Comparison of Transcutaneous and Total Serum Bilirubin Measurements at Five Different Sites in Newborns before and after Phototherapy

Abstract

Objective This study aims to examine the accuracy of transcutaneous bilirubin (TcB) in estimating the total serum bilirubin (TSB) level at five different sites before and immediately after phototherapy.

Methods This study prospectively enrolled infants with a gestational age of 34 to 41^6/7 weeks who were clinically diagnosed with neonatal jaundice and required phototherapy within 28 days after birth. TcB levels were measured on the uncovered four areas (forehead, mid-sternum, abdomen, and interscapular site) and covered hipbone by using the Dräger JM-103 Jaundice Meter before phototherapy and at 0 min after discontinuing phototherapy. Correlation and agreement between TcB and TSB levels were assessed before and after phototherapy.

Results We included 108 infants with a mean gestational age of 37.6±1.5 weeks and birth weight of 3108±548 g. A strong significant correlation was found between TSB and TcB measurements at all five sites before phototherapy with the strongest correlation at the interscapular site (r=0.768, p=0.001). The correlation was weakened between TSB and TcB at all five sites after phototherapy; however, the strongest correlation was at the covered hipbone (r=0.619, p=0.001). TcB measurements at all five sites tended to underestimate TSB levels before and after phototherapy. The difference (TcB − TSB) tended to increase with increasing TSB levels.

Conclusions TcB levels were most accurately measured at the interscapular site and covered hipbone before and immediately after phototherapy, respectively.

Zusammenfassung

Ziel Diese Studie zielt darauf ab, die Genauigkeit des transkutanen Bilirubins (TcB) bei der Schätzung des Gesamtserumbilirubinspiegels (GSB) an fünf verschiedenen Stellen vor und unmittelbar nach der Phototherapie zu untersuchen.

Methoden In diese Studie wurden prospektiv Neugeborene mit einem Gestationsalter von 34 bis 416/7 Wochen aufgenommen, bei denen klinisch eine Neugeborenen-Gelbsucht diagnostiziert wurde und die innerhalb von 28 Tagen nach der Geburt eine Phototherapie benötigten. Die TcB-Spiegel wurden an den unbedeckten vier Bereichen (Stirn, Mitte des Brustbeins, Abdomen und zwischen den Schulterblättern) und am bedeckten Hüftknochen unter Verwendung des Dräger JM-103-Gelbsuchtmessgeräts vor der Phototherapie und 0 min nach Beendigung der Phototherapie gemessen. Korrelation und Übereinstimmung zwischen TcB- und GSB-Spiegeln wurden vor und nach der Phototherapie bewertet.

Ergebnisse Wir schlossen 108 Neugeborene mit einem mittleren Gestationsalter von 37,6±1,5 Wochen und einem Geburtsgewicht von 3108±548 g ein. Eine starke signifikante Korrelation wurde zwischen den GSB- und TcB-Messungen an allen fünf Stellen vor der Phototherapie gefunden, wobei die stärkste Korrelation an der interskapulären Stelle (r=0,768, p=0,001) auftrat. Die Korrelation zwischen TSB und TcB war an allen fünf Stellen nach Phototherapie geringer; die stärkste Korrelation bestand jedoch am bedeckten Hüftknochen (r=0,619, p=0,001). TcB-Messungen an allen fünf Stellen neigten dazu, die GSB-Spiegel vor und nach der Phototherapie zu unterschätzen. Die Differenz (TcB – GSB) nahm tendenziell mit steigenden TSB-Spiegeln zu.

Schlussfolgerungen Die TcB-Spiegel wurden am genauesten an der Stelle zwischen den Schulterblättern und am bedeckten Hüftknochen vor bzw. unmittelbar nach der Phototherapie gemessen.

Key words

transcutaneous - bilirubin - jaundice - hyperbilirubinemia - newborn - phototherapy

Schlüsselwörter

Transkutanes - Bilirubin - Gelbsucht - Hyperbilirubinämie - Neugeborene - Phototherapie

Publication History

Article published online:
30 August 2023

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