Diagnostic Usefulness of Transcutaneous Bilirubinometry in Very Preterm Newborns

Background: this study was performed to find out whethertranscutaneous bilirubinometry could be a valid screening methodfor hyperbilirubinemia in preterm infants, especially for those whoneeded mechanical ventilation.methods: we evaluated 63 preterm iranian newborns who weremanaged in the neonatal intensive care unit of shahidbeheshtiuniversity hospital, isfahan, iran from april 2009 to april 2010.transcutaneous bilirubin (tcb) measurements were obtainedusing bilicheck™ shortly before or 10 minutes after taking bloodfor determination of the plasma bilirubin level in prematurenewborns, who did not receive phototherapy. we assessed thecorrelation between the transcutaneous bilirubin and plasmabilirubin level by linear regression analysis. we also analyzed thegestational age, birth weight, postnatal age, sex, and hematocrit,for determination of their effect on transcutaneous bilirubinaccuracy.results: the overall bilirubin concentration ranged from 5.4 to17 mg/dl and from 4.8 to 17.3 mg/dl for total serum bilirubin(tsb) and transcutaneous bilirubin, respectively. the mean valuesobtained by transcutaneous bilirubinometry were slightly higherthan the total tsb values. the correlation coefficient betweentsb and tcb was r=0.82, p < 0.001, and this was not influenced bygestational age, postnatal age or hematocrit, which were previouslyconsidered to be important. the correlation coefficient betweentsb and tcb in mechanically ventilated preterm infants wasr=0.75, p < 0.001.conclusion: plasma bilirubin level can be accurately measured bybilicheck™ in premature newborns, even in newborns who needmechanical ventilation.