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The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants

BACKGROUND: To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. METHODS: We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and s...

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Autores principales: Jeon, Jaesung, Lim, Gina, Oh, Ki Won, Lee, Na Mi, Park, Hye Won, Chung, Mi Lim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718678/
https://www.ncbi.nlm.nih.gov/pubmed/33278875
http://dx.doi.org/10.1186/s12887-020-02450-w
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author Jeon, Jaesung
Lim, Gina
Oh, Ki Won
Lee, Na Mi
Park, Hye Won
Chung, Mi Lim
author_facet Jeon, Jaesung
Lim, Gina
Oh, Ki Won
Lee, Na Mi
Park, Hye Won
Chung, Mi Lim
author_sort Jeon, Jaesung
collection PubMed
description BACKGROUND: To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. METHODS: We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). RESULTS: There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value (r = 0.925 and 0.915, respectively). With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead (r = 0.751) was a better match to the TSB than was TcB at the sternum (r = 0.668). Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. CONCLUSIONS: TcB was more accurate in infants not receiving phototherapy. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum.
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spelling pubmed-77186782020-12-07 The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants Jeon, Jaesung Lim, Gina Oh, Ki Won Lee, Na Mi Park, Hye Won Chung, Mi Lim BMC Pediatr Research Article BACKGROUND: To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. METHODS: We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). RESULTS: There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value (r = 0.925 and 0.915, respectively). With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead (r = 0.751) was a better match to the TSB than was TcB at the sternum (r = 0.668). Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. CONCLUSIONS: TcB was more accurate in infants not receiving phototherapy. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum. BioMed Central 2020-12-05 /pmc/articles/PMC7718678/ /pubmed/33278875 http://dx.doi.org/10.1186/s12887-020-02450-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Jeon, Jaesung
Lim, Gina
Oh, Ki Won
Lee, Na Mi
Park, Hye Won
Chung, Mi Lim
The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title_full The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title_fullStr The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title_full_unstemmed The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title_short The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
title_sort forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718678/
https://www.ncbi.nlm.nih.gov/pubmed/33278875
http://dx.doi.org/10.1186/s12887-020-02450-w
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