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 < .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 >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 (>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.

Evaluation of the Minolta Bilirubin Meter as a Screening Device in White and Black Infants

PEDIATRICS ◽  
1982 ◽  
Vol 69 (1) ◽  
pp. 107-109 ◽  
Author(s):  
Robert E. Hannemann ◽  
Richard L. Schreiner ◽  
David P. DeWitt ◽  
Steven A. Norris ◽  
Melvin R. Glick
Keyword(s):  
Premature Infants ◽  
Serum Bilirubin ◽  
Full Term ◽  
Blood Sampling ◽  
Published Data ◽  
Bilirubin Concentration ◽  
Transcutaneous Bilirubin ◽  
Screening Device ◽  
Serum Bilirubin Concentration

The only currently available method for the determination of the serum bilirubin concentration is blood sampling followed by analysis in the laboratory. Yamanouchi et al1 have presented data concerning a two-wavelength (460, 555 nm) transcutaneous bilirubin meter (Minolta Camera Company, Ltd). They found a significant correlation with serum bilirubin concentrations of 0 to 20 mg/100 ml in full-term Oriental infants. However, there are no published data concerning the use of the instrument in white or black full-term or premature infants. The purpose of this study was to evaluate the Minolta transcutaneous bilirubin meter in these populations. MATERIALS AND METHODS During a two-month period, measurements were taken with the Minolta transcutaneous bilirubin meter on any infant for whom a serum bilirubin determination had been ordered.

Comment on Transcutaneous Bilirubin Device of Yamanouchi

PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 442-442
Author(s):  
Carlo Corchia ◽  
Gennaro Vetrano
Keyword(s):  
Serum Bilirubin ◽  
Newborn Infants ◽  
Full Term ◽  
Noninvasive Method ◽  
Color Intensity ◽  
Term Infants ◽  
Transcutaneous Bilirubin ◽  
Clinical Problems ◽  
Transcutaneous Measurement ◽  
Small Instrument

Yamanouchi et al (Pediatrics 65:195, 1980) have reported a new simple noninvasive method for the transcutaneous measurement of bilirubin levels in newborn infants using a small instrument which measures the color intensity of the skin. By using that method, we have estimated the number of serum bilirubin measurements on capillary samples which could be avoided in full-term infants without clinical problems other than jaundice. In the last 12 months 2,555 newborns weighing 2,501 to 4,000 gm were admitted to our nursery; bilirubinemia was determined at least once in 2,011 (78.7%) of them, giving a total number of determinations of 11,301.

Kernicterus in a Full Term Infant

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 1003-1006
Author(s):  
Anna A. Penn ◽  
Dieter R. Enzmann ◽  
Jin S. Hahn ◽  
David K. Stevenson
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Neonatal Period ◽  
Elevated Serum ◽  
Term Infant ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Term Infants ◽  
Appropriate Treatment ◽  
The Central Nervous System

Neonatal jaundice can represent a benign physiologic process or be the harbinger of serious illness with associated severe neurotoxicity. The neurological manifestations of kernicterus, a condition resulting from the deposition of unconjugated bilirubin in the central nervous system, are rarely seen in modern neonatal care, but jaundice, which reflects elevated serum bilirubin levels, is one of the most common findings in the neonatal period.1 More than half of all term infants will develop some neonatal jaundice and at least 6% will have a serum bilirubin concentration above 12.9 mg/dL.2 The appropriate treatment of hyperbilirubinemia is currently a topic of much debate in pediatrics, particularly treatment of full term infants without risk factors for hemolytic disease.3,4

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.

Study of Gilbert's Syndrome-Associated UGT1A1 Polymorphism in Jaundiced Neonates of ABO Incompatibility Hemolysis Disease

2019 ◽  
Vol 37 (06) ◽  
pp. 652-658
Author(s):  
Yingfang Yu ◽  
Lizhong Du ◽  
An Chen ◽  
Lihua Chen
Keyword(s):  
Gene Polymorphism ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Ugt1a1 Gene ◽  
Abo Incompatibility ◽  
Significant Difference ◽  
Abo Hemolytic Disease ◽  
The Relationship

Abstract Objective This study aimed to assess the probable relationship between icter in neonates with ABO incompatibility hemolysis and UGT1A1 gene polymorphism. Study Design There were 65 ABO hemolytic disease of the newborn (HDN) neonates of full term in the study group and 82 non-ABO HDN neonates of full term in the compared group. We tested the UGT1A1 gene mutation of neonates of ABO HDN and non-ABO HDN. We compared the incidence of hyperbilirubinemia between neonates with and without UGT1A1 mutations in the ABO HDN and non-ABO HDN, to determine the relationship between icter in neonates with ABO HDN and UGT1A1 gene polymorphism. SPSS 13.0 were used to analyze those two groups' data. Results There was statistically significant difference of the serum bilirubin level between the Gly71Arg homozygous and no mutation group in the ABO HDN patients (p < 0.05). When hyperbilirubinemia was defined as serum bilirubin concentration >342 μmol/L, the incidence of hyperbilirubinemia between patients of UGT1A1 and non-UGT1A1 mutations in the ABO HDN group was significantly different (p < 0.05). But in the non-ABO HDN group, no significant difference was found. Conclusion Individuals with Gly71Arg homozygous contributed to their hyperbilirubinemia in ABO HDN patients.

scholarly journals Autonomic Nervous System Maturation and Emotional Coordination in Interactions of Preterm and Full-Term Infants With Their Parents: Protocol for a Multimethod Study

10.2196/28089 ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. e28089
Author(s):  
Christina Koumarela ◽  
Theano Kokkinaki ◽  
Giorgos Giannakakis ◽  
Katerina Koutra ◽  
Eleftheria Hatzidaki
Keyword(s):  
Preterm Infants ◽  
Family Cohesion ◽  
Neonatal Period ◽  
Developmental Outcomes ◽  
Full Term ◽  
Term Infants ◽  
Parent Group ◽  
Video Recordings ◽  
The University ◽  
The Relationship

Background There is limited knowledge on the physiological and behavioral pathways that may affect the developmental outcomes of preterm infants and particularly on the link between autonomic nervous system maturation and early social human behavior. Thus, this study attempts to investigate the way heart rate variability (HRV) parameters are related to emotional coordination in interactions of preterm and full-term infants with their parents in the first year of life and the possible correlation with the developmental outcomes of infants at 18 months. Objective The first objective is to investigate the relationship between emotional coordination and HRV in dyadic full-term infant–parent (group 1) and preterm infant–parent (group 2) interactions during the first postpartum year. The second objective is to examine the relationship of emotional coordination and HRV in groups 1 and 2 in the first postpartum year with the developmental outcomes of infants at 18 months. The third objective is to investigate the effect of maternal and paternal postnatal depression on the relation between emotional coordination and HRV in the two groups and on developmental outcomes at 18 months. The fourth objective is to examine the effect of family cohesion and coping on the relation between emotional coordination and HRV in the two groups and on developmental outcomes at 18 months. Methods This is an observational, naturalistic, and longitudinal study applying a mixed method design that includes the following: (1) video recordings of mother-infant and father-infant interactions at the hospital, in the neonatal period, and at home at 2, 4, 6, 9, and 12 months of the infants’ life; (2) self-report questionnaires of parents on depressive symptoms, family cohesion, and dyadic coping of stress; (3) infants’ HRV parameters in the neonatal period and at each of the above age points during and after infant-parent video recordings; and (4) assessment of toddlers’ social and cognitive development at 18 months through an observational instrument. Results The study protocol has been approved by the Research Ethics Committee of the University of Crete (number/date: 170/September 18, 2020). This work is supported by the Special Account for Research Funds of the University of Crete (grant number: 10792-668/08.02.2021). All mothers (with their partners) of full-term and preterm infants who give birth between March 2021 and January 2022 at the General University Hospital of Crete (northern Crete, Greece) will be invited to participate. The researcher will invite the parents of infants to participate in the study 1 to 2 days after birth. Data collection is expected to be completed by March 2023, and the first results will be published by the end of 2023. Conclusions Investigating the regulatory role of HRV and social reciprocity in preterm infants may have implications for both medicine and psychology. International Registered Report Identifier (IRRID) PRR1-10.2196/28089

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 Severe Perinatal Asphyxia and Risk of Neonatal Jaundice at a Tertiary Hospital in Northern Nigeria

2021 ◽  
pp. 17-22
Author(s):  
I. A. Imoudu ◽  
M. O. Yusuf ◽  
A. T. Aro ◽  
P. E. Akpabio ◽  
Z. M. Waziri
Keyword(s):  
Medical Records ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Perinatal Asphyxia ◽  
Tertiary Hospital ◽  
P Value ◽  
Community Based ◽  
Special Care Baby Unit ◽  
The Mean ◽  
The Relationship

Background: The risk factors of neonatal jaundice are largely known, yet there is little agreement on the association between it and perinatal asphyxia. Aim: To investigate the association between severe perinatal asphyxia (SPA) and the risk of clinical jaundice (NNJ) among neonates managed at the Federal Medical Centre, Azare, Nigeria. Methodology: Case control design was employed. Medical records of 315 babies managed at the special care baby unit from 1st January, 2011 to 31st December, 2018 were analysed. The exposure of interest was SPA and the outcome was jaundice. Logistic regression was applied to demonstrate the relationship between neonatal jaundice and SPA. Relative risk was provided as odds ratio and 95% confidence interval. Results: Sixty-three cases and 252 controls were enrolled in the study. The mean age of the cases (4.39) and that of the controls (4.95 ) did not differ significantly (t= -0.52, P= 0.30). One hundred and fifty-six (61.9%) of the controls were males while 34 (54.0%) of the cases were females. For 59 (93.7%) of the cases treatment for jaundice was done with phototherapy and 1.6% required exchange blood transfusion. SPA significantly reduced the risk of developing NNJ (adjusted OR = 0.27, P-value ˂ 0.01).                                                                           Conclusion: We demonstrated a significantly reduced risk of developing neonatal jaundice with prior exposure to severe perinatal asphyxia. Prospective multicenter and community based studies correlated with serum bilirubin levels are recommended.   

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