Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants
-
Felix K. Quist
Abstract
Objective:
This is a comprehensive study designed to evaluate the clinical usefulness of transcutaneous bilirubinometry (TcB) in very low birth weight (VLBW) newborns of African American (AA) descent.
Methods:
TcB was conducted at the anterior superior iliac spine (ASIS), temporal region and sternum within 2 h of total serum bilirubin (TSB) measurements in newborns born at ≤32 weeks’ gestation prospectively. Average (AVG) TcB levels were also calculated. The relationships between TSB and TcB levels were analyzed using non-parametric Spearman bivariate correlations, a Bland-Altman plot procedure and a decision tree (DT) analysis.
Results:
One hundred newborns and 555 TSB data points were available. Eighty-nine percent of the newborns were AA. A significant correlation (P<0.0001) was observed between TSB and TcB values obtained at the ASIS (r=0.73), sternum (0.73), temporal region (0.61) and AVG (0.77). The Bland-Altman plot revealed a good agreement between AVG TcB values and TSB values. A DT analysis indicated that AVG TcB was also found to be the most significant predictor of TSB values in both the no phototherapy (PT) and biliblanket subgroups.
Conclusion:
TcB can be used reliably in VLBW AA newborns in the absence of overhead PT. The use of TcB in monitoring jaundice in VLBW newborns would help decrease the number of blood draws and cost of care.
Acknowledgments:
We acknowledge the nursing staff and the clinical house staff at Hutzel Women’s Hospital, who helped co-ordinate blood draws with TcB measurements.
References
[1] Robertson A, Kazmierczak S, Vos P. Improved transcutaneous bilirubinometry: comparison of SpectR(X) BiliCheck and Minolta Jaundice Meter JM-102 for estimating total serum bilirubin in a normal newborn population. J Perinatol. 2002;22:12–4.10.1038/sj.jp.7210592Suche in Google Scholar PubMed
[2] Varvarigou A, Fouzas S, Skylogianni E, Mantagou L, Bougioukou D, Mantagos S. Transcutaneous bilirubin nomogram for prediction of significant neonatal hyperbilirubinemia. Pediatrics. 2009;124:1052–9.10.1542/peds.2008-2322Suche in Google Scholar PubMed
[3] Maisels MJ, Kring E. Transcutaneous bilirubinometry decreases the need for serum bilirubin measurements and saves money. Pediatrics. 1997;99:599–601.10.1542/peds.99.4.599Suche in Google Scholar PubMed
[4] Maisels MJ, Ostrea EM, Jr., Touch S, Clune SE, Cepeda E, Kring E, et al. Evaluation of a new transcutaneous bilirubinometer. Pediatrics. 2004;113:1628–35.10.1542/peds.113.6.1628Suche in Google Scholar PubMed
[5] Tayaba R, Gribetz D, Gribetz I, Holzman IR. Noninvasive estimation of serum bilirubin. Pediatrics. 1998;102:E28.10.1542/peds.102.3.e28Suche in Google Scholar PubMed
[6] Ebbesen F, Rasmussen LM, Wimberley PD. A new transcutaneous bilirubinometer, BiliCheck, used in the neonatal intensive care unit and the maternity ward. Acta Paediatr. 2002;91:203–11.10.1111/j.1651-2227.2002.tb01696.xSuche in Google Scholar
[7] Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A, et al. Transcutaneous bilirubin measurement: a multicenter evaluation of a new device. Pediatrics. 2001;107:1264–71.10.1542/peds.107.6.1264Suche in Google Scholar PubMed
[8] Nanjundaswamy S, Petrova A, Mehta R, Bernstein W, Hegyi T. The accuracy of transcutaneous bilirubin measurements in neonates: a correlation study. Biol Neonate. 2004;85:21–5.10.1159/000074953Suche in Google Scholar PubMed
[9] Watchko JF, Maisels MJ. Jaundice in low birthweight infants: pathobiology and outcome. Arch Dis Child Fetal Neonatal Ed. 2003;88:F455–8.10.1136/fn.88.6.F455Suche in Google Scholar PubMed PubMed Central
[10] Willems WA, van den Berg LM, de Wit H, Molendijk A. Transcutaneous bilirubinometry with the Bilicheck in very premature newborns. J Matern Fetal Neonatal Med. 2004;16:209–14.10.1080/jmf.16.4.209.214Suche in Google Scholar
[11] Namba F, Kitajima H. Utility of a new transcutaneous jaundice device with two optical paths in premature infants. Pediatr Int. 2007;49:497–501.10.1111/j.1442-200X.2007.02386.xSuche in Google Scholar
[12] Yasuda S, Itoh S, Isobe K, Yonetani M, Nakamura H, Nakamura M, et al. New transcutaneous jaundice device with two optical paths. J Perinat Med. 2003;31:81–8.10.1515/JPM.2003.012Suche in Google Scholar
[13] Karolyi L, Pohlandt F, Muche R, Franz AR, Mihatsch WA. Transcutaneous bilirubinometry in very low birthweight infants. Acta Paediatr. 2004;93:941–4.10.1111/j.1651-2227.2004.tb02693.xSuche in Google Scholar
[14] Schmidt ET, Wheeler CA, Jackson GL, Engle WD. Evaluation of transcutaneous bilirubinometry in preterm neonates. J Perinatol. 2009;29:564–9.10.1038/jp.2009.38Suche in Google Scholar
[15] Stillova L, Matasova K, Zibolen M, Stilla J, Kolarovszka H. Transcutaneous bilirubinometry in preterm neonates. Indian Pediatr. 2009;46:405–8.Suche in Google Scholar
[16] Donzelli G, Pratesi S. Transcutaneous bilirubinometry in healthy preterm newborns. Clin Biochem. 2000;33:505–8.10.1016/S0009-9120(00)00140-5Suche in Google Scholar
[17] De Luca D, Zecca E, de Turris P, Barbato G, Marras M, Romagnoli C. Using BiliCheck for preterm neonates in a sub-intensive unit: diagnostic usefulness and suitability. Early Hum Dev. 2007;83:313–7.10.1016/j.earlhumdev.2006.06.006Suche in Google Scholar PubMed
[18] Bhutani VK, Gourley GR, Adler S, Kreamer B, Dalin C, Johnson LH. Noninvasive measurement of total serum bilirubin in a multiracial predischarge newborn population to assess the risk of severe hyperbilirubinemia. Pediatrics. 2000;106:E17.10.1542/peds.106.2.e17Suche in Google Scholar PubMed
[19] Engle WD, Jackson GL, Sendelbach D, Manning D, Frawley WH. Assessment of a transcutaneous device in the evaluation of neonatal hyperbilirubinemia in a primarily Hispanic population. Pediatrics. 2002;110(1 Pt 1):61–7.10.1542/peds.110.1.61Suche in Google Scholar PubMed
[20] Ozkan H, Oren H, Duman N, Duman M. Dermal bilirubin kinetics during phototherapy in term neonates. Acta Paediatr. 2003;92:577–81.10.1515/jpm-2019-0157Suche in Google Scholar PubMed
[21] Morris BH, Oh W, Tyson JE, Stevenson DK, Phelps DL, O’Shea TM, et al. Aggressive vs. conservative phototherapy for infants with extremely low birth weight. N Engl J Med. 2008;359:1885–96.10.1056/NEJMoa0803024Suche in Google Scholar PubMed PubMed Central
[22] Adare A, Aidala C, Ajitanand NN, Akiba Y, Al-Bataineh H, Alexander J, et al. Cold-nuclear-matter effects on heavy-quark production in d+Au collisions at sqrt[S(NN)]=200 GeV. Phys Rev Lett. 2012;109:242301.10.1103/PhysRevLett.109.242301Suche in Google Scholar PubMed
[23] Oh W, Tyson JE, Fanaroff AA, Vohr BR, Perritt R, Stoll BJ, et al. Association between peak serum bilirubin and neurodevelopmental outcomes in extremely low birth weight infants. Pediatrics. 2003;112:773–9.10.1542/peds.112.4.773Suche in Google Scholar PubMed
[24] Nanjundaswamy S, Petrova A, Mehta R, Hegyi T. Transcutaneous bilirubinometry in preterm infants receiving phototherapy. Am J Perinatol. 2005;22:127–31.10.1055/s-2005-863785Suche in Google Scholar PubMed
[25] Zecca E, Barone G, De Luca D, Marra R, Tiberi E, Romagnoli C. Skin bilirubin measurement during phototherapy in preterm and term newborn infants. Early human development. 2009;85:537–40.10.1016/j.earlhumdev.2009.05.010Suche in Google Scholar PubMed
[26] Juster-Reicher A, Flidel-Rimon O, Rozin I, Shinwell ES. Correlation of transcutaneous bilirubinometry (TcB) and total serum bilirubin (TsB) levels after phototherapy. J Matern Fetal Neonatal Med. 2014:1–3. PubMed PMID: 25234102. Epub 2014/09/23. Eng.10.3109/14767058.2014.953923Suche in Google Scholar PubMed
[27] Grabenhenrich J, Grabenhenrich L, Buhrer C, Berns M. Transcutaneous bilirubin after phototherapy in term and preterm infants. Pediatrics. 2014;134:e1324–9.10.1542/peds.2014-1677Suche in Google Scholar PubMed
[28] Slusher TM, Angyo IA, Bode-Thomas F, Akor F, Pam SD, Adetunji AA, et al. Transcutaneous bilirubin measurements and serum total bilirubin levels in indigenous African infants. Pediatrics. 2004;113:1636–41.10.1542/peds.113.6.1636Suche in Google Scholar PubMed
[29] Knupfer M, Pulzer F, Braun L, Heilmann A, Robel-Tillig E, Vogtmann C. Transcutaneous bilirubinometry in preterm infants. Acta Paediatr. 2001;90:899–903.10.1111/j.1651-2227.2001.tb02454.xSuche in Google Scholar
[30] Taylor JA, Burgos AE, Flaherman V, Chung EK, Simpson EA, Goyal NK, et al. Discrepancies between transcutaneous and serum bilirubin measurements. Pediatrics. 2015;135:224–31.10.1542/peds.2014-1919Suche in Google Scholar PubMed PubMed Central
[31] Samiee-Zafarghandy S, Feberova J, Williams K, Yasseen AS, Perkins SL, Lemyre B. Influence of skin colour on diagnostic accuracy of the jaundice meter JM 103 in newborns. Arch Dis Child Fetal Neonatal Ed. 2014;99:F480–4.10.1136/archdischild-2013-305699Suche in Google Scholar PubMed
[32] Afanetti M, Eleni Dit Trolli S, Yousef N, Jrad I, Mokhtari M. Transcutaneous bilirubinometry is not influenced by term or skin color in neonates. Early Hum Dev. 2014;90:417–20.10.1016/j.earlhumdev.2014.05.009Suche in Google Scholar PubMed
[33] Chiou YB, Blume-Peytavi U. Stratum corneum maturation. A review of neonatal skin function. Skin Pharmacol Physiol. 2004;17:57–66.10.1159/000076015Suche in Google Scholar PubMed
[34] Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin’s neonatal-perinatal medicine: diseases of the fetus and infant. 9th ed. Philadelphia: Saunders/Elsevier. 2 v. (1840. lx, [lx] p.) p.Suche in Google Scholar
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Multiple gestation: more research challenges to come
- Highlight articles - Multiples
- Fertility treatment and dichorionic discordant twins – are they related?
- Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome
- Prospective risk of intrauterine death of monochorionic twins: update
- Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets
- Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study
- Neonatal morbidities and need for intervention in twins and singletons born at 34–35 weeks of gestation
- Glucose tolerance in singleton, twin and triplet pregnancies
- Respiratory morbidity in twins by birth order, gestational age and mode of delivery
- Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery
- Original papers - Newborn
- Congenital diaphragmatic hernia – a Belgrade single center experience
- Iron homeostasis after blood transfusion in stable preterm infants – an observational study
- Detection and quantification of left-to-right shunting using transpulmonary ultrasound dilution (TPUD): a validation study in neonatal lambs
- Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants
- Outcome of small for gestational age preterm singletons: a population-based cohort study
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- Multiple gestation: more research challenges to come
- Highlight articles - Multiples
- Fertility treatment and dichorionic discordant twins – are they related?
- Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome
- Prospective risk of intrauterine death of monochorionic twins: update
- Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets
- Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study
- Neonatal morbidities and need for intervention in twins and singletons born at 34–35 weeks of gestation
- Glucose tolerance in singleton, twin and triplet pregnancies
- Respiratory morbidity in twins by birth order, gestational age and mode of delivery
- Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery
- Original papers - Newborn
- Congenital diaphragmatic hernia – a Belgrade single center experience
- Iron homeostasis after blood transfusion in stable preterm infants – an observational study
- Detection and quantification of left-to-right shunting using transpulmonary ultrasound dilution (TPUD): a validation study in neonatal lambs
- Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants
- Outcome of small for gestational age preterm singletons: a population-based cohort study
- Congress Calendar
- Congress Calendar