Transcutaneous bilirubin--comparing the accuracy of BiliChek® and JM 103® in a regional postnatal unit

Abstract

Objective: Transcutaneous bilirubin (TcB) has the potential to reduce serum bilirubin sampling. During a recent survey on the use of TcB in postnatal units in the Republic of Ireland, we identified that only 58% of the 19 units were using TcB and that only two devices were in use, the BiliChek® and JM 103®. We aimed to evaluate and compare these two devices in a regional postnatal unit.

Methods: To evaluate and compare the accuracy of the BiliChek® and JM 103®, we studied simultaneous TcB and total serum bilirubin (TSB) measurements from a population of jaundiced term and near term infants. We evaluated each device with regard to correlation with TSB and potential to safely reduce serum bilirubin testing.

Results: Both TcB devices strongly correlated with TSB (r = 0.88 for BiliChek® and r = 0.70 for JM 103®. The BiliChek® and JM 103® were accurate up to cut-off values of 200 μmol/L and 180 μmol/L, respectively. Using Bhutani's nomogram, 100% sensitivity was achieved using the 75th percentile for BiliChek® and the 40th percentile for JM 103®.

Conclusion: Both TcB devices correlated closely with moderately increased TSB levels and are suitable screening tools to identify jaundiced infants that require a serum bilirubin, with upper limit cut-off values. Both devices reduced the need for TSB levels. We found the BiliChek® slightly more accurate than the JM 103® for our study population. TcB however, is not in widespread use.