Abstract
BackgroundHyperbilirubinemia can lead to potentially irreversible bilirubin-induced neurotoxicity. Transcutaneous bilirubin (TcB) determination has become a valuable aid in non invasive screening of neonatal jaundice.The aim of this study is to compare the performance of three most widespread transcutaneous bilirubinometers on a multiracial population of term and late pre-term neonates.MethodsBilirubin concentration was determined using traditional photometric determination and transcutaneously with Bilicheck, BiliMed and JM-103, in random order.Total serum bilirubin (TSB) was determined over a wide concentration range (15,8–0,7 mg/dl) with a mean of 9,5 mg/dl. Related TcB values using Bilicheck (TcB-BC), BiliMed (TcB-BM), and JM-103 (TcB-JM) are reported in Table 1.ResultsA multiracial population of 289 neonates was enrolled with a gestational age ranging from 35 to 41 weeks; birth weight ranging from 1800to 4350 grams; hours of life ranging from 4 to 424. In the total study population correlation analysis using Pearson coefficients showed good results for Bilicheck (r = 0.86) and JM-103 (r = 0.85) but poor for BiliMed (r = 0,70). Similar results were found for the non-Caucasian neonates subgroup. Bilicheck and JM-103 had a greater area under the curve than BiliMed when TSB =14 mg/dl was chosen as a threshold value both for the total study population and the non-Caucasian subgroup.ConclusionsBilicheck and JM-103, but not BiliMed, are equally reliable screening tools for hyperbilirubinemia in our multiracial neonatal population.
Highlights
Hyperbilirubinemia can lead to potentially irreversible bilirubin-induced neurotoxicity
Transcutaneous bilirubin (TcB) determination has become a valuable aid in avoiding significant neonatal hyperbilirubinemia [1] and has significantly reduced the number of heel stick blood samplings and their complications [2]
Current technology analyses the light reflected by the skin and the subcutaneous tissue providing a useful alternative measurement for total serum bilirubin (TSB)
Summary
Hyperbilirubinemia can lead to potentially irreversible bilirubin-induced neurotoxicity. Transcutaneous bilirubin (TcB) determination has become a valuable aid in non invasive screening of neonatal jaundice. The aim of this study is to compare the performance of three most widespread transcutaneous bilirubinometers on a multiracial population of term and late pre-term neonates. Transcutaneous bilirubin (TcB) determination has become a valuable aid in avoiding significant neonatal hyperbilirubinemia [1] and has significantly reduced the number of heel stick blood samplings and their complications [2]. Current technology analyses the light reflected by the skin and the subcutaneous tissue providing a useful alternative measurement for total serum bilirubin (TSB). Neonatal skin colour and thickness represents important variables in TcB measurements. To provide useful clinical information, we compared the performance of the three most widespread transcutaneous bilirubinometers on a multiracial population of term and late pre-term neonates Different devices have been individually validated versus spectrophotometric or high pressure liquid chromatography determination of TSB, often on neonates with a single ethnic background [3].
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