The aim of this study was to compare predictions of hyperbilirubinaemia by eye , performed by trained physicians and nurses, with predictions obtained using tw o commercial bilirubinome-ters. Jaundice was assessed in ...The aim of this study was to compare predictions of hyperbilirubinaemia by eye , performed by trained physicians and nurses, with predictions obtained using tw o commercial bilirubinome-ters. Jaundice was assessed in 92 white and 48 non-w hite healthy full-term neonates using three non-invasive methods and by total serum bilirubin as the reference method. Clinical assessment of cephalocaudal pr ogression of jaundice was carried out independently by a physician and by nurses . Simultaneously, the Minolta Airshields JM-102 was applied on the sternum, the BiliCheck on both the forehead and the sternum, and finally, serum bilirubin co ncentrations were determined. The Minolta JM-102 showed the best performance wi th r2 = 0.90, an intraclass correlation coefficient (ICC) of 0.93, and a 95%c onfidence interval (CI) of ±4 units (approx. 56 μmol/l). The BiliCheck perform ed slightly better on the forehead than over the sternum with r2 = 0.90, an ICC of 0.88, and a CI of ±62 μmol/l. Assessment of jaundice by eye was least acc urate with r2 = 0.74, an ICC of 0.67, and a CI of ±1.5 zones (corresponding to ±75 μmol/l). Skin pigmentation and ambient light both adversely affected no n-invasive bilirubin estimation. Conclusion: All three non-invasive methods ar e well suited for estimation of serum bilirubin but show large confidence interv als. In healthy term newborns, hyperbilirubinaemia ( > 250 μmol/l) can be safel y ruled out by eye if jaundice does not reach the abdomen or the extremities (Kr amer zones 1 and 2), with < 22 units ( < 230 μmol/l) for the Minolta JM-102, o r with a cut-off of 190 μmol/l for the BiliCheck. If these respective threshol ds are exceeded, serum bilirubin concentrations should be measured.展开更多
文摘The aim of this study was to compare predictions of hyperbilirubinaemia by eye , performed by trained physicians and nurses, with predictions obtained using tw o commercial bilirubinome-ters. Jaundice was assessed in 92 white and 48 non-w hite healthy full-term neonates using three non-invasive methods and by total serum bilirubin as the reference method. Clinical assessment of cephalocaudal pr ogression of jaundice was carried out independently by a physician and by nurses . Simultaneously, the Minolta Airshields JM-102 was applied on the sternum, the BiliCheck on both the forehead and the sternum, and finally, serum bilirubin co ncentrations were determined. The Minolta JM-102 showed the best performance wi th r2 = 0.90, an intraclass correlation coefficient (ICC) of 0.93, and a 95%c onfidence interval (CI) of ±4 units (approx. 56 μmol/l). The BiliCheck perform ed slightly better on the forehead than over the sternum with r2 = 0.90, an ICC of 0.88, and a CI of ±62 μmol/l. Assessment of jaundice by eye was least acc urate with r2 = 0.74, an ICC of 0.67, and a CI of ±1.5 zones (corresponding to ±75 μmol/l). Skin pigmentation and ambient light both adversely affected no n-invasive bilirubin estimation. Conclusion: All three non-invasive methods ar e well suited for estimation of serum bilirubin but show large confidence interv als. In healthy term newborns, hyperbilirubinaemia ( > 250 μmol/l) can be safel y ruled out by eye if jaundice does not reach the abdomen or the extremities (Kr amer zones 1 and 2), with < 22 units ( < 230 μmol/l) for the Minolta JM-102, o r with a cut-off of 190 μmol/l for the BiliCheck. If these respective threshol ds are exceeded, serum bilirubin concentrations should be measured.
