Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study
-
Abdón Castro
,
Mª Teresa Cuesta
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.
Acknowledgments
We would like to thank the Hospital of Getafe Neonatal Unit nurses, and Israel J. Thuissard Vasallo and David Sanz Rosa from the Statistical Department, for their valuable contribution to perform this study. We also appreciate Flora Shan (The Children’s Hospital of Winnipeg, Canada) for the revision of this manuscript.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Financial disclosure: The authors declare no conflict of interest.
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Articles in the same Issue
- Frontmatter
- Editorial
- Preterm premature rupture of membranes (PPROM)
- Original Articles – Obstetrics
- The value of amniotic fluid analysis in patients with suspected clinical chorioamnionitis
- Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
- Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes
- The earlier the gestational age, the greater the intensity of the intra-amniotic inflammatory response in women with preterm premature rupture of membranes and amniotic fluid infection by Ureaplasma species
- Assessment of maternal GBS colonization and early-onset neonatal disease rate for term deliveries: a decade perspective
- Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
- Expression of genes involved in inflammation and growth – does sampling site in human full-term placenta matter?
- Impact of cell-free fetal DNA on invasive prenatal diagnostic tests in a real-world public setting
- Perinatal outcome in gestational diabetes according to different diagnostic criteria
- Original Articles – Fetus
- Change in fetal behavior in response to vibroacoustic stimulation
- Diagnostic accuracy of isolated clubfoot in twin compared to singleton gestations
- Original Article – Newborn
- Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study
- Letters to the Editor
- Methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
- Reply to the Letter to the Editor: methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large-for-gestational-age (LGA) fetuses in non-diabetic pregnancies
