scholarly journals Uptodate about techniques for the neonatal screening values of bilirubin levels used for jaundice

2021 ◽  
Vol 16 (S4) ◽  
pp. 11-15
Author(s):  
Vlad DIMA ◽  
◽  
Anca Angela SIMIONESCU ◽  
Ana Maria Alexandra STĂNESCU ◽  
Andreea CALOMFIRESCU-AVRAMESCU ◽  
...  
Keyword(s):  
Neonatal Screening ◽  
Neonatal Jaundice ◽  
Current Practice ◽  
Serum Bilirubin ◽  
Vital Signs ◽  
Normal Weight ◽  
Transcutaneous Bilirubin ◽  
Low Costs ◽  
Main Factors ◽  
Length Of Hospitalization

Neonatal jaundice is one of the main factors responsible for maternal stress and the increasing length of hospitalization in the first days after birth. Therefore, accurately determining bilirubin values with low costs investment is essential to guide a quickly and effectively treated. This article aims to review the main techniques used in current practice to measure bilirubin levels in the newborn and establish the correlation between treatment and monitoring. Thus, we will present the working methods for transcutaneous bilirubin measurement, continuous transcutaneous bilirubin monitoring simultaneously with vital signs and serum bilirubin measurement. Furthermore, we will present the main differences in the evaluation in normal weight and premature newborns. In conclusion, the measurement of bilirubin in the newborn contributes to initiating the phototherapy and the decrease of kernicterus cases with significant neurological consequences.

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.

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 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 Association of Neonatal Jaundice with Gut Dysbiosis Characterized by Decreased Bifidobacteriales

Metabolites ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 887
Author(s):  
Shohei Akagawa ◽  
Yuko Akagawa ◽  
Sohsaku Yamanouchi ◽  
Yoshiki Teramoto ◽  
Masahiro Yasuda ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Alpha Diversity ◽  
Normal Weight ◽  
Interquartile Range ◽  
Total Serum ◽  
Serum Total Bilirubin ◽  
Rrna Gene ◽  
Linear Discriminant

Neonatal jaundice, caused by excess serum bilirubin levels, is a common condition in neonates. Imbalance in the gut microbiota is believed to play a role in the development of neonatal jaundice. Thus, we aimed to reveal the gut microbiota characteristics in neonates with jaundice. 16S rRNA gene sequencing was performed on stool samples collected on day 4 from 26 neonates with jaundice (serum total bilirubin > 15.0 mg/dL) and 17 neonates without jaundice (total serum bilirubin < 10.0 mg/dL). All neonates were born full term, with normal weight, by vaginal delivery, and were breastfed. Neonates who were administered antibiotics, had serum direct bilirubin levels above 1 mg/dL, or had conditions possibly leading to hemolytic anemia were excluded. The median serum bilirubin was 16.0 mg/dL (interquartile range: 15.5–16.8) and 7.4 mg/dL (interquartile range: 6.8–8.3) for the jaundice and non-jaundice groups, respectively. There was no difference in the alpha diversity indices. Meanwhile, in the jaundice group, linear discriminant analysis effect size revealed that Bifidobacteriales were decreased at the order level, while Enterococcaceae were increased and Bifidobacteriaceae were decreased at the family level. Bifidobacteriaceae may act preventatively because of their suppressive effect on beta-glucuronidase, leading to accelerated deconjugation of conjugated bilirubin in the intestine. In summary, neonates with jaundice had dysbiosis characterized by a decreased abundance of Bifidobacteriales.

scholarly journals The Impact of Phototherapy on the Accuracy of Transcutaneous Bilirubin Measurements in Neonates: Optimal Measurement Site and Timing

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1729
Author(s):  
Shau-Ru Ho ◽  
Yu-Chen Lin ◽  
Chi-Nien Chen
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Pearson Correlation ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Optimal Measurement ◽  
The Impact ◽  
Transcutaneous Bilirubinometer ◽  
Time Point

Transcutaneous bilirubinometer devices are widely applied to assess neonatal hyperbilirubinemia. However, the optimal skin site and timing of transcutaneous bilirubin (TCB) measurements for the strongest correlation with total serum bilirubin (TSB) levels after phototherapy are still unclear. We conducted a retrospective observational study evaluating the correlation of TCB and TSB levels in neonates postphototherapy. The TCB measurements on the forehead and mid-sternum at 0 and 30 min postphototherapy were assessed by using a JM-103 bilirubinometer. Paired TCB and TSB measurements were assessed by Pearson correlation and Bland–Altman plots. We analyzed 40 neonates with 96 TSB and 384 TCB measurements. The TSB level correlated moderately with the forehead TCB level at 30 min postphototherapy (r = 0.65) and less strongly with the midsternum TCB level at 0 min postphototherapy (r = 0.52). The forehead at 30 min after cessation of phototherapy was the best time point and location of TCB measurement for the assessment of neonatal jaundice status. The reliability of TCB measurements varied across skin sites and durations after phototherapy. The effectiveness of TCB measurement to assess neonatal hyperbilirubinemia is much better on covered skin areas (foreheads) 30 min postphototherapy. The appropriate application of transcutaneous bilirubinometers could aid in clinical practice and avoid unnecessary management.

scholarly journals Transcutaneous bilirubin measurement to estimate serum bilirubin in neonates in a multi-ethnic cohort: a literature review

2016 ◽  
Vol 26 (1) ◽  
pp. 42-57 ◽  
Author(s):  
Peter Kirm Seng Moey
Keyword(s):  
Literature Review ◽  
Ethnic Groups ◽  
Correlation Coefficient ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Transcutaneous Bilirubin ◽  
Premature Babies ◽  
Good For ◽  
Healthy Chinese

Neonatal jaundice (NNJ) is common in Singapore and is usually monitored with serum bilirubin (SB). This paper reviews literature on the accuracy of transcutaneous bilirubin (TcB) measurement compared to SB to monitor jaundice in neonates of major ethnic groups of Singapore, i.e. Chinese, Malay, and Indian. 15 studies with Chinese babies, 5 with Malay babies, and 15 with Indian babies were identified (total of 28 articles, some with more than one race). Correlation coefficient is good for all three races. Chest is a better site for TcB measurement than forehead, though both are good. Infants with TcB levels more than 160–200 μmol/L should have SB checked. While post-phototherapy infants may benefit from TcB 24 hours after cessation of phototherapy, more needs to be done to ascertain its usefulness. Premature babies should have SB measurements. TcB measurement is suitable to monitor NNJ in term and healthy Chinese, Malay, and Indian babies.

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.

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