Comparison between transcutaneous bilirubinometry and total serum bilirubin measurements in preterm infants <35 weeks gestation.

BACKGROUND: Neonatal hyperbilirubinaemia is a common treatable cause of brain injury. The treatment for this condition is phototherapy. The decision whether to use phototherapy is currently dependent upon serum bilirubin assay results. However, repeated blood sampling is not only traumatic but may also be a cause of anaemia in neonates. We evaluated a transcutaneous bilirubin assay method to determine whether it was suitable for routine use in preterm infants.
METHODS: One hundred and eighty-three transcutaneous bilirubin measurements were taken contemporaneously with blood samples for laboratory measurement of serum bilirubin. The study was carried out with informed parental consent and approval by the local research ethics committee.
RESULTS: The transcutaneous bilirubin method (BiliChek) exhibited a consistent positive bias compared with the laboratory bilirubin assay. Consequently, for a given detection rate, the transcutaneous method had a higher screen positive rate, i.e. more neonates would be given phototherapy if transcutaneous bilirubin results were used to decide. There was a margin of safety in the transcutaneous bilirubin assay calibration.
CONCLUSION: The BiliChek transcutaneous bilirubin assay is a safe alternative to laboratory bilirubin assay in deciding whether to give preterm neonates phototherapy.