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 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

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 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 Kramer’s scale or transcutaneous bilirubinometry: the ideal choice of a pediatrician? can we trust our eyes?

2019 ◽  
Vol 6 (5) ◽  
pp. 1794 ◽  
Author(s):  
Pearl Mary Varughese
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Roc Curves ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Neonatal Septicemia ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometer ◽  
Transcutaneous Bilirubinometry

Background: Neonatal hyperbilirubinemia, though benign in 80% cases, can lead to kernicterus if not diagnosed and treated early. The golden method of estimation is measuring serum bilirubin levels. Both Kramer’s scale and Transcutaneous bilirubinometer are non -invasive methods. Its high time the pediatricians choose an ideal non-invasive and reliable method to detect hyperbilirubinemia. Objective of this study is to find out which has a better correlation with serum bilirubin - transcutaneous bilirubinometer reading (TcB) or Kramer's scale.Methods: The study was conducted in a tertiary newborn 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. The sample size was 450 and the correlation was analyzed using ROC curves and plots of agreement was done using Bland Altman charts.Results: The incidence of significant Hyperbilirubinemia is 12%. Transcutaneous bilirubin level had a better correlation and prediction level compared to Kramer at both 24 hours and 48 hours. Bland Altman analysis showed that transcutaneous values were closer to the total serum bilirubin level compared to Kramer values.Conclusion: Transcutaneous bilirubinometry is a better and more ideal choice to replace serum bilirubin levels. In settings where TcB is not feasible, it’s always best to screen for jaundice using Kramer’s scale rather than estimating serum bilirubin values in all babies. In babies where TcB levels are above the cut off range, it’s better to do serum bilirubin levels.

scholarly journals Non invasive trans-cutaneous bilirubin as a screening test to identify the need for serum bilirubin assessment in healthy term neonates

2014 ◽  
Vol 1 (4) ◽  
pp. 17-21 ◽  
Author(s):  
BK Gupta ◽  
N Chaudhary ◽  
BD Bhatia ◽  
Binod Gupta
Keyword(s):  
Bilirubin Level ◽  
Clinical Assessment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Trained Observer ◽  
Term Neonates ◽  
Transcutaneous Bilirubin ◽  
Non Invasive

INTRODUCTION: Hyperbilirubinemia is a common problem in the neonates. It can progress to develop kernicterus unless intervention is initiated. Severity of jaundice and decision for management are usually based on total serum bilirubin (TsB) estimation which technique and results closely correlates with total serum bilirubin levels. OBJECTIVES: To compare the accuracy of visual assessment of jaundice by single trained observer based on Kramer's index with total serum bilirubin levels in healthy term neonates. To compare accuracy of non invasive bilirubin assessment with serum bilirubin levels, to compare trans-cutaneous bilirubin assessment on different sites (forehead and sternum) and to develop a cutoff point oftrans-cutaneous bilirubin level for serum bilirubin assessment. METHODS: This prospective study was conducted in the Neonatal unit of the department of Paediatrics at Kasturba Hospital ,Manipal. Study period was from October 2007 to June 2008. Clinical assessment of jaundice was done in healthy term neonates by observer (Trained Paediatric Post Graduate Resident) based on Kramer's index. Transcutaneous bilirubin assessment was done on the forhead and sternum of each baby using JM-103 Minolta. Air shields bilirubino meter. Serum bilirubin level was measured within 30 minutes of the clinical assessment for each baby. RESULTS: This study included 187 healthy term neonates. The mean birth weight was 2856.83gm ± 493.89gm and mean gestation was 38.25+ 1.030 SD. Clinical assessment and Transcutaneous bilirubin(TcB) significantly correlated with total serum bilirubin (TsB), with correlation co-efficient of 0.757 and 0.801 respectively (p 0.0001). Transcutaneous bilirubin assessment over forehead showed a tendency to under estimate total serum bilirubin, with mean difference of-0.31 mg/dl, SD 1.75 mg/dl with 95% confidence interval ofthe mean -0.60 and -0.02 mg/dl (p value 0.05).Transcutaneous bilirubin assessments between 10 mg/dl to 15 mg/dl correlated accurately with total serum bilirubin levels avoiding blood sampling. CONCLUSION: Trained observer clinical assessment of jaundice can be used for screening neonatal jaundice. Non invasive transcutaneous bilirubin assessment has demonstrated significant accuracy with serum bilirubin level estimates between 48 hours to 7 days on two different sites forehead and sternum. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9567 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 17-21

scholarly journals EFFECTIVENESS OF TRANSCUTANEOUS BILIRUBIN (TCBR) MEASUREMENT IN HIGH RISK NEONATES AND TO EVALUATE THE VALIDITY OF TRANSCUTANEOUS BILIRUBIN (TCBR) WITH TOTAL SERUM BILIRUBIN (TSBR) LEVELS IN BOTH LOW AND HIGH RISK NEONATES AT A TERTIARY CARE CENTER OF....

2021 ◽  
Vol 71 (1) ◽  
pp. 357-63
Author(s):  
Durre Shahwar ◽  
Sabina Ariff ◽  
Batha Tariq ◽  
Arjumand Rizvi ◽  
Syed Rehan ◽  
...  
Keyword(s):  
High Risk ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Risk Group ◽  
Tertiary Care ◽  
Low Risk ◽  
Total Serum Bilirubin ◽  
University Hospital ◽  
Total Serum ◽  
Transcutaneous Bilirubin

Objective: To evaluate the utility of a Transcutaneous Bilirubin nomogram in high risk neonates and to evaluate the validity of Transcutaneous Bilirubin and Total serum bilirubin in both low and high-risk neonates. Study Design: Cross-sectional study. Place and Duration of Study: Postnatal Ward, Aga Khan University Hospital, Karachi, from May to Oct 2019. Methodology: The participants will include all neonates born and admitted in the well baby nursery withjaundice. All neonates with gestational age of <35 weeks, requiring admission in Neonatal intensive care unit, and neonates with conjugated hyperbilirubinemia will be excluded. We will stratify our neonates into high and low risk population based on predefined criteria. Eighty five neonates in low risk group and 122 neonates in high risk group will be included. Results: We aim to assess the effectiveness of Transcutaneous Bilirubin nomogram in high risk neonates asan effective and non-invasive tool in the management of neonatal jaundice in high risk neonates. We will alsoassess the sensitivity and specificity of Transcutaneous Bilirubin and Total serum bilirubin measurementsand the analysis would be performed separately for high risk and low risk neonates to evaluate the validity ofTranscutaneous Bilirubin independently in both groups. Conclusion: We hope to establish a validated phototherapy guideline based on the Transcutaneous Bilirubinnomogram, as a cost effective and noninvasive tool in the management of neonatal jaundice in both high and low risk groups in Pakistan.

scholarly journals Most Proper Timing of Transcutaneous Bilirubin Measurement after Phototherapy Treatment in the Newborn Period

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sinan T&uuml;fekci ◽  
Erhan Aygün
Keyword(s):  
Serum Bilirubin ◽  
Correlation Coefficients ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Blood Collection ◽  
Limited Data ◽  
Transcutaneous Bilirubin ◽  
Median Level ◽  
Term Newborns ◽  
Very High

Background: There are limited data about the proper transcutaneous bilirubin measuring time to detect levels that are close to serum bilirubin levels after ending the phototherapy treatment. Objectives: To compare the transcutaneous bilirubin and total serum bilirubin levels, and to evaluate the reliability of transcutaneous bilirubin measurements after phototherapy treatment of newborns because of hyperbilirubinemia. Methods: The study included 105 late preterm and term newborns consisting of 56 females (53.3%) and 49 males (46.6%), with gestational age 350/7 - 416/7 weeks who were treated with phototherapy. A Bilicheck (M&B-MBJ20) device was used for transcutaneous bilirubin measurements. The average of three measurements on the skin in the mid-sternal area were obtained. Correlations between transcutaneous bilirubin and venous bilirubin levels were evaluated 6 and 12 hours after phototherapy. Transcutaneous bilirubin measurements were performed simultaneously with blood collection or within a maximum ± 15 minutes time difference for total serum bilirubin. Results: The average phototherapy time was 10 ± 2 (range, 8 - 12) hours. The average difference between transcutaneous bilirubin and venous bilirubin levels post phototherapy was 2.61 mg/dL after 6 hours and 0.8 mg/dL after 12 hours. The hematocrit levels of the patients ranged between 40 - 66% with an average of 53% ± 4.8, the median level was 51%. Correlation coefficients according to hours after treatment were high for the 6th hour (r = 0.76) and very high for the 12th hour. Conclusions: Jaundice scanning with transcutaneous bilirubin measurements 6 - 12 hours after the end of phototherapy is reliable and may be helpful in preventing additional blood collection from the heel.

Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study

2019 ◽  
Vol 47 (5) ◽  
pp. 568-573 ◽  
Author(s):  
Abdón Castro ◽  
Carlos Zozaya ◽  
Mª Teresa Cuesta ◽  
Marina González ◽  
Gema Villar ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Total Serum ◽  
Skin Area ◽  
Correct Treatment ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Exposed Skin ◽  
Wide Range ◽  
The Difference ◽  
Mean Differences

Abstract Background Transcutaneous bilirubinometers are a non-invasive tool to estimate serum bilirubin. However, once on phototherapy (PHT) and after PHT, its usefulness is precluded. The objective of this study was to prove the hypothesis that transcutaneous bilirubin (TcB) assessment in a covered skin area during PHT could be used to guide the duration of PHT in term and moderate-late preterm infants with non-isoimmune hyperbilirubinemia. Methods A small area of parasternal skin was covered before starting on PHT. Total serum and TcB (both in exposed and non-exposed areas) were determined before starting treatment, every 12 h once on PHT and 12 h after its discontinuation. Pearson’s correlation coefficient and paired mean differences between TcB and total serum bilirubin (TSB) were calculated. Bland-Altman plots were obtained. The percentage of correct treatment decisions made based on non-exposed TcB values was calculated. Results During PHT, there was a relatively good correlation between TSB and non-exposed TcB (0.74) estimates, in contrast to exposed TcB estimates (0.52). However, even when comparing non-exposed TcB with TSB, there was a wide range of agreement limits (−3.8 to 4.6 mg/dL). Decisions based on non-exposed TcB values would have been incorrect in 26.6% of the cases. Conclusion Although there is a relatively strong correlation between total serum and TcB in non-PHT-exposed regions, the difference is not narrow enough to be utilized in guiding clinical decisions on the duration of PHT.

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].

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