Accuracy of transcutaneous bilirubinometer estimates using BiliCheck in Thai neonates.

BACKGROUND: Neonatal jaundice is the most frequently encountered diagnostic and therapeutic problem in the newborn. In the jaundiced infant, it is thought that the binding capacity of plasma albumin is exceeded, which allows free bilirubin to diffuse into and accumulate within extravascular tissues, such as the central nervous system. Affected newborns may develop kernicterus. The standard method of serum bilirubin measurement requires blood specimen taken by heel prick or venepunetue which involves pain of the newborn and is time consuming. A non invasive, transcutaneous measurement of bilirubin concentration is developed to be an alternative method as a reliable for the screening method to detect hyperbilirubinemia

OBJECTIVE: To compare the estimates of serum bilirubin using a recently introduced device called a BiliCheck and its transcutaneous bilirubinometer index with the standard direct spectrophotometric measurement of serum bilirubin.

DESIGN: Prospective descriptive study.

MATERIAL AND METHOD: Estimates of serum bilirubin, as measured using the BiliCheck, were compared with serum bilirubin concentration measured by direct spectrophotometry in neonates at Songklanagarind Hospital. Transcutaneous bilirubinometer readings were taken on the forehead.

RESULTS: Eighty-two newborns were enrolled in the present study. The means and standard deviations of serum bilirubin concentration and transcutaneous bilirubinometer index were 11.96 +/- 2.98 and 11.61 +/- 2.93 mg/dl, respectively. There was no statistically significant difference (p = 0.44, paired t-test). The correlation coefficient between total serum bilirubin and BiliCheck index was 0.95 with the linear regression equation of Y= 0.99x + 0.4.

CONCLUSION: Serum bilirubin can be accurately measured by the transcutaneous bilirubinometer index in full term newborn infants prior to any intervention modalities.