Diurnal variation in serum bilirubin concentrations in infants with neonatal jaundice

1995 ◽  
Vol 127 (5) ◽  
pp. 801-803 ◽  
Author(s):  
Shimon Reif ◽  
Amir Belson ◽  
Yael Villa ◽  
Boaz Milbauer ◽  
Yoram Bujanover
Keyword(s):  
Diurnal Variation ◽  
Neonatal Jaundice ◽  
Serum Bilirubin

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.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

2021 ◽  
pp. 17-19
Author(s):  
Aradhana Gupta ◽  
Anand Kumar Bhardwaj ◽  
Anisha Aggarwal ◽  
Gauri Chauhan
Keyword(s):  
Serum Calcium ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Calcium Supplementation ◽  
Clinical Signs ◽  
Total Serum ◽  
Medical Sciences ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

2021 ◽  
Vol 17 (2) ◽  
pp. 199-203
Author(s):  
Tehreem Afzal ◽  
Naveed Butt ◽  
Shahzad Munir ◽  
Nazish Zia
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Standard Treatment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Combination Group ◽  
Medical Institute ◽  
Significant Difference ◽  
The Mean ◽  
Time Required

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.  Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

Transcutaneous Bilirubin Measurements: Variation in Meter Response

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 457-459
Author(s):  
M. JEFFREY MAISELS ◽  
CHERYL LEE
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Full Term ◽  
Term Infants ◽  
Transcutaneous Bilirubin ◽  
Potential Variation ◽  
Screening Device ◽  
The Relationship

The transcutaneous bilirubin meter has been shown to be a useful screening device for the identification of significant neonatal jaundice in full-term infants.1-3 Investigators have, nevertheless, emphasized the necessity for each institution to establish the relationship between the transcutaneous bilirubin index, as measured with a particular instrument, and the serum bilirubin determination obtained from the institution's laboratory. 3 This is important, because of the known variation between laboratories in the measurement of serum bilirubin concentration4 and because no information has been published regarding the potential variation in the response of different transcutaneous bilirubin meters.

Transcutaneous Bilirubin Measurements in Full-Term Infants

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 464-467 ◽  
Author(s):  
M. Jeffrey Maisels ◽  
Sarah Conrad
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
False Negative ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Term Infants ◽  
Transcutaneous Bilirubin

A total of 292 transcutaneous bilirubin (TcB) measurements were performed in 157 white full-term infants: 157 were obtained from the forehead and 135 from the midsternum. TcB measurements correlated well with serum bilirubin determinations (r = .93, P &lt; .0001). The sensitivity of the test was 100% and the specificity 97%. It was possible to establish guidelines for the TcB measurement which identified all infants whose serum bilirubin concentrations exceeded 12.9 mg/100 ml (221 µmoles/liter) with no false-negative and only five false-positive determinations (3%). The positive predictive value for the TcB measurements was 58%. This implies that, in our population, an infant with a TcB index ≥24 has a 58% chance of having a serum bilirubin concentration &gt;12.9 mg/100 ml. The negative predictive value was 100%. Thus, a negative test will correctly predict the absence of hyperbilirubinemia in all cases. As these measurements were obtained prospectively in a well-baby population with a prevalence of hyperbilirubinemia (&gt;12.9 mg/100 ml) of 4.5%, the positive predictive value should be applicable to other similar populations and will, in fact, increase in populations with a higher prevalence of hyperbilirubinemia. TcB measurements can be recommended for the identification of significant neonatal jaundice in full-term infants. It is important to recognize, however, that because of potential variations in TcB meters as well as serum bilirubin measurements in different laboratories, each institution should establish its own criteria for the use of this instrument.

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 The Use of Icterometer in Assessing Neonatal Jaundice

2017 ◽  
Vol 18 (5-6) ◽  
pp. 158
Author(s):  
M. Ruskandi ◽  
H. Garna ◽  
A. Alisjahbana
Keyword(s):  
General Hospital ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Bilirubin Concentration ◽  
Grade 3 ◽  
Serum Bilirubin Concentration

A study was made to assess neonatal jaundice by icterometer compared with serum bilirubin concentration, which was determined by Mercko photometric test, on 98 newborns with jaundice born in the Dr. Hasan Sadikin General Hospital, Bandung, throughout October 1975 until March 1976. A good correlation between bilirubin concentration as determined by the icterometer and actual serum bilirubin concentration was found, so that the icterometer could be used in Indonesian newborns. None of the icterometer values grade 3 or less had actual serum bilirubin concentrations more than 15 mg.%, so that grade 3 or less did not necessarily require additional serum bilirubin determination. On the contrary 46.7% and 81.8% of newborns with icterometer values of grades 3½ and 4 respectively have bilirubin concentrations more than 15 mg.%. Therefore, grade 3½ or more required further photometric bilirubin determination with a view to possible treatment.

scholarly journals Comparative Study of Liver Function and Rh Blood Group between both Physiological and Pathological Neonatal Jaundice

2021 ◽  
Vol 30 (1) ◽  
pp. 101-109
Author(s):  
Ayia N. Kamal ◽  
Ali F. Hassan
Keyword(s):  
Serum Albumin ◽  
Blood Group ◽  
Neonatal Jaundice ◽  
Liver Enzymes ◽  
Serum Bilirubin ◽  
Cross Sectional Study ◽  
Auditory Neuropathy ◽  
Albumin Concentration ◽  
Cross Sectional ◽  
High Level

Abstract Backgrounds: Jaundice occurs in most newborn due to increased bilirubin concentration. Jaundice is observed during the first week after birth in approximately 60% of term neonates. A high level of bilirubin is neurotoxic and may cause neonatal kernicterus, auditory neuropathy or death. Objectives: to compare the Rh group compatibility, serum bilirubin (total and direct), serum albumin and several liver enzymes between physiological and pathological neonatal jaundice Materials and Methods: A cross sectional study for one hundred neonates with jaundice divided into group 1: 50 newborns with physiological jaundice, Group 2: 50 newborns with pathological jaundice. Blood samples taken from each patient use to determination of Rh Group and blood group, serum bilirubin (total and direct, liver enzymes and albumin concentration. Results: in the present study Rh Compatibility show a significant relationship between newborns with physiological and pathological jaundice (p<0.05). Serum bilirubin (total and direct), serum albumin concentration and several liver enzymes were significantly higher when compare newborns with pathological jaundice with newborns of physiological jaundice (p<0.05). Conclusion: these finding demonstrate that newborns with pathological jaundice have higher concentrations of these parameters as compared with physiological jaundice .  

scholarly journals A Study of Neonatal Hyperbilirubinemia in Mid-Western Part of Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 41-43 ◽  
Author(s):  
K.M. Roma ◽  
Piush Kanodia ◽  
Manita Pyakurel ◽  
Veena Gupta
Keyword(s):  
Neonatal Jaundice ◽  
Hospital Admissions ◽  
Serum Bilirubin ◽  
Study Data ◽  
Neonatal Hyperbilirubinemia ◽  
Treatment Modalities ◽  
Total Serum ◽  
Common Cause ◽  
Abo Incompatibility ◽  
Satisfactory Outcome

Introduction: Neonatal hyperbilirubinemia is a common cause of hospital admissions. Serum Bilirubin depends on birth weight and gestational age. Common causes of neonatal jaundice are physiological jaundice, breast feeding/milk jaundice, prematurity and pathological causes. Surmount total serum bilirubin over critical level, crosses the blood brain barrier leading to kernicterus. Prompt identification and proper management is of great importance otherwise there is a risk of bilirubin encephalopathy. Objectives: To find out the prevalence and causes of neonatal jaundice in our setting and treatment modalities undertaken. Materials and methods: A hospital based descriptive study was done among total newborns including both inborn and out born admitted in NICU, NGMC over the period of one year. A total 288 newborns with jaundice were enrolled in the study .Data were entered in excel and th analyzed in SPSS 18 version. Descriptive data were presented through pie, bar graph, and table with frequency and percentage. Results: Prevalence of neonatal jaundice was 31%. Causes of neonatal jaundice were physiological and pathological in 56% and 44% cases respectively. Among the pathological causes ABO incompatibility was the most common cause seen in 11.4% cases followed by sepsis seen in 8.7% cases. Conclusions: Phototherapy is very effective treatment modality to reduce the serum bilirubin in most of the cases neonatal hyperbilirubinemia and if the bilirubin crosses the cut off limit according to Bhutani's chart then we have to consider exchange transfusion. Appropriate management in time leads to satisfactory outcome.

scholarly journals Zinc supplementation in preterm neonates with jaundice: is it beneficial?

2020 ◽  
Vol 21 ◽  
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada M Al-Ashmawy ◽  
Sally Abu-Risha
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Zinc Supplementation ◽  
University Hospital ◽  
Preterm Neonates ◽  
P Value ◽  
Indirect Bilirubin ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Neonatal jaundice is a common neonatal disease which had adverse effect in the neonates especially preterm neonates when the level of indirect bilirubin is high enough to pass the blood brain barrier causing bilirubin encephalopathy or kernicterus. Aim: The aim of this study is to investigate the value of zinc (Zn) supplementation in preterm neonates with jaundice and if it will be beneficial or not. Patients and methods: A prospective randomized clinical trial (RCT) study, identification number is TCTR20200504007, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 200 preterm neonates suffering from neonatal jaundice. The studied neonates were divided into 2 groups: group 1, which received Zn and phototherapy, and group 2, which received phototherapy only and did not take Zn. In the group 1, 100 preterm neonates with jaundice received Zn as 0.6 ml(cm3 ) of zinc origin/kg/day orally through oro/nasogastric tube divided into 2 doses (/12 hours) which is equal 1.2 mg elemental zinc/kg/day orally for 10 day. Results: There was no significant difference in serum bilirubin between the 2 groups in the 2nd, 4th and 6th day of admission while the serum bilirubin was significantly decreased in neonates who were treated by Zn and phototherapy in group 1, compared with neonates of group 2 who were treated with phototherapy only in the 8th , 9th and 10th day of admission where the p value was 0.045* ,0.027* and 0.004* respectively. Conclusion: Zn administration in jaundiced preterm neonates is beneficial in decreasing serum bilirubin. Recommendation: Zn supplementation for jaundiced preterm neonates.

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