, especially with bilirubin levels ≤15 mg/dl in 2-7 days of life. TCB can be a viable option for universal screening. Incorporating the use of TCB devices in clinical practice, can reduce the need for blood sampling for the management of neonatal jaundice.

scholarly journals Quality improvement initiative using transcutaneous bilirubin nomogram to decrease serum bilirubin sampling in low-risk babies

2019 ◽  
Vol 3 (1) ◽  
pp. e000403 ◽  
Author(s):  
Muhammad Hussain Shah ◽  
Shabina Ariff ◽  
Syed Rehan Ali ◽  
Rayaan Asad Chaudhry ◽  
Maryam Pyar Ali Lakhdir ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Total Serum ◽  
Quality Improvement Initiative ◽  
Transcutaneous Bilirubin ◽  
Implementation Phase ◽  
Postnatal Ward ◽  
Before And After ◽  
The Impact ◽  
Before And After Study ◽  
Transcutaneous Bilirubinometer

BackgroundScreening for neonatal hyperbilirubinaemia in the postnatal ward has traditionally been performed using serum bilirubin sampling, but this has significant drawbacks such as risk of infection and slower reporting time.ObjectiveWe aimed to assess the impact of introducing transcutaneous bilirubin (TcBR) testing using TcBR nomogram on the number of serum bilirubin samples sent.MethodsA before-and-after study was performed following the introduction of a protocol integrating the use of the Dragger JM-105 transcutaneous bilirubinometer in the postnatal ward. Only babies born at ≥37 weeks of gestation, weighing ≥2500 g who presented with jaundice after the first 24 hours and within the first 7 days of life were included in the study. The number of total serum bilirubin samples (TSBRs) sent were compared for the 6-month periods before and after (a total of 12 months) implementation of the new protocol.ResultsIn the pre-implementation phase, a total of 882 (49%) out of 1815 babies had at least one serum bilirubin sample taken as opposed to a total of 236 (17%) out of 1394 babies in the post-implementation phase. The odds of performing TSBRs at least one time among babies in post-implementation phase were 79% lower than in pre-implementation phase (OR 0.21, 95% CI 0.18 to 0.25). We also estimated a significant cost saving of approximately US$1800 over a period of 6 monthsConclusionTcBR testing used in conjunction with our proposed nomogram significantly reduces the need for serum bilirubin sampling.

scholarly journals Predictive Models for Neonatal Follow-Up Serum Bilirubin: Model Development and Validation (Preprint)

2020 ◽  
Author(s):  
Joseph H Chou
Keyword(s):  
Neural Network ◽  
Predictive Models ◽  
Serum Bilirubin ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Test Set

BACKGROUND Hyperbilirubinemia affects many newborn infants and, if not treated appropriately, can lead to irreversible brain injury. OBJECTIVE This study aims to develop predictive models of follow-up total serum bilirubin measurement and to compare their accuracy with that of clinician predictions. METHODS Subjects were patients born between June 2015 and June 2019 at 4 hospitals in Massachusetts. The prediction target was a follow-up total serum bilirubin measurement obtained &lt;72 hours after a previous measurement. Birth before versus after February 2019 was used to generate a training set (27,428 target measurements) and a held-out test set (3320 measurements), respectively. Multiple supervised learning models were trained. To further assess model performance, predictions on the held-out test set were also compared with corresponding predictions from clinicians. RESULTS The best predictive accuracy on the held-out test set was obtained with the multilayer perceptron (ie, neural network, mean absolute error [MAE] 1.05 mg/dL) and Xgboost (MAE 1.04 mg/dL) models. A limited number of predictors were sufficient for constructing models with the best performance and avoiding overfitting: current bilirubin measurement, last rate of rise, proportion of time under phototherapy, time to next measurement, gestational age at birth, current age, and fractional weight change from birth. Clinicians made a total of 210 prospective predictions. The neural network model accuracy on this subset of predictions had an MAE of 1.06 mg/dL compared with clinician predictions with an MAE of 1.38 mg/dL (<i>P</i>&lt;.0001). In babies born at 35 weeks of gestation or later, this approach was also applied to predict the binary outcome of subsequently exceeding consensus guidelines for phototherapy initiation and achieved an area under the receiver operator characteristic curve of 0.94 (95% CI 0.91 to 0.97). CONCLUSIONS This study developed predictive models for neonatal follow-up total serum bilirubin measurements that outperform clinicians. This may be the first report of models that predict specific bilirubin values, are not limited to near-term patients without risk factors, and take into account the effect of phototherapy. CLINICALTRIAL

scholarly journals The smart phone study: assessing the reliability and accuracy of neonatal jaundice measurement using smart phone application

2018 ◽  
Vol 5 (2) ◽  
pp. 285 ◽  
Author(s):  
Srujana Swarna ◽  
Sekar Pasupathy ◽  
Balaji Chinnasami ◽  
Nirmala Manasa D. ◽  
Balaji Ramraj
Keyword(s):  
Gold Standard ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Smart Phone ◽  
Medical Application ◽  
Background Current ◽  
Blood Samples ◽  
Smart Phone Application ◽  
Transcutaneous Bilirubinometer ◽  
Better Than

Background: Current gold standard for bilirubin estimation in newborns is invasive while transcutaneous bilirubinometer which is a noninvasive option is costly. Smart phone applications can be used as an alternative to measure bilirubin. We did the study to evaluate “Biliscan” medical application for screening of neonatal jaundice.Methods: During the first seven days, neonates with suspected jaundice were taken blood samples for serum bilirubin. Within two hours photographs were taken using Biliscan app by placing a colour calibration card over the chest. Bilirubin estimate obtained after colour balancing, feature extraction and machine learning regression were compared with blood values.Results: There is a good correlation (0.6) between Biliscan bilirubin estimation and serum bilirubin levels (p <0.0001) in the present study on 35 neonates. Biliscan thorax values correlated better than abdomen values (0.6 versus 0.551) with serum values. Hence chest is the preferred area for Biliscan measurement. Conclusions: Biliscan app appears to be a good cheap option to screen for jaundice in newborns noninvasively.

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