Jaundice meter: Evaluation of new guidelines

doi:10.1016/S0022-3476(82)80135-2

The Journal of Pediatrics

Volume 101, Issue 2, August 1982, Pages 253-256

https://doi.org/10.1016/S0022-3476(82)80135-2 Get rights and content

The correlation of transcutaneous bilirubin measurements with serum bilirubin concentrations is not good enough to allow for accurate prediction of the serum values. To improve the jaundice meter's potential clinical usefulness, we evaluated 344 paired jaundice meter-serum bilirubin measurements in 125 infants, using new guidelines from the marketing company which were designed to identify which infants require serum bilirubin determinations rather than to predict the actual bilirubin values. Use of the new guidelines correctly assessed the need for serum determinations in most infants, but false positives and, more importantly, false negatives (missed high serum values) did occur.

References (7)

HegyiT et al.
Transcutaneous bilirubinometry. I. Correlations in term infants
J Pediatr
(1981)
YamanouchiI et al.
Transcutaneous bilirubinometry: Preliminary studies of non invasive transcutaneous bilirubin meter in the Okayama National Hospital
Pediatrics
(1980)
BrownAK et al.
Transcutaneous bilirubinometry in infants; influence of race and phototherapy
Pediatr Res
(1981)

There are more references available in the full text version of this article.

Cited by (23)

Point of care testing: Transcutaneous bilirubinometry in neonates
2009, Clinical Biochemistry
Physicians taking care of infants in the first days of life are often faced with neonatal jaundice, especially in an era where post-partum discharge occurs earlier and assessment of newborn bilirubinemia status is required prior to discharge. The Canadian Pediatric Society and the American Academy of Pediatrics have developed and published guidelines for the diagnosis and management of hyperbilirubinemia in newborns. Point of care testing refers to any test performed outside of laboratory by clinical personnel and close to the site of patient care. Based on a summary of multiple reports during the last twenty years, we realize that devices which provide a non-invasive transcutaneous bilirubin (TcB) measurement have proven to be very useful as screening tools and provide a valid estimate of the total serum bilirubin level (TSB). Published data suggest that these devices provide measurements within 30–50 μmol/L of the TSB levels and can replace laboratory measurement particularly when TSB levels are less than 260 μmol/L. At the present time, in the literature, evidence is insufficient to abandon neonatal serum bilirubin testing and replace it with TcB. Any measurement, TSB or TcB, has potential for error. However, we have evidence that TcB, can help avoiding potential errors associated with even visual assessment of jaundice and may be useful as screening device to detect significant jaundice and decrease a large number of unnecessary skin punctures. The current manuscript is based on a careful comprehensive literature review concerning neonatal hyperbilirubinemia. We consider that this manuscript will help clinicians and laboratory professionals in the management of neonatal jaundice.
Transcutaneous bilirubinometry: Its role in the assessment of neonatal jaundice
1997, Clinical Biochemistry
objective: to review the literature on transcutaneous bilirubinometry so that its exact role in the prevention of kernicterus or bilirubin encephalopathy could be determined.
Design and Methods: Literature searches were done in Medline and Current Contents.
Results: It is estimated that about 50% of newborns have an episode of jaundice in the first few days of life. Six percent of newborns may develop hyperbilirubinemia (> 220 μmol/L), which can potentially cause bilirubin encephalopathy or kernicterus, a severe neonatal disease. In the past, serum bilirubin (SB) has been the preferred method of detecting hyperbilirubinemia in newborns. The ordering of SB in neonates is based on visual evaluation by either physicians or nursing staff. Skin puncture collection of blood exposes the neonate to trauma and risk of infection. A noninvasive device for predicting serum bilirubin levels in newborns diminishes the need to do skin punctures. One such device that has been very extensively studied is the Minolta AirShields Jaundice Meter.™ It is a portable light-weight instrument that uses reflectance measurements on the skin to determine the amount of yellow color present in the skin, namely transcutaneous bilirubin (TcB). Although the TcB measurements correlate well with serum bilirubin (SB) levels, they cannot accurately predict serum bilirubin because of error related to a variety of factors.
Conclusions: TcB cannot be used directly to make decisions about transfusions or phototherapy in neonates. It is a good tool for screening neonates to determine when a laboratory measurement of serum bilirubin is needed. Such a practice requires careful selection of the decision level so that false-negative TcB values do not prevent appropriate serum bilirubin tests from being done.
Advances in the diagnosis and treatment of neonatal hyperbilirubinemia
1995, Clinics in Perinatology
The production of bilirubin from heme degradation can be an important cause of neonatal hyperbilirubinemia in a certain subpopulation. Measurements of carbon monoxide production can be used as an index of heme catabolism and bilirubin production. This process can be inhibited by synthetic metalloporphyrin analogs of heme. This review focuses on approaches to identify those neonates who have increased total bilirubin production and to explore some of the new developments in therapeutic modalities.
Noninvasive measurements of bilirubin in the newborn
1990, Clinics in Perinatology
The practice of noninvasive measurement of bilirubin in newborns is not at all a new one; indeed, visual estimates of the degree of jaundice or icterus were being made before the recognition that bilirubin was the agent responsible for the presence of jaundice. This article reviews the use of transcutaneous bilirubinemetry as a noninvasive replacement for serum bilirubin testing or as a screening device to gauge whether or not the degree of jaundice present warrants serum bilirubin testing.
Neonatal transcutaneous bilirubinometry
1985, Clinics in Perinatology
Measurements of blood pressure are important in the care of the critically ill neonate. Although direct measurement of mean arterial pressure remains the standard, noninvasive methods provide clinically useful estimations of pressure. Clinicians are often faced with situations where measurements of pressure obtained by direct and indirect methods do not agree. Although the explanation for this is not entirely clear, at least two factors are important: first, direct techniques measure pressure while indirect (noninvasive) methods measure flow; second, neither direct or indirect measurements are straightforward and both are subject to error. Of the noninvasive methods, the oscillometric and Doppler devices appear to be most clinically usefUI in the newborn intensive care unit.
Transcutaneous monitoring in the newborn infant
1983, The Journal of Pediatrics

View all citing articles on Scopus

^**: Presented, in part, at the Southern Society for Pediatric Research, New Orleans, January, 1982.

View full text

Jaundice meter: Evaluation of new guidelines**

J Pediatr

Transcutaneous bilirubinometry: Preliminary studies of non invasive transcutaneous bilirubin meter in the Okayama National Hospital

Pediatrics

Transcutaneous bilirubinometry in infants; influence of race and phototherapy

Pediatr Res