title: Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants.
abstract: OBJECTIVE
  This is a comprehensive study designed to evaluate the clinical usefulness of transcutaneous bilirubinometry (TcB) in very low birth weight (VLBW) newborns of African American (AA) descent.
  
  
  METHODS
  TcB was conducted at the anterior superior iliac spine (ASIS), temporal region and sternum within 2 h of total serum bilirubin (TSB) measurements in newborns born at ≤32 weeks' gestation prospectively. Average (AVG) TcB levels were also calculated. The relationships between TSB and TcB levels were analyzed using non-parametric Spearman bivariate correlations, a Bland-Altman plot procedure and a decision tree (DT) analysis.
  
  
  RESULTS
  One hundred newborns and 555 TSB data points were available. Eighty-nine percent of the newborns were AA. A significant correlation (P<0.0001) was observed between TSB and TcB values obtained at the ASIS (r=0.73), sternum (0.73), temporal region (0.61) and AVG (0.77). The Bland-Altman plot revealed a good agreement between AVG TcB values and TSB values. A DT analysis indicated that AVG TcB was also found to be the most significant predictor of TSB values in both the no phototherapy (PT) and biliblanket subgroups.
  
  
  CONCLUSIONS
  TcB can be used reliably in VLBW AA newborns in the absence of overhead PT. The use of TcB in monitoring jaundice in VLBW newborns would help decrease the number of blood draws and cost of care.
authors.forename: Felix K
authors.initials: FK
authors.lastname: Quist
authors.forename: Roopali
authors.initials: R
authors.lastname: Bapat
authors.forename: Helen K
authors.initials: HK
authors.lastname: Kuch-Kunich
authors.forename: Kanayo
authors.initials: K
authors.lastname: Ezeanolue
authors.forename: Saraswati
authors.initials: S
authors.lastname: Keeni
authors.forename: Ronald
authors.initials: R
authors.lastname: Thomas
authors.forename: Joseph
authors.initials: J
authors.lastname: Callaghan
authors.forename: Michael
authors.initials: M
authors.lastname: Callaghan
authors.forename: Eugene
authors.initials: E
authors.lastname: Cepeda
authors.forename: Nitin S
authors.initials: NS
authors.lastname: Chouthai
mesh_terms: D001741:Black or African American; D001663:Bilirubin / Q000097:blood*; D001774:Blood Chemical Analysis / Q000295:instrumentation / Q000379:methods*; D003663:Decision Trees; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D008297:Male; D015997:Neonatal Screening / Q000295:instrumentation / Q000379:methods; D010789:Phototherapy; D011446:Prospective Studies
chemical_list: D001663:Bilirubin