A multi-center evaluation of a device for measurement of bilirubin binding capacity in neonates: the effects of gestational age, Intralipid exposure and illness severity

Objectivemeasure daily bilirubin-binding capacity (bbc) variation using an automated, not as-yet fda approved, point-of-care hematofluorometer. measure the effects of prematurity, clinical instability and exposure to intralipid on bbc.subjectsconvenience sample of 109 infants from well-baby and intensive care nurseries. gestational ages 28–41 weeks. 261 specimens obtained from postnatal ages 1–4 days. unstable neonates were defined by need for at least noninvasive respiratory support and fio2 ≥ 0.25.resultsmedian interday variation was 2.9 ± 5.1 mg/dl. bbc (0.254 mg/dl/wk) and albumin (0.037 g/dl/wk) increased for each week of gestation. bbc was lower in unstable compared to well infants (26.1 ± 7.6 mg/dl v 28.6 ± 6.3 mg/dl). bbc was not significantly different in infants receiving or not receiving il.conclusionsbbc measurements using the device had acceptable intraspecimen reproducibility and interday variability. bbc may be helpful in guiding the assessment of aggressive versus conservative management decisions in preterm and sick infants with hyperbilirubinemia.