Predictive accuracy of transcutaneous bilirubin assessments

The American Academy of Pediatrics recommends that a “screening” total serum bilirubin (TSB) or transcutaneous (TcB) measurement should be obtained prior to discharge in infants ≥35 weeks' gestation and used with an assessment clinical risk factors predict which are at develop severe hyperbilirubinemia (Pediatrics 2004;129:1193-8) (J Perinatol 2009;29:612-7). TcB TSB values plotted on hour specific nomogram the zone for determined basis infant's age hours. Transcutaneous measurements widely as screening tool decide need measurement. may underestimate overestimate concentration by small amount depending range concentrations, device ethnic background 2004;113:1628-35). In this volume Journal Konana et al from Intermountain Healthcare completed quality improvement project ≥35-weeks' quantify (>85th percentile Utah algorithm) would fail identify confirmatory when alone have revealed phototherapy was indicated. Out 727 paired specimens, indicated “no phototherapy” just one infant Four points worth emphasizing study. First, is fairly accurate but cannot replace gold standard (Figure). Second, authors BiliChek device; other devices (JM 103/105) yield different results. Third, population (77% Caucasian) not representative populations around country. Finally, use will result high number false positive values. study al, 18.2% exceeded 95th (suggesting phototherapy). However, 78% corresponding did exceed indicating rate. If only followed lead excessive phototherapy. Phototherapy has recently been shown associated increase seizures 2018;142;e201800648) (Epilepsy Res 2016;124:67-72). investigators well designed offers reassurance safety relative accuracy measurements. deciding management. Article page 53 ▸ Decision Accuracy Safety Bilirubin Screening HealthcareThe PediatricsVol. 228PreviewTo recommend neonate who qualified it if were used. Full-Text PDF