Header

UZH-Logo

Maintenance Infos

Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?


Szabo, Peter; Wolf, Martin; Bucher, Hans Ulrich; et al (2004). Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer? European Journal of Pediatrics, 163(12):722-727.

Abstract

The aim of this study was to compare predictions of hyperbilirubinaemia by eye, performed by trained physicians and nurses, with predictions obtained using two commercial bilirubinometers. Jaundice was assessed in 92 white and 48 non-white healthy full-term neonates using three non-invasive methods and by total serum bilirubin as the reference method. Clinical assessment of cephalocaudal progression of jaundice was carried out independently by a physician and by nurses. Simultaneously, the Minolta Airshields JM-102 was applied on the sternum, the BiliCheck on both the forehead and the sternum, and finally, serum bilirubin concentrations were determined. The Minolta JM-102 showed the best performance with r2=0.90, an intraclass correlation coefficient (ICC) of 0.93, and a 95% confidence interval (CI) of ±4units (approx. 56µmol/l). The BiliCheck performed slightly better on the forehead than over the sternum with r2=0.90, an ICC of 0.88, and a CI of ±62µmol/l. Assessment of jaundice by eye was least accurate with r2=0.74, an ICC of 0.67, and a CI of ±1.5 zones (corresponding to ±75µmol/l). Skin pigmentation and ambient light both adversely affected non-invasive bilirubin estimation. Conclusion:All three non-invasive methods are well suited for estimation of serum bilirubin but show large confidence intervals. In healthy term newborns, hyperbilirubinaemia (>250µmol/l) can be safely ruled out by eye if jaundice does not reach the abdomen or the extremities (Kramer zones 1 and 2), with <22 units (<230µmol/l) for the Minolta JM-102, or with a cut-off of 190µmol/l for the BiliCheck. If these respective thresholds are exceeded, serum bilirubin concentrations should be measured

Abstract

The aim of this study was to compare predictions of hyperbilirubinaemia by eye, performed by trained physicians and nurses, with predictions obtained using two commercial bilirubinometers. Jaundice was assessed in 92 white and 48 non-white healthy full-term neonates using three non-invasive methods and by total serum bilirubin as the reference method. Clinical assessment of cephalocaudal progression of jaundice was carried out independently by a physician and by nurses. Simultaneously, the Minolta Airshields JM-102 was applied on the sternum, the BiliCheck on both the forehead and the sternum, and finally, serum bilirubin concentrations were determined. The Minolta JM-102 showed the best performance with r2=0.90, an intraclass correlation coefficient (ICC) of 0.93, and a 95% confidence interval (CI) of ±4units (approx. 56µmol/l). The BiliCheck performed slightly better on the forehead than over the sternum with r2=0.90, an ICC of 0.88, and a CI of ±62µmol/l. Assessment of jaundice by eye was least accurate with r2=0.74, an ICC of 0.67, and a CI of ±1.5 zones (corresponding to ±75µmol/l). Skin pigmentation and ambient light both adversely affected non-invasive bilirubin estimation. Conclusion:All three non-invasive methods are well suited for estimation of serum bilirubin but show large confidence intervals. In healthy term newborns, hyperbilirubinaemia (>250µmol/l) can be safely ruled out by eye if jaundice does not reach the abdomen or the extremities (Kramer zones 1 and 2), with <22 units (<230µmol/l) for the Minolta JM-102, or with a cut-off of 190µmol/l for the BiliCheck. If these respective thresholds are exceeded, serum bilirubin concentrations should be measured

Statistics

Citations

Dimensions.ai Metrics
28 citations in Web of Science®
33 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

24 downloads since deposited on 19 Oct 2018
5 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Pediatrics, Perinatology and Child Health
Uncontrolled Keywords:Pediatrics, Perinatology, and Child Health
Language:English
Date:1 December 2004
Deposited On:19 Oct 2018 08:15
Last Modified:15 Apr 2021 14:52
Publisher:Springer
ISSN:0340-6199
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00431-004-1533-7

Download

Green Open Access

Download PDF  'Detection of hyperbilirubinaemia in jaundiced full-term neonates by eye or by bilirubinometer?'.
Preview
Content: Published Version
Language: English
Filetype: PDF (Nationallizenz 142-005)
Size: 223kB
View at publisher