Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice
Abstract: The gold standard
for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement.
This method, however, is invasive, painful, and costly in terms of workload,
time, and money. Moreover, repeated blood sampling may lead to significant
blood loss, which is of particular concern in preterm infants. To overcome
these drawbacks, non-invasive methods of bilirubin measurement have been
proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the
subcutaneous tissue of a newborn infant by measuring the difference between
optical densities for light in the blue and green wavelength regions.
Objective To evaluate the accuracy of transcutaneous bilirubinometry for
estimating TSB levels in neonatal jaundice.
Methods Subjects were infants aged < 28 days with jaundice who had
never been treated with phototherapy or exchange transfusion. The study was
done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent
transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15
minutes between tests.
Results One hundred fifty patients were included in this study. The TcB
values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity
and 83.3% specificity. This cut-off point was obtained from a receiver-operator
characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The
correlation coefficients (r) for TSB and TcB measurements on the forehead were
0.897 (P<0.001).
Conclusion Transcutaneous bilirubinometry can be used to accurately
estimate TSB levels in neonatal jaundice, and may be useful in clinical
practice as a non-invasive method to reduce blood sampling.
Keywords: JM-105;
transcutaneous bilirubin; total serum bilirubin
Author: Andra Kurnianto,
Herman Bermawi, Afifa Darmawanti, Erial Bahar
Journal Code: jpkedokterangg170121
