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Dear Collective
Are labs following the
recently published guideline on neonatal jaundice published in May this year?
Quite interesting that
TC Bilirubin seems to be first line choice of measurement
BW John
http://www.nice.org.uk/nicemedia/live/12986/48678/48678.pdf
•
use a transcutaneous bilirubinometer in
babies with a gestational age of
35
weeks or more and postnatal age of more than 24 hours
•
if a transcutaneous bilirubinometer is
not available, measure the serum
bilirubin
•
if a transcutaneous bilirubinometer
measurement indicates a bilirubin
level
greater than 250 micromol/litre check the result by measuring the
serum
bilirubin
•
always use serum bilirubin measurement
to determine the bilirubin
level
in babies with jaundice in the first 24 hours of life
•
always use serum bilirubin measurement
to determine the bilirubin
level
in babies less than 35 weeks gestational age
•
always use serum bilirubin measurement
for babies at or above the
relevant
treatment threshold for their postnatal age, and for all
subsequent
measurements
• do not use an icterometer.
The important bit is
at the end
Research recommendation
What is the comparative accuracy of the Minolta
JM-103 and the BiliChek when compared
to serum bilirubin levels in all babies?
Why this is important
Evidence:
The accuracy of transcutaneous bilirubinometers (Minolta JM-103 and BiliChek)
has
been adequately demonstrated in term babies below treatment levels (bilirubin
<
250 micromol/litre). New research is needed to evaluate the accuracy of
different
transcutaneous
bilirubinometers in comparison to serum bilirubin levels in all babies.
Population:
Babies in the first 28 days of life. Subgroups to include preterm babies,
babies
with
dark skin tones, babies with high levels of bilirubin and babies after
phototherapy.
Exposure:
Bilirubin levels taken from different transcutaneous bilirubinometers.
Comparison:
Bilirubin
levels assessed using serum (blood) tests. Outcome: Diagnostic accuracy
(sensitivity,
specificity,
positive predictive value, negative predictive value), parental anxiety, staff
and
parental satisfaction
with test and cost effectiveness. Time stamp: Sept 2009