Abstract

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To Compare Transcutaneous Bilirubin With Total Serum Bilirubin In Preterm Neonates Receiving Phototherapy

Kushagra Chaudhari, Ruchi Nanavati 

Institution(s)

Department of Neonatology, KEM Hospital, Parel, Mumbai 400012

Princess Anne Hospital, Southampton

Introduction (include hypothesis)

The incidence of neonatal hyperbilirubinemia is between 30-60% in full-term neonatesand nearly 100% in preterm neonates.[1] Preterm neonates are a unique population who are susceptible to higher risk of kernicterus at lower bilirubin values as well as the adverse effects of frequent blood samplings. Therefore testing their level of jaundice with a non-invasive method is extremely beneficial.

Evidence has shown a good correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) in preterm neonates before initiation of phototherapy (PT). There is limited data on the reliability of use of TcB in preterm neonatesa after initiation of PT. Hence we aimed to compare TcB with TSB in preterm neonates after initiation of phototherapy.

Methods (include source of funding and ethical approval if required)

30 preterm neonates (>28 but <37 weeks) having clinically detectable jaundice were enrolled. Jaundice was assessed with TcB and TSB before initiation of PT. A photo-occlusive patch was applied over the sternum. A repeat TcB was assessed at 12 hours after the initiation of PT on the shielded skin area along with simultaneous TSB estimation. Correlation coefficients of TcB with TSB were calculated using Pearson correlation and compared according to gestational age and postnatal age.

Results

TcB holds a good correlation with TSB both before (r=0.874, p=0.0001) and after initiation of PT. (r=0.751, p=0.0001). Correlation is better for neonates 28-32 weeks gestational age (r=0.944) than 32-37 weeks (r=0.864). It is also better for lower postnatal age <72h (r=0.956) than >72h (r=0.607).

Conclusions

TcB correlates significantly with TSB at the patched sternal site after initiation of PT in preterm neonates

References (include acknowledgement here if appropriate)

– Nagar G, Vandermeer B, Campbell S, Kumar M. Reliability of transcutaneous bilirubin devices in preterm infants: a systematic review. Pediatrics. 2013 Nov;132(5):871-81.

– Jaundice Meter JM-105 instruction manual. 2014. Drägerwerk AG & Co. KGaA. Ref Type Generic

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