Determining the Correlation and Accuracy of Three Methodsof Measuring Neonatal Bilirubin Concentration: Serum,Capillary and Transcutaneous Bilirubin
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Background: The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Trying to overcome these drawbacks, non-invasive methods of bilirubin measurements have been proposed. Our aim was to assess the agreement between capillary sample gas analyzer results, total serum bilirrubin levels and transcutaneous bilirrubin results. Methods: the transcutaneous bilirubin (TCB) measurements were performed on the infant’s sternum and serum and capillary bilirubin were determined simultaneously. The agreement between both methods was assessed by Spearman´srank correlation coefficient. Results: A total of 217 measurements were performed in 75infants. Median bilirrubin measurements were 6,127 mg/dl (for serum samples) 6,684 mg/dl (gasometry) and 4,371 mg/dl (TCB). A significant correlation was observed between serum samples and analyzed by gasometry (Spearman´s Rho 0,895; 95% IC CCI: 0.955). Correlation was strong but lower between serum samples and TCB (Spearman´s Rho 0,881; 95% CI CCI: 0.847) and gasometry and transcutaneous samples (Spearman´s Rho 0,914; 95% CI CCI: 0,834). Analyzing for ranges; correlation is higher in 5-9 mg/dl interval comparing serum samples and analyzed by gasometry (95% CI CCI: 0.882). Conclusion: transcutaneous bilirubin and determined by gasometry could be alternatives to total serum for early diagnosis, proper management of the neonatal jaundice, increase quality of care, improve in parent satisfaction, and an overall decrease in hospital charges.Neonatal jaundice is a common condition seen in primary care. It is caused by high levels of bilirubin in the blood. Although blood can be sampled routinely from neonates, it could aggressive and painful. Therefore, an accurate and noninvasive method of monitoring of jaundice in such neonates would be desirable. Capillary sample gas analyzer (less accurate sample) and transcutaneous bilirrubin (TCB) determination (fast and painless) have been proposed an alternative to newborns.Jaundice affects 60% of healthy term neonates during the first week of life. The most common cause of jaundice in newborns is increased unconjugated bilirubin in the blood that is in large part attributable to immaturity of hepatic uptake, conjugation, and secretion of bilirubin. In most of the babies, early jaundice is physiological and harmless, but there are multiple risk factors contribute to severe neonatal jaundice: prematurity, low birth weight, jaundice in the first 24 hours of life, sepsis, lactation failure in exclusive breastfeeding, diabetic mother... High levels of bilirubin can lead to brain damage, which may result in neurodevelopmental impairment such as cerebral palsy, and visual and hearing loss.
Authors and Affiliations
Aranda Cazón C, Torrubia Doredo B, Álvarez López C, De Gracia Hils Y, Cuadrado Cenzual MC
Keywords
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- EP ID EP571710
- DOI 10.26717/BJSTR.2017.01.000286
- Views 186
- Downloads 0
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