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Visual screening versus transcutaneous bilirubinometry for predischarge jaundice assessment
Author(s) -
Kaplan Michael,
Shchors Irena,
Algur Nurit,
Bromiker Ruben,
Schimmel Michael S,
Hammerman Cathy
Publication year - 2008
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2008.00807.x
Subject(s) - medicine , percentile , jaundice , bilirubin , gastroenterology , mathematics , statistics
Objective: Comparison of visual screening with transcutaneous bilirubinometry (TcB) in identifying neonates with plasma total bilirubin (PTB) ≥75th percentile. Design: In 100 paired readings PTB was 34 ± 24 μmol/L higher than the TcB counterpart. A TcB reading of 154 μmol/L was therefore regarded as equivalent to a PTB of 188 μmol/L, corresponding to the 75th percentile at 48 h. Predischarge, all newborns were evaluated for jaundice, first by visual inspection and then transcutaneously. PTB was ordered as indicated by visual assessment or if the TcB reading was ≥154 μmol/L. Results: Of 346 newborns tested, 25 (7.2%) had a PTB concentration ≥75th percentile. Forty‐nine had PTB determinations based on TcB compared with 83 by visual assessment. However, a similar number of affected newborns was identified by each method (21/25 (84%) by visual screening vs. 18/25 (72%) by TcB). PTB concentrations of those who had been chosen by TcB were higher than those selected visually (202 ± 24 μmol/L vs. 186 ± 31 μmol/L). Conclusions: A practical method for predischarge detection of neonates with plasma total bilirubin concentration ≥ 75th percentile, implementing transcutaneous bilirubinometry, is described. The transcutaneous technique required fewer blood tests than visual assessment for similar yield.