Document Detail


Assessment of a transcutaneous device in the evaluation of neonatal hyperbilirubinemia in a primarily Hispanic population.
MedLine Citation:
PMID:  12093947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare estimates of serum bilirubin as determined by a transcutaneous device (BiliChek [BC]) with laboratory-measured total serum bilirubin (TSB) in a predominately Hispanic population in which a significant number of TSB values > or =15 mg/dL was anticipated. METHODS: A total of 248 Hispanic and 56 non-Hispanic neonates were studied. Transcutaneous measurements were performed by 1 investigator within 30 minutes of blood sampling for TSB; TSB was determined in a large clinical laboratory using the diazo Jendrassik-Grof with blank method. Agreement between BC and TSB determinations was assessed using Bland-Altman plots and the Bradley-Blackwood test. Interdevice comparisons were made among the BC devices. Predictive indices for TSB >10 mg/dL and >15 mg/dL were determined using various BC cutoff values. RESULTS: TSB was > or =15 mg/dL in 31% of the Hispanic neonates. BC generally tended to underestimate TSB determinations, and this trend was more pronounced when TSB was >10 mg/dL. Very high sensitivities were observed only when relatively low BC cutoff values were used to predict TSB >10 mg/dL or >15 mg/L. Relatively small numbers of infants had BC values in these low ranges. CONCLUSIONS: The tendency of BC to underestimate TSB limits its usefulness in neonates with relatively high TSB. In this population, most infants would have required additional evaluation to ensure that TSB was not >10 mg/dL or >15 mg/dL. It seems that the discrepancy between this study and previous studies of BC is related to our relatively large number of TSB values > or =15 mg/dL.
Authors:
William D Engle; Gregory L Jackson; Dorothy Sendelbach; Denise Manning; William H Frawley
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  110     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-02     Completed Date:  2002-08-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9063, USA. william.engle@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Bilirubin / blood*
Blood Chemical Analysis / instrumentation
Chromatography, High Pressure Liquid / statistics & numerical data
Hispanic Americans / statistics & numerical data*
Humans
Infant, Newborn
Jaundice, Neonatal / blood*,  diagnosis
Neonatal Screening / methods
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Spectrum Analysis
Chemical
Reg. No./Substance:
635-65-4/Bilirubin
Comments/Corrections
Comment In:
Pediatrics. 2002 Aug;110(2 Pt 1):407-8   [PMID:  12165601 ]
Pediatrics. 2003 Apr;111(4 Pt 1):919-20; author reply 919-20   [PMID:  12671137 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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