Cieľ štúdie: Posúdiť spoľahlivosť transkutánneho merania koncentrácie bilirubínu prístrojom Air-Shields Minolta JM-103 u nezrelých novorodencov a porovnať výsledky získané meraním na čele, sterne a bruchu. Metodika: Súbor tvorilo 68 novorodencov narodených v 32. až 37. gestačnom týždni, ktorí neboli liečení pre hyperbilirubinémiu. Prospektívne sa vyhodnotili rozdiely medzi transkutánne nameranou hodnotou koncentrácie bilirubínu na čele (?C), sterne (?S), bruchu (?B) a hodnotou koncentrácie bilirubínu v sére (ich priemerné hodnoty a CI 95%) a boli vypočítané korelačné koeficienty. Výsledky: Koncentrácia sérového bilirubínu bola v rozpätí 38,3 až 292,4 µmol/l. Medzi laboratórne a transkutánne nameranými hodnotami bola zistená tesná korelácia (r >0,70). Nevýznamné rozdiely sa zistili pri meraní na sterne (?S = 0,9 µmol/l; CI 95% = 9,3 µmol/l) a bruchu (?B = 1,1 µmol/l; CI 95% = 9,4 µmol/l). Merania na čele významne podhodnocovali koncentráciu sérového bilirubínu (?C = –21,9 µmol/l; CI 95% = 6,8 µmol/l). Záver: Hodnoty koncentrácie bilirubínu získané transkutánnym meraním Minoltou JM-103 u nedonosených novorodencov preukázali v prospektívnej štúdii dobrú koreláciu so sérovými koncentráciami bilirubínu. Na základe výsledkov autori odporúčajú neinvazívne merania na trupe (na sterne a bruchu) u nedonosených novorodencov s gestačným vekom viac ako 31. g. t. ako vhodnú a spoľahlivú objektívnu skríningovú metódu na identifikáciu novorodencov so signifikantnou hyperbilirubinémiou.
Objective: To evaluate reliability of transcutaneous measurement of bilirubin concentration using Air-Shields Minolta JM-103 device in preterm newborns, and to compare the results obtained over forehead, sternum and abdomen. Patients and methods: The study group consisted of 68 newborns born within 32.–37. gestational weeks, who had not been treated for hyperbilirubinemia. Differences (their mean values and CI 95%) between the transcutaneous value of bilirubin concentration over forehead (?C), sternum (?S) and abdomen (?B) and the value of serum bilirubin concentration were prospectively evaluated. Correlation coefficients were calculated. Results: Serum bilirubin concentration ranged from 38.3 to 292.4 µmol/l. The correlation between bilirubin concentration values obtained by means of laboratory and transcutaneous measurements was close (r >0.70). Transcutaneous measurements over sternum (?S = 0.9 µmol/l; CI 95% = 9.3 µmol/l) and abdomen (?B = 1.1 µmol/l; CI 95% = 9.4 µmol/l) did not show significant differences. Transcutaneous measurements over forehead underestimated serum bilirubin concentrations significantly (?C = –21.9 µmol/l; CI 95% = 6.8 µmol/l). Conclusion: Transcutaneous measurements using Minolta JM-103 in preterm newborns are considered to be reliable due to the close correlation. Based on the resultsthe authors recommend noninvasive measurements of bilirubin concentration over sternum and abdomen in preterm newborns of more than 31 weeks of gestation. Transcutaneous bilirubinometry seems to be an appropriate and reliable method to identify newborns with significant hyperbilirubinemia.
- MeSH
- bilirubin analýza diagnostické užití MeSH
- finanční podpora výzkumu jako téma MeSH
- interpretace statistických dat MeSH
- lidé MeSH
- novorozenec nedonošený metabolismus MeSH
- novorozenecká hyperbilirubinemie diagnóza MeSH
- novorozenecká žloutenka diagnóza MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
AIMS: The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site. METHODS: Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, differences between TSB and TcB, their CI 95%, and correlation coefficients (r) between TcB and TSB were evaluated. RESULTS: The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be significant and close. Minimal differences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels. CONCLUSIONS: Noninvasive measurement by Minolta JM-103 demonstrated significant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.
- MeSH
- bilirubin krev MeSH
- lidé MeSH
- nemoci nedonošenců diagnóza MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- novorozenecká hyperbilirubinemie diagnóza MeSH
- novorozenecký screening přístrojové vybavení MeSH
- spektrofotometrie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
