Visual screening versus transcutaneous bilirubinometry for predischarge jaundice assessment.
OBJECTIVE
Comparison of visual screening with transcutaneous bilirubinometry (TcB) in identifying neonates with plasma total bilirubin (PTB) > or =75th percentile.


METHODS
In 100 paired readings PTB was 34 +/- 24 micromol/L higher than the TcB counterpart. A TcB reading of 154 micromol/L was therefore regarded as equivalent to a PTB of 188 micromol/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 > or =154 micromol/L.


RESULTS
Of 346 newborns tested, 25 (7.2%) had a PTB concentration > or =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 micromol/L vs. 186 +/- 31 micromol/L).


CONCLUSIONS
A practical method for predischarge detection of neonates with plasma total bilirubin concentration > or = 75th percentile, implementing transcutaneous bilirubinometry, is described. The transcutaneous technique required fewer blood tests than visual assessment for similar yield.
Kaplan
Michael
M
Department of Neonatology Shaare Zedek Medical Center, Jerusalem, Israel. kaplan@cc.huji.ac.il
Shchors
Irena
I
Algur
Nurit
N
Bromiker
Ruben
R
Schimmel
Michael S
MS
Hammerman
Cathy
C
D001663:Bilirubin / Q000097:blood*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000175:diagnosis; D007223:Infant; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening; D015997:Neonatal Screening / Q000295:instrumentation* / Q000379:methods; D010351:Patient Discharge; D012307:Risk Factors; D013997:Time Factors
D001663:Bilirubin