Bilirubin Measurement Through a Smartphone Application in Preterm Infants

Abstract

Backround Aim of the present study is to evaluate the feasibility and reliability of an smartphone application for monitore of bilirubin levels in preterm infants.

Methods Preterm infants hospitalized in the neonatal intensive care unit with gestational age of<35 weeks were included. Exclusion criteria were parental reluctance and requirement of phototherapy in the last 12 hours. Measurements were obtained through a smartphone application (BiliScan) along with simultaneous transcutaneous device (Dräger JM 105) and venous blood biochemistry.

Results Mean gestational age was 30.8±2.4 weeks and birth weight was 1622±566 g. Measurements were obtained at a median of 4 (1–21) days of life. Twenty-five infants (19.4%) had ABO and/or Rh incompatibility and 39 infants (30.2%) required phototherapy. None of the cases required exchange transfusion. Mean total serum bilirubin (TSB) level was 8.16±2.60 mg/dL, mean transcutaneous bilirubin (TcB) level was 8.60±2.70 mg/dL, and the mean bilirubin level measured by BiliScan was 7.26±2.68 mg/dL. For TSB and TcB measurements, the intraclass correlation coefficient (ICC) was found to be 0.915 (95% confidence interval 0.835–0.951; p<0.001) and a strong positive correlation was found between these two measurements. When TSB and BiliScan measurements were compared, ICC was found to be significant as 0.512 (95% confidence interval 0.353–0.638; p<0.001), with a moderate correlation.

Conclusions In this study, we evaluated the feasibility and reliability of a smartphone application for monitoring bilirubin levels in preterm infants. Although BiliScan measurements reported to display high correlation in term infants, a moderate correlation was found in the preterm infants. It is an emerging low-cost, non-invasive alternative for neonatal jaundice monitoring, however, results should be interpreted with caution in preterm infants.

Zusammenfassung

Hintergrund und Ziel Ziel der vorliegenden Studie ist es, die Machbarkeit und Zuverlässigkeit einer Smartphone-Anwendung zur Überwachung des Bilirubin-Spiegels bei Frühgeborenen zu prüfen.

Methode Aufgenommen in die Studie wurden stationär in der Neugeborenen-Intensivstation behandelte Frühgeborene mit einem Gestationsalter < 35 SSW. Als Ausschlusskriterien galten Vorbehalte der Eltern und die Notwendigkeit einer Phototherapie in den letzten 12 Stunden. Die Bestimmungen erfolgten mit einem transkutanen Messgerät (Dräger JM 105) in Kombination mit einer Smartphone-App (BiliScan) sowie laborchemisch im venösen Blut.

Ergebnisse Das mittlere Gestationsalter lag bei 30,8±2,4 SSW und das mittlere Geburtsgewicht betrug 1622±566 g. Die Bestimmungen erfolgten im Median am 4 (1–21) Lebenstag. Eine ABO- und/oder Rhesus-Unverträglichkeit fand sich bei 25 Säuglingen (19,4%) und bei 39 Säuglingen (30,2%) war eine Phototherapie erforderlich. In keinem der Fälle bestand die Notwendigkeit einer Austauschtransfusion. Der mittlere Gesamtbilirubinspiegel im Serum (TSB) betrug 8,16±2,60 mg/dL, der mittlere transkutane Bilirubinspiegel (TcB) 8,60±2.70 mg/dL und der mittlere mittels BiliScan gemessene Bilirubinspiegel 7,26±2,68 mg/dL. Für die TSB- und TcB-Bestimmungen fand sich ein Intraklassen-Korrelationskoeffizient (ICC) von 0,915 (95-%-Konfidenzintervall 0,835–0,951; p<0,001) und eine starke positive Korrelation zwischen diesen zwei Bestimmungen. Beim Vergleich der TSB- und BiliScan-Messungen fand sich ein signifikanter ICC mit 0,512 (95-%-Konfidenzintervall 0,353–0,638; p<0,001) bei einer mäßigen Korrelation.

Schlussfolgerung In der vorliegenden Studie prüften wir die Machbarkeit und Zuverlässigkeit einer Smartphone-Anwendung zur Überwachung des Bilirubin-Spiegels bei Frühgeborenen. Trotz der berichteten hohen Korrelation der Bestimmungen bei termingerecht geborenen Kindern wurde bei den Frühgeborenen eine mäßige Korrelation festgestellt. Die Bilirubinbestimmung mittels Smartphone-App ist eine neue, kostengünstige, nicht-invasive Alternative für die Überwachung des Neugeborenen-Ikterus. Bei Frühchen ist allerdings bei der Interpretation der Ergebnisse Vorsicht geboten.

Key words

Smartphone app - premature - jaundice - hyperbilirubinemia - BiliScan

Schlüsselwörter

Smartphone-App - Frühgeburt - Gelbsucht - Hyperbilirubinämie - BiliScan

Publication History

Article published online:
20 December 2022

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