NEW YORK (Reuters Health) - A transcutaneous bilirubinometer (TcB) is sufficiently accurate to make most serum bilirubin determinations unnecessary in full-term newborns, according to a report in the June issue of Pediatrics.
A previous study showed a good correlation between results obtained with the Minolta/Hill-Rom Air-Shields Transcutaneous Jaundice Meter JM-103 and total serum bilirubin levels in Japanese infants, the authors explain, but transcutaneous measurement cannot yet substitute for serum measurements.
Dr. M. Jeffrey Maisels from William Beaumont Hospital in Royal Oak, Michigan, and colleagues evaluated the accuracy of the JM-103 in a convenience sample of 849 newborns at least 35 weeks’ gestation who had a clinical indication for bilirubin measurement, comparing total serum bilirubin levels with TcB results obtained within an hour of the serum sample.
Values obtained by JM-103 differed from total serum bilirubin levels by 3 mg/L or more in only 2% of white, 17.4% of black, and 3.2% of other infants, the authors report. In all of these black infants, JM-103 values were higher than total serum bilirubin values.
Results were similar with another transcutaneous bilirubinometer, the BiliChek (Respironics, Marietta, Georgia), the researchers note, but results were obtained much more quickly with the JM-103 than with the BiliChek, which requires 5 repeat measurements.
“TcB measurements using the JM-103 Jaundice Meter correlate closely with total serum bilirubin levels over the range of total serum bilirubin encountered in this study,” the authors conclude. “TcB measurements should obviate the need for most serum bilirubin levels in newborn infants > 35 weeks gestation.”
However, they advise, “Decisions to implement phototherapy or exchange transfusion should be made only after confirmation by a total serum bilirubin measurement and should almost never be based on a single measurement.”
Dr. Maisels elaborated in comments to Reuters Health. “Until we have more information, I recommend that TcB measurements be used as a screening tool,” he said.
“The physician can set a value for a TcB measurement (based on the infant’s age in hours and other risk factors) above which a TSB level will always be obtained,” he explained. “In this manner, no infant with significant hyperbilirubinemia should be missed, and many infants and their families will be spared the trauma, cost, and inconvenience of having a laboratory measurement of serum bilirubin,” Dr. Maisels said.
Source: Pediatrics 2004;113:1628-1635. [ Google search on this article ]
MeSH Headings:Diagnosis: Laboratory Techniques and Procedures: Hematologic Tests: Infant, Newborn, Diseases: Jaundice, Neonatal: Neonatal Diseases and Abnormalities: Analytical, Diagnostic and Therapeutic Techniques and Equipment: DiseasesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
