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Am J Perinatol 2005; 22(4): 173-179
DOI: 10.1055/s-2005-867087
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Improvement of Conventional Transcutaneous Bilirubinometry Results in Term Newborn Infants

Zlata Felc1
  • 1General Hospital, Neonatal Unit, Oblakova ulica 5, 3000 Celje, Slovenia
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Publication History

Publication Date:
02 May 2005 (online)

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ABSTRACT

This prospective study was performed to determine a way to improve conventional transcutaneous bilirubinometry results in healthy term newborn infants. In 118 infants during phototherapy (group A), and in 118 infants without phototherapy (group B), bilirubin determinations were done in duplicate using the Minolta AirShields Jaundice Meter type 101 (transcutaneous bilirubin index [TcB]), and the diazometric method on the Hitachi 717 Automated Analyzer (total reacting serum bilirubin [SeB]). In 112 infants (group C), bilirubin determinations were done in triplicate, using simple direct-reading photometry on the Moltronic Bilirubinometer (direct serum bilirubin [BiB]). A close correlation between TcB and SeB values was observed in group A (r = 0.69; p < 0.001) and in group B (r = 0.59; p < 0.001). The 95% confidence intervals of TcB readings corresponding to SeB were ± 80.7 μmol/L in group A and ± 76.9 μmol/L in group B, respectively. In group C, using a correctly calibrated BiB with adult sera containing bilirubin concentration in the range 271 to 344 μmol/L, the 95% confidence intervals of parallel TcB and BiB readings corresponding to SeB were ± 28 μmol/L. Parallel determinations of the TcB and the BiB in healthy term newborn infants give results almost identical to those of bilirubin determination by the laboratory method.

KEYWORDS

Transcutaneous bilirubinometry - conventional - term newborn infant

REFERENCES

  • 1 Maisels M J, Gifford K, Antle C E, Leib G R. Jaundice in the healthy newborn infant: a new approach to an old problem.  Pediatrics. 1988;  53 132-137
    PubMedGoogle Scholar
  • 2 Newman T B, Maisels M J. Evaluation and treatment of jaundice in the term newborn: a kinder, gentler approach.  Pediatrics. 1992;  89 809-818
    PubMedGoogle Scholar
  • 3 Levi A J, Gatmaintan Z, Arais I M. Deficiency of hepatic organic anion-binding protein, impaired organic anion uptake by liver and psysiologic jaundice in newborn monkeys.  N Eng J Med. 1970;  283 1136-1139
    PubMedGoogle Scholar
  • 4 Valaes T. Bilirubin toxicity: the problem was solved a generation ago.  Pediatrics. 1992;  89 819-820
    PubMedGoogle Scholar
  • 5 American Academy of Pediatrics . Practice parameter: management of hyperbilirubinemia in the healthy term newborn.  Pediatrics . 1994;  94 558-565
    Google Scholar
  • 6 Yamanouchi I, Yamanouchi Y, Igarashi I. Transcutaneous bilirubinometry: preliminary studies of noninvasive transcutaneous bilirubin meter in the Okayama national Hospital.  Pediatrics. 1980;  65 195-202
    Google Scholar
  • 7 Knudsen A. The cephalocaudal progression of jaundice in newborns in relation to the transfer of bilirubin from plasma to skin.  Early Hum Dev. 1990;  22 23-28
    Google Scholar
  • 8 Heygi T, Hiatt M, Indyk L. Transcutaneous bilirubinometry. I. Correlations in term infants.  J Pediatr. 1981;  98 454-457
    Google Scholar
  • 9 Goldman S L, Penalver A, Peneranda R. Jaundice meter: evaluation of new guidelines.  J Pediatr. 1982;  101 253-256
    PubMedGoogle Scholar
  • 10 Tan K L. Transcutaneous bilirubinometry in Chinese and Malay Infants.  Acta Paediatr Scand. 1982;  71 593-596
    PubMedGoogle Scholar
  • 11 Yamauchi Y, Yamanouchi I. Transcutaneous bilirubinometry. Bilirubin kinetics of the skin and serum during and after phototherapy.  Biol Neonate. 1989;  56 263-269
    PubMedGoogle Scholar
  • 12 Cohen A N, Ostrow J D. New Concepts in phototherapy: Photoisomerization of bilirubin IX α and potential toxic effects of light.  Pediatrics. 1980;  65 740-747
    PubMedGoogle Scholar
  • 13 Granati B, Felice M, Fortunato A, Giancola G, Rubaltelli F F. Sites of action of light during phototherapy.  Biol Neonate. 1983;  43 1-8
    PubMedGoogle Scholar
  • 14 Yamauchi Y, Yamanouchi I. Transcutaneous bilirubinometry. Effect of irradiation on the skin bilirubin index.  Biol neonate. 1988;  54 314-319
    PubMedGoogle Scholar
  • 15 Rutledge J C, Ou C-N. Bilirubin and the laboratory. Advances in the 1980s, considerations for the 1990s.  Pediatr Clin North Am. 1989;  36 189-198
    PubMedGoogle Scholar
  • 16 Brügmann G. Calibration of direct reading photometers for the determination of neonatal bilirubin.  J Clin Chem Clin Biochem. 1990;  28 83-89
    PubMedGoogle Scholar
  • 17 Schlebusch H, Axer K, Schneider Ch, Liappis N, Röhle G. Comparison of five routine methods with the candidate reference method for the determination of bilirubin in neonatal serum.  J Clin Chem Clin Biochem. 1990;  28 203-210
    PubMedGoogle Scholar
  • 18 Schlebusch H, Röhle G, Schneider Ch, Liappis N, Geilenkeuser W-J, Genz R. Improvement of the accuracy of bilirubinometer results.  Lab Med. 1991;  15 10-15
    PubMedGoogle Scholar
  • 19 Blijenberg B G, Brügmann G, Geilenkeuser W-J et al.. Calibrators and control Samples for bilirubinometers.  J Clin Chem Clin Biochem. 1993;  31 367-374
    PubMedGoogle Scholar
  • 20 Rubaltelli F, Gourley G, Laskamp N et al.. Transcutaneous bilirubin measurement: a multicenter evaluation of a new device.  Pediatrics. 2001;  107 1264-1271
    Google Scholar
  • 21 Robertson A, Kazmierczak S, Vos P. Improved transcutaneous bilirubinometry: comparison of ScectRxBiliCheck and Minolta Jaundice meter JM-102 for estimating serum bilirubin in a normal newborn population.  J Perinatol. 2002;  22 12-14
    Google Scholar
  • 22 Wong C M, Van Dijk P JE, Laing I A. A comparison of transcutaneous bilirubinometers: SpectRx BiliCheck versus Minolta AirShields.  Arch Dis Child Fetal Neonatal Ed. 2002;  87 F137-F140
    PubMedGoogle Scholar
  • 23 Maisels M J, Lee C. Transcutaneous bilirubin measurements: variation in meter response.  Pediatrics. 1983;  71 457-459
    PubMedGoogle Scholar
  • 24 Tan K L, Dong F. Transcutaneous bilirubinometry during and after phototherapy.  Acta Paediatr. 2003;  92 327-331
    CrossrefPubMedGoogle Scholar
  • 25 O'Brien P C, Shampo M A. Statistics for clinicians. 7. Regression.  Mayo Clin Proc. 1981;  56 452-454
    PubMedGoogle Scholar
  • 26 Kapitulnik J, Horner-Mibashan R, Blondheim S H, Kaufmann N A, Russel A. Increase in bilirubin-binding affinity of serum with age of infant.  J Pediatr. 1975;  86 442-445
    PubMedGoogle Scholar
  • 27 Lindner N, Regev A, Gazit G, Carplus M, Mandelberg A, Tamir I, Reichman B. Noninvasive determination of neonatal hyperbilirubinemia: standardization for variation in skin color.  Am J Perinatol. 1994;  11 223-225
    PubMedGoogle Scholar
  • 28 Knudsen A. The influence of the reserve albumin concentration and pH on the cephalocaudal progression of jaundice in newborns.  Early Hum Dev. 1991;  25 37-41
    CrossrefPubMedGoogle Scholar
  • 29 Knudsen A. The influence of the basal yellow colour of the skin at birth on later jaundice meter readings in mature newborn infants.  Acta Paediatr Scand. 1992;  81 494-497
    PubMedGoogle Scholar
  • 30 Fok T-F, Lau S-P, Hui C-W, Fung K-P, Wan C-W. Transcutaneous bilirubinometer: its use in Chinese term infants and the effect of haematocrit and phototherapy on the TCB index.  Aust Paediatr J. 1986;  22 107-109
    PubMedGoogle Scholar
  • 31 Kramer L I. Advancement of dermal icterus in the jaundiced newborn.  Am J Dis Child. 1969;  118 454-458
    PubMedGoogle Scholar
  • 32 Myara A, Sender A, Valette V et al.. Early changes in cutaneous bilirubin and serum bilirubin isomers during intensive phototherapy of jaundiced neonates with blue and green light.  Biol Neonate. 1997;  71 75-82
    PubMedGoogle Scholar
  • 33 Christensen T, Kinn G. Bilirubin bound to cells does not form photoisomers.  Acta Paediatr. 1993;  82 22-25
    PubMedGoogle Scholar
  • 34 Dominiguez Ortega F, Ormazabal Ramos J C, Martin Zarza M. Tanscutaneous bilirubinometry: correlation of the reading site obtained with spectrophotometry and diazo reaction technique.  An Esp Pediatr. 1993;  39 438-440
    PubMedGoogle Scholar
  • 35 Clark R P, Stothers J K. Neonatal skin temperature distribution using infra-red colour thermography.  J Physiol. 1980;  302 323
    PubMedGoogle Scholar
  • 36 Karlsson H, Hänel S-E, Nilsson K, Olegard R. Measurement of skin temperature and heat flow from skin in term newborn babies.  Acta Paediatr. 1995;  84 605-612
    PubMedGoogle Scholar

Zlata FelcM.D. 

General Hospital, Neonatal Unit, Celje, Slovenia

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