Evaluation of a point-of-care transcutaneous bilirubinometer in Chinese neonates at an accident and emergency department

Abstract

Objective: To evaluate the use of a point-of-care transcutaneous bilirubinometer, JM-103 Minolta, for estimation of the serum bilirubin level in the management of neonatal jaundice in term or near-term Chinese neonates.

Design: Prospective correlation study.

Setting: Accident and Emergency Department of a regional hospital in Hong Kong.

Patients: All term or near-term Chinese neonates aged 3 to 7 days, who attended the Accident and Emergency Department because of jaundice between September and November 2007.

Main outcome measures: Paired transcutaneous bilirubin measurements by the JM-103 Minolta and the total serum bilirubin measurement by a direct spectrophotometric method in the laboratory.

Results: The mean age of the 113 neonates at the time of data collection was 5 days (range, 3-7 days). Transcutaneous bilirubin showed a good correlation with total serum bilirubin; the highest correlation coefficient was 0.83 (P < 0.001). Transcutaneous bilirubin cutoff values of 230 micromoles per litre and 298 micromoles per litre could have 100% sensitivity and specificity respectively, to predict a total serum bilirubin level of higher than 250 micromoles per litre (the accepted threshold for treatment). The mean difference between transcutaneous and total serum bilirubin was 14 micromoles per litre (standard deviation, 28 micromoles per litre; P < 0.001); the JM-103 tended to overestimate total serum bilirubin. The 95% limits of agreement were between -40 and 69 micromoles per litre.

Conclusion: The new point-of-care transcutaneous bilirubinometer, JM-103 Minolta, demonstrated good correlation with the serum bilirubin measurement in Chinese neonates aged 3 to 7 days. Thus, it is a useful screening device to facilitate quick decisions on disposal of jaundiced neonates presenting to accident and emergency departments or in out-patient clinic settings.