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How to use: transcutaneous bilirubinometry
Matthew C O'Connor1, Meredith A Lease, Bonny L Whalen
1Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Insights
Transcutaneous bilirubinometry (TcB) offers a non-invasive method to assess neonatal jaundice, reducing the need for blood draws. While effective for infants over 35 weeks gestation, accuracy decreases at higher bilirubin levels.
Area of Science:
- Neonatal Medicine
- Medical Device Technology
Background:
- Neonatal jaundice is common, necessitating bilirubin level assessment.
- Total serum bilirubin (TSB) is the standard diagnostic method.
- Transcutaneous bilirubinometry (TcB) offers a non-invasive alternative.
Purpose of the Study:
- To evaluate the clinical utility and limitations of TcB in assessing neonatal jaundice.
- To compare TcB with TSB in infants greater than 35 weeks gestation.
Main Methods:
- Review of existing studies validating TcB against TSB.
- Analysis of TcB's performance in identifying hyperbilirubinemia risk.
- Assessment of TcB's advantages and limitations in clinical practice.
Main Results:
- TcB reliably identifies infants at risk for severe hyperbilirubinemia (>35 weeks gestation).
- TcB can decrease the number of TSB measurements required.
- TcB accuracy diminishes at higher bilirubin levels.
Conclusions:
- TcB is a valuable tool for managing neonatal jaundice, offering convenience and reducing invasive procedures.
- Paediatric providers must be aware of TcB's limitations, including accuracy at high levels and lack of validated nomograms.
- Further research is needed on TcB use during phototherapy.
Abstract:
The National Institute for Health and Clinical Excellence neonatal jaundice guidelines recommend checking the bilirubin level in all infants with visible jaundice. The gold standard for this measurement is total serum bilirubin (TSB). Transcutaneous bilirubinometry (TcB) is an alternative to TSB that has been validated for clinical use through extensive study. TcB provides many advantages over TSB including instantaneous measurements without requiring a painful lab draw. For infants >35 weeks gestation, TcB can reliably identify infants at risk for severe hyperbilirubinaemia and can decrease the number of TSB measurements obtained. However, paediatric providers should be aware of limitations in clinical use of TcB including decreasing accuracy at higher bilirubin levels, lack of independently validated nomograms for interpretation and limited research regarding its use during phototherapy.
