Comparison of Serum Bilirubin to Transcutaneous Bilirubin During and After Phototherapy

Abstract

Objective: To compare transcutaneous bilirubin with total serum bilirubin in neonates during and after phototherapy
Study design: A prospective observational study for one year
Participants: 799 neonates >35 weeks of gestation, developing jaundice within 10 days of life.
Intervention: A photo-occlusive patch was applied over the sternum. TcB assessment with Drager JM 103 multi wavelength handheld transcutaneous bilirubinometer was done in this area paired with a concurrent serum sample during and 24 hours after stopping phototherapy.
Outcome: In our study the mean TCB during phototherapy was 13.26 ± 2.42 mg/dl with minimum value of 4.50 mg/dL and maximum value of 18.40 mg/dL in the study population (95% CI 13.09 to 13.43 mg/dL). The mean TSB during phototherapy was 13.06 ± 2.52 mg/dl with minimum value of 4.30 mg/dL and maximum value of 18.70 mg/dl in the study population (95% CI 12.88 to 13.23 mg/dL). The mean TCB 24 hours after stopping phototherapy was 10.37 ± 2 mg/dL with minimum value of 4.20 mg/dL and maximum value of 16.10 mg/dL in the study population (95% CI 10.33 to 10.61 mg/dL). The mean TSB 24 hours after stopping phototherapy was 10.47 ± 2.02 mg/dL, minimum value of 4.80 mg/dl and maximum value of 15.30 mg/dL in the study population (95% CI 10.33 to 10.61).
Results: Transcutaneous bilirubin has a good correlation with total serum bilirubin during phototherapy. (r=0.881, P<0.001). Transcutaneous bilirubin has a significant correlation with total serum bilirubin after phototherapy. (r=0.912, P<0.001).
Conclusion: In our study transcutaneous bilirubin correlated significantly with total serum bilirubin at the patched sternal site during and 24 hours after stopping phototherapy, supporting previous studies.