Comparison of skin sites for estimating serum total bilirubin in in-patients and out-patients: chest is superior to brow.
OBJECTIVE
[corrected] To compare transcutaneous bilirubin readings from the chest and forehead of inpatient and outpatient infants to investigate whether one site is more accurate for estimating serum bilirubin concentration.


METHODS
In all, 31 infants were followed with serum and transcutaneous bilirubins using BiliChek trade mark at two skin sites.


RESULTS
For inpatients average chest bilirubin was 0.4 mg/dl (7 micromol/l) higher than serum while brow was 0.3 mg/dl (5 micromol/l) lower. For outpatients, skin readings from both sites underestimated serum values. Chest estimates were 0.6 mg/dl (10 micromol/l) lower; brow was 2.1 mg/dl (36 micromol/l) lower (p<0.0001). Correlation coefficients and mean differences between skin and serum values for Hispanic and non-Hispanic infants were similar.


CONCLUSIONS
In our inpatients, chest and brow readings approximated serum values. After discharge, brow readings were lower than serum values by almost 20%, while chest readings were underestimated by 5%. We recommend using the chest for transcutaneous bilirubin estimates.
Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
Ronald L
RL
Poland
Carol
C
Hartenberger
Helen
H
McHenry
Andrew
A
Hsi
D001663:Bilirubin / Q000097:blood*; D005260:Female; D005546:Forehead; D006801:Humans; D007231:Infant, Newborn; D007297:Inpatients; D008297:Male; D010045:Outpatients; D012867:Skin / Q000098:blood supply*; D013053:Spectrophotometry; D013909:Thorax
D001663:Bilirubin