Correlation of Capillary Tube and Transcutaneous Methods with Serum Biochemistry in Bilirubin Levels in Neonates with Jaundice
Abstract
Objective: The aim of this study was to compare transcutaneous bilirubin (TcB) measurement, which is a noninvasive, easy, fast and inexpensive method in the treatment of patients with neonatal jaundice, with total serum bilirubin (TSB) measurement values, which is the standard method. Simultaneous capillary tube bilirubin values were also included in the study in terms of correlation. We investigated whether it would be safe to use TcB measurement instead of blood sampling for jaundice assessment.
Materials and Methods: Between January 1, 2023 and July 1, 2023, newborns with gestational jaundice aged 37-42 weeks who were hospitalized with neonatal jaundice were enrolled in the neonatal intensive care unit of Gaziosmanpaşa University Faculty of Medicine (Tokat, Turkey). Patients with confirmed neonatal jaundice were retrospectively analyzed. Patients with antenatal or postnatal disease, ABO-Rh blood group incompatibility, and preterm-post-term neonates were excluded from the study. In addition, those who received phototherapy for the first time and did not have a history of transfusion were included in the study.
Results: All 72 patients were term neonates. The mean gestational age was 37.26 weeks (range, 37-40 weeks) and the mean weight was 2789 ± 15 g (2255-4550 g). Thirty-one (43.1%) of the newborns were male. The direct Coombs test was 1+ in three newborns and 4+ in one newborn. There was a strong correlation between TcB bilirubin levels and TSB values before and after treatment (r = 0.776, p < 0.001; r = 0.773, p < 0.001, respectively). A strong correlation was observed between capillary tube bilirubin and TSB measurement values before and after treatment (r = 0.875, p < 0.001; r = 0.899, p < 0.001, respectively).
Conclusion: In our study, we found a strong correlation between transcutaneous bilirubin measurement, serum bilirubin and capillary tube method performed through the ear before and after phototherapy treatment. However, due to the small size of this study, we cannot recommend the use of transcutaneous measurement alone in making treatment decisions.
Keywords
References
- 1. Çayönü N, Bülbül A, Uslu S, Bolat F, Güran Ö, Nuhoğlu A Indirect hyperbilirubinemia in newborn infants change over the last decade. Sisli Etfal Hastane Tip Bul 2011;45:85–93.
- 2. Rizvi MR, Alaskar FM, Albaradie RS, Rizvi NF, Al-Abdulwahab K. A novel non-invasive technique of measuring bilirubin levels using Bili capture. Oman Med J 2019; 34:26–33.
- 3. Cohen RS, Wong RJ, Stevenson DK. Understanding neonatal jaundice: a perspective on causation. Pediatric Neonatal 2010; 51:143–8.
- 4. Rennie JM, Beer J, Upton M. Learning from claims: hyperbilirubinemia and kernicterus. Arch Dis Child Fetal Neonatal Ed 2019;104: F202–4.
- 5. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297– 316.
- 6. Alsaedi SA. Transcutaneous bilirubin measurements can be used to measure bilirubin levels during phototherapy. Int J Pediatric 2018; 2018:4856390.
- 7. Oldak D, García G, Gonzalez EE, Aillon E, Falcon JC, Ayala E, et al. Reproducibility of Bili Care TM transcutaneous bilirubin meter in Mexican newborns. Int J Pediatric 2019; 2019:3812152.
- 8. Hussain AS, Shah MH, Lakhdir M, Ariff S, Demas S, Qaiser F, et al. Effectiveness of transcutaneous bilirubin measurement in man-aging neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan. BMJ Pediatric Open 2017;1: e000065.
- 9. Kuzniewicz MW, Escobar GJ, Newman TB. Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use. Pediatrics 2009; 124:1031–9.
- 10. Eggert LD, Wiedmeier SE, Wilson J, Christensen RD. The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics 2006;117: e855–62.
- 11. Petersen JR, Okorodudu AO, Mohammad AA, Fernando A, Shat-tuck KE. Association of transcutaneous bilirubin testing in hospital with decreased readmission rate for hyperbilirubinemia. Clin Chem 2005; 51: 540–4.
- 12. Tan KL, Dong F. Transcutaneous bilirubinometer during and after phototherapy. Acta Pediatric 2003; 92:327–31.
- 13. Ozkan H, Oren H, Duman N, Duman M. Dermal bilirubin kinetics during phototherapy in term neonates. Acta Pediatric 2003; 92:577–81.
- 14.Casnocha Lucanova L, Matasova K, Zibolen M, Krcho P. Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy. J Perinatal 2016; 36:858–61.
- 15. Çoban A, Türkmen M, Gürsoy T. Transkutan Bilirubin Ölçümü. In: Yenidoğan Sarılıklarında Yaklaşım, İzlem ve Tedavi Rehberi. Türk Neonatoloji Derneği; 2014. p. 14. Available at: http://www.neonatology.org.tr/wp-content/uploads/2016/12/sarilik.pdf. Accessed Apr 14, 2021.
- 16. Kaplan M, Bromiker R. Variation in transcutaneous bilirubin nomograms across population groups. J Pediatric 2019; 208:273–8.
- 17.Brits H, Adendorff J, Huisman D, Beukes D, Botha K, Herbst H, et al. The prevalence of neonatal jaundice and risk factors in healthy term neonates at National District Hospital in Bloemfontein. Afr J Prim Health Care Fam Med 2018;10: e1–6.
- 18. Gunaseelan S, Devadas S, Pai N. Correlation of transcutaneous bilirubin and serum bilirubin concentration in term and late preterm newborns. J Clin Neonatal 2017; 6:154–8.
- 19. Ho HT, Ng TK, Tsui KC, Lo YC. Evaluation of a new transcutaneous bilirubin meter in Chinese newborns. Arch Dis Child Fetal Neonatal Ed 2006;91: F434–8.
- 20. Maisels MJ, Engle WD, Wainer S, Jackson GL, McManus S, Artinian F. Transcutaneous bilirubin levels in an outpatient and office population. J Perinatal 2011; 31: 621–4.
- 21. Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A, et al. Transcutaneous bilirubin measurement: a multicenter evaluation of a new device. Pediatrics 2001; 107: 1264– 71.
- 22. Piazza AJ, Stol BJ. Jaundice and hyperbilirubinemia in newborn Nelson Text Book of Pediatrics. 200818th ed., Ch. 102 Philadelphia Saunders:756–7
- 23. Draque CM, Sañudo A, de Araujo Peres C, de Almeida MF. Transcutaneous bilirubin in exclusively breastfed healthy term newborns up to 12 days of life Pediatrics. 2011;128: e565–71
- 24. Bhutani VK, Gourley GR, Adler S, Kreamer B, Dalin C, Johnson LH. Noninvasive measurement of total serum bilirubin in a multiracial predischarge newborn population to assess the risk of severe hyperbilirubinemia Pediatrics. 2000;106 :E17
- 25. Kolman KB, Mathieson KM, Frias C. A comparison of transcutaneous and total serum bilirubin in newborn Hispanic infants at 35 or more weeks of gestation J Am Board Fam Med. 2007; 20: 266–71
- 26. Lisa ten Kate, Tiemen van Oorschot, Jessica Woolderink, Sarah Teklenburg-Roord, Jolita Bekhof; Transcutaneous Bilirubin Accuracy Before, During, and After Phototherapy: A Meta- Analysis. Pediatrics December 2023; 152 (6): e2023062335. 10.1542/peds.2023-062335
- 27. Thivia Jegathesan, Douglas M. Campbell, Joel G. Ray, Vibhuti Shah, Howard Berger, Robin Z. Hayeems, Michael Sgro, for the NeoHBC; Transcutaneous versus Total Serum Bilirubin Measurements in Preterm Infants. Neonatology 19 August 2021; 118 (4): 443–453.
- 28. Çoban A, Türkmen MK, Gürsoy T. Turkish Neonatal Society guideline to the approach, follow-up, and treatment of neonatal jaundice. Turk Pediatri Ars 2018; 53: S172-S179
Sarılıklı Yenidoğanlarda Bilirubin Düzeyleri Açısından Kılcal Tüp ve Transkutanöz Yöntemlerin Serum Biyokimyası ile Korelasyonu
Abstract
Amaç: Çalışmamızda, yenidoğan sarılığı tanılı hastaların tedavisinde noninvaziv, kolay, hızlı ve ucuz bir yöntem olan transkütan bilirubin(TcB) ölçümünün standart yöntem olan total serum bilirubini(TSB) ölçüm değerleri ile karşılaştırılması amaçlanmıştır. Eş zamanlı kapiller tüp bilirubin değerleri de korelasyon açısından çalışmaya dahil edildi. Sarılık değerlendirmesi için kan örneklemesi yerine TcB ölçümünün kullanılmasının güvenli olup olmayacağını araştırdık.
Gereç ve Yöntem: Gaziosmanpaşa Üniversitesi Tıp Fakültesi(Tokat, Türkiye) yenidoğan yoğun bakım ünitesine 1 Ocak 2023 - 1 Temmuz 2023 tarihleri arasında yenidoğan sarılığı ile hastaneye yatırılan gebelik yaşı 37-42 hafta olan yenidoğanlar kaydedildi. Yenidoğan sarılığı doğrulanmış hastalar retrospektif olarak incelendi. Antenatal veya postnatal hastalığı olan, ABO-Rh kan grubu uyumsuzluğu olan hastalar ve preterm-post-term yenidoğanlar çalışma dışı bırakıldı. Ayrıca ilk kez fototerapi alan ve transfüzyon öyküsü olmayanlar çalışmaya dahil edildi.
Bulgular: 72 hastanın tamamı term yenidoğan idi. Ortalama gebelik yaşı 37.26 hafta (37-40 hafta) ve ortalama ağırlık 2789 ± 15 g (2255-4550 g) idi. Yenidoğanların otuz biri (%43.1) erkekti. Direkt Coombs testi üç yenidoğanda 1+ ve bir yenidoğanda 4+ olarak tespit edildi. Tedavi öncesi ve sonrası TcB bilirubin düzeyleri ile TSB ölçüm değerleri arasında güçlü bir korelasyon saptandı (sırasıyla: r = 0.776, p < 0.001; r = 0.773, p < 0.001). Tedavi öncesi ve sonrası kapiller tüp bilirubin ile TSB ölçüm değerleri arasında güçlü bir korelasyon gözlendi (sırasıyla r = 0.875, p < 0.001; r = 0.899, p < 0.001).
Sonuç: Çalışmamızda, fototerapi tedavisi öncesi ve sonrası kulak yoluyla yapılan transkutanöz bilirubin ölçümü, serum bilirubin ve kapiller tüp yöntemi arasında güçlü bir korelasyon bulduk. Bununla birlikte, bu çalışmanın küçük olması nedeniyle, tedavi kararlarının alınmasında transkutanöz ölçümün tek başına kullanılmasını öneremiyoruz.
Keywords
References
- 1. Çayönü N, Bülbül A, Uslu S, Bolat F, Güran Ö, Nuhoğlu A Indirect hyperbilirubinemia in newborn infants change over the last decade. Sisli Etfal Hastane Tip Bul 2011;45:85–93.
- 2. Rizvi MR, Alaskar FM, Albaradie RS, Rizvi NF, Al-Abdulwahab K. A novel non-invasive technique of measuring bilirubin levels using Bili capture. Oman Med J 2019; 34:26–33.
- 3. Cohen RS, Wong RJ, Stevenson DK. Understanding neonatal jaundice: a perspective on causation. Pediatric Neonatal 2010; 51:143–8.
- 4. Rennie JM, Beer J, Upton M. Learning from claims: hyperbilirubinemia and kernicterus. Arch Dis Child Fetal Neonatal Ed 2019;104: F202–4.
- 5. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297– 316.
- 6. Alsaedi SA. Transcutaneous bilirubin measurements can be used to measure bilirubin levels during phototherapy. Int J Pediatric 2018; 2018:4856390.
- 7. Oldak D, García G, Gonzalez EE, Aillon E, Falcon JC, Ayala E, et al. Reproducibility of Bili Care TM transcutaneous bilirubin meter in Mexican newborns. Int J Pediatric 2019; 2019:3812152.
- 8. Hussain AS, Shah MH, Lakhdir M, Ariff S, Demas S, Qaiser F, et al. Effectiveness of transcutaneous bilirubin measurement in man-aging neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan. BMJ Pediatric Open 2017;1: e000065.
- 9. Kuzniewicz MW, Escobar GJ, Newman TB. Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use. Pediatrics 2009; 124:1031–9.
- 10. Eggert LD, Wiedmeier SE, Wilson J, Christensen RD. The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics 2006;117: e855–62.
- 11. Petersen JR, Okorodudu AO, Mohammad AA, Fernando A, Shat-tuck KE. Association of transcutaneous bilirubin testing in hospital with decreased readmission rate for hyperbilirubinemia. Clin Chem 2005; 51: 540–4.
- 12. Tan KL, Dong F. Transcutaneous bilirubinometer during and after phototherapy. Acta Pediatric 2003; 92:327–31.
- 13. Ozkan H, Oren H, Duman N, Duman M. Dermal bilirubin kinetics during phototherapy in term neonates. Acta Pediatric 2003; 92:577–81.
- 14.Casnocha Lucanova L, Matasova K, Zibolen M, Krcho P. Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy. J Perinatal 2016; 36:858–61.
- 15. Çoban A, Türkmen M, Gürsoy T. Transkutan Bilirubin Ölçümü. In: Yenidoğan Sarılıklarında Yaklaşım, İzlem ve Tedavi Rehberi. Türk Neonatoloji Derneği; 2014. p. 14. Available at: http://www.neonatology.org.tr/wp-content/uploads/2016/12/sarilik.pdf. Accessed Apr 14, 2021.
- 16. Kaplan M, Bromiker R. Variation in transcutaneous bilirubin nomograms across population groups. J Pediatric 2019; 208:273–8.
- 17.Brits H, Adendorff J, Huisman D, Beukes D, Botha K, Herbst H, et al. The prevalence of neonatal jaundice and risk factors in healthy term neonates at National District Hospital in Bloemfontein. Afr J Prim Health Care Fam Med 2018;10: e1–6.
- 18. Gunaseelan S, Devadas S, Pai N. Correlation of transcutaneous bilirubin and serum bilirubin concentration in term and late preterm newborns. J Clin Neonatal 2017; 6:154–8.
- 19. Ho HT, Ng TK, Tsui KC, Lo YC. Evaluation of a new transcutaneous bilirubin meter in Chinese newborns. Arch Dis Child Fetal Neonatal Ed 2006;91: F434–8.
- 20. Maisels MJ, Engle WD, Wainer S, Jackson GL, McManus S, Artinian F. Transcutaneous bilirubin levels in an outpatient and office population. J Perinatal 2011; 31: 621–4.
- 21. Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A, et al. Transcutaneous bilirubin measurement: a multicenter evaluation of a new device. Pediatrics 2001; 107: 1264– 71.
- 22. Piazza AJ, Stol BJ. Jaundice and hyperbilirubinemia in newborn Nelson Text Book of Pediatrics. 200818th ed., Ch. 102 Philadelphia Saunders:756–7
- 23. Draque CM, Sañudo A, de Araujo Peres C, de Almeida MF. Transcutaneous bilirubin in exclusively breastfed healthy term newborns up to 12 days of life Pediatrics. 2011;128: e565–71
- 24. Bhutani VK, Gourley GR, Adler S, Kreamer B, Dalin C, Johnson LH. Noninvasive measurement of total serum bilirubin in a multiracial predischarge newborn population to assess the risk of severe hyperbilirubinemia Pediatrics. 2000;106 :E17
- 25. Kolman KB, Mathieson KM, Frias C. A comparison of transcutaneous and total serum bilirubin in newborn Hispanic infants at 35 or more weeks of gestation J Am Board Fam Med. 2007; 20: 266–71
- 26. Lisa ten Kate, Tiemen van Oorschot, Jessica Woolderink, Sarah Teklenburg-Roord, Jolita Bekhof; Transcutaneous Bilirubin Accuracy Before, During, and After Phototherapy: A Meta- Analysis. Pediatrics December 2023; 152 (6): e2023062335. 10.1542/peds.2023-062335
- 27. Thivia Jegathesan, Douglas M. Campbell, Joel G. Ray, Vibhuti Shah, Howard Berger, Robin Z. Hayeems, Michael Sgro, for the NeoHBC; Transcutaneous versus Total Serum Bilirubin Measurements in Preterm Infants. Neonatology 19 August 2021; 118 (4): 443–453.
- 28. Çoban A, Türkmen MK, Gürsoy T. Turkish Neonatal Society guideline to the approach, follow-up, and treatment of neonatal jaundice. Turk Pediatri Ars 2018; 53: S172-S179
Details
| Primary Language | English |
|---|---|
| Subjects | Neonatology |
| Journal Section | Original Research |
| Authors | |
| Publication Date | March 28, 2024 |
| Submission Date | February 9, 2024 |
| Acceptance Date | March 28, 2024 |
| Published in Issue | Year 2024 Volume: 14 Issue: 2 |
