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Transcutaneous Measurement of Bilirubin in Newborns: Comparison with an Automated Jendrassik–Grof Procedure and HPLC

Departments of¹ Pathology and ⁵ Pediatrics, Oregon Health and Science University, Portland, OR; Departments of² Pediatrics and Pathology and ³ Laboratory Medicine, The Brody School of Medicine at East Carolina University, Greenville, NC;⁴ Waisman Center, University of Wisconsin, Madison, WI

^aaddress correspondence to this author at: Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Mailcode L-471, Portland, OR 97239; e-mail kazmierc@ohsu.edu

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Measurement of bilirubin in sera of newborn infants is one of the most frequently performed laboratory tests in this patient population (1)(2)(3)(4). Chemical methods for measurement of bilirubin are the standard of care in the assessment of neonatal jaundice. However, transcutaneous techniques for assessing in vivo bilirubin concentrations have been advocated as a more cost-effective and less traumatic alternative to the collection of blood by heel puncture (2)(3).

Studies have varied in their assessment of the accuracy of transcutaneous bilirubin assessment; poor to excellent agreement between transcutaneous bilirubin measurements and bilirubin measured in plasma has been reported (1)(2)(3)(5)(6)(7)(8)(9). The best agreement between transcutaneous bilirubin measurements and measurement of plasma bilirubin concentrations has been reported for studies using homogeneous populations of newborns with comparable basal skin color (9). Unfortunately, many factors, such as hemoglobin concentration, the pH and bilirubin-binding capacity of albumin, the technique used to obtain the blood sample, skin pigmentation, and requirement by some methods for baseline measurement of skin color immediately after birth, can significantly effect the agreement between transcutaneous and chemical methods for bilirubin (6)(10)(11).

We evaluated the BiliCheck point-of-care device (Respironics, Marietta, GA), which performs transcutaneous measurement of bilirubin by multiwavelength spectral analysis. We compared results obtained with the BiliCheck with bilirubin concentrations in blood specimens measured in a hospital laboratory. In addition, we also measured bilirubin by HPLC. Although HPLC is labor-intensive and not practical for routine use, this method is not subject to interference from hemoglobin or lipemia. Our goals were to evaluate the accuracy of the BiliCheck method compared with a laboratory-based bilirubin method, using HPLC as . . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				J. R. Petersen, A. O. Okorodudu, A. A. Mohammad, A. Fernando, and K. E. Shattuck Association of Transcutaneous Bilirubin Testing in Hospital with Decreased Readmission Rate for Hyperbilirubinemia Clin. Chem., March 1, 2005; 51(3): 540 - 544. [Abstract] [Full Text] [PDF]