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 analysis   diagnostic use   MeSH
• Research Support as Topic MeSH
• Data Interpretation, Statistical MeSH
• Humans MeSH
• Infant, Premature metabolism   MeSH
• Hyperbilirubinemia, Neonatal diagnosis   MeSH
• Jaundice, Neonatal diagnosis   MeSH
• Prospective Studies MeSH
• Check Tag
• Humans MeSH

• MeSH
• Bilirubin analysis   blood   MeSH
• Infant, Newborn MeSH
• Spectrum Analysis instrumentation   MeSH
• Check Tag
• Infant, Newborn MeSH

• MeSH
• Bilirubin diagnostic use   blood   standards   MeSH
• Biomedical Research MeSH
• Infant, Newborn MeSH
• Jaundice, Neonatal diagnosis   MeSH
• Skin Pigmentation MeSH
• Equipment and Supplies MeSH
• Check Tag
• Infant, Newborn MeSH

Objective: To examine the accuracy of transcutaneous bilirubinometry (TCB) measurements during and after phototherapy (PT) in preterm infants. Design: Prospective observational cohort study. Setting: Level III neonatal centre. Patients: Preterm infants (from 23+0 to 36+6 weeks of gestation) born between June 2017 and May 2018 requiring PT. Interventions: TCB was measured from an exposed area of the skin (the sternum; TCBU) and the covered area of the skin under the nappy (the bony part of the upper outer quadrant of the buttock; TCBC) within an hour of obtaining total serum bilirubin (TSB). Main outcome measures: Correlation and agreement between TCB (TCBU and TCBC) and TSB during and after PT. Results: We have enrolled 196 preterm infants. There was a significant correlation between TSB and TCB during PT (r=0.72, 95% CI 0.66 to 0.77 in covered area; r=0.75, 95% CI 0.70 to 0.80 in uncovered area) and after PT (r=0.87, 95% CI 0.83 to 0.91). TCB underestimated TSB level during PT, with a mean TCBC-TSB difference of -25±43 (95% agreement limits of 62 to -112) and a mean TCBU-TSB difference of -48±46 (95% agreement limits of 45 to -140). The agreement between TCB and TSB after cessation of PT improved, with TCB underestimating TSB by a mean TCB-TSB difference of -10±31 (95% agreement limits of 52 to -72). Conclusion: TCB measurements correlated strongly with TSB levels during and after PT. However, there was a wide and clinically relevant disagreement between TCB and TSB measurements during the PT phase, improving significantly after PT.

• Publication type
• Journal Article 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 blood   MeSH
• Humans MeSH
• Infant, Premature, Diseases diagnosis   MeSH
• Infant, Premature MeSH
• Infant, Newborn MeSH
• Hyperbilirubinemia, Neonatal diagnosis   MeSH
• Neonatal Screening instrumentation   MeSH
• Spectrophotometry MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: Neonatal hyperbilirubinemia is a common condition that frequently requires treatment with phototherapy and less commonly by exchange transfusion, especially in preterm infants. It is important to identify and monitor infants at risk of severe unconjugated hyperbilirubinemia early in the postnatal period to instigate appropriate management plans. AIMS: To evaluate transcutaneous bilirubinometry (TCB) as a screening tool at 24 and 48 h of age to predict the need for phototherapy during hospital stay in preterm infants. STUDY DESIGN: A single centre prospective cohort study in a level III perinatal centre. SUBJECTS: Preterm infants (23+0 to 36+6 weeks of gestation) were eligible for enrolment. OUTCOME MEASURES: Primary outcome was to assess the predictive value of TCB at 24 and 48 h of age for the need of phototherapy during hospital stay. RESULTS: A total of 338 preterm infants were enrolled. The majority of infants (98.1%) born below 32 weeks of gestation required phototherapy. For infants born at >31 + 6 weeks of gestation, TCB at 24 h of age ≥81 μmol/l had sensitivity 83%, specificity 56%, positive predictive value (PPV) 54.7% and negative predictive value (NPV) 84%. TCB at 48 h of age ≥145 μmol/l had sensitivity 65%, specificity 62%, PPV 24% and NPV 90%. CONCLUSION: TCB performed poorly at 24 and 48 h of age as a predictor of phototherapy during hospital stay in preterm infants. The negative predictive value of the test at 48 h of age might be helpful for infants born after 31 + 6 weeks of gestation.

• MeSH
• Bilirubin blood   MeSH
• Blood Chemical Analysis instrumentation   methods   MeSH
• Length of Stay MeSH
• Adult MeSH
• Phototherapy MeSH
• Humans MeSH
• Infant, Extremely Premature MeSH
• Infant, Premature MeSH
• Infant, Newborn MeSH
• Hyperbilirubinemia, Neonatal diagnosis   therapy   MeSH
• Neonatal Screening methods   MeSH
• Prospective Studies MeSH
• Sensitivity and Specificity MeSH
• Maternal Age MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH