Transcutaneous Bilirubinometer: definition 22 and best description

Transcutaneous Bilirubinometer

Jaundice in newborns occurs in about 70% term and 80% in preterm.

Management of jaundiced neonates often requires measurement of total serum bilirubin (TSB).

Total serum bilirubin (TSB) is usually determined by spectrophotometric methods by analyzing plasma or serum samples.

Such techniques require blood to be drawn to cause pain and trauma to the newborn. In addition there is a wide range of intra- and inter-laboratory variability in performance Bilirubin analyzer.

These problems have led to the search for a non-invasive, reliable technique for the assessment of TSB. A transcutaneous bilirubin meter works by directing light into the skin and measuring the intensity of the wavelength of the light coming back.

Transcutaneous bilirubin measurement is a non-invasive method for measuring serum bilirubin levels.

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Working Principle

Bilirubin concentrations are determined either by whole blood or serum analysis using spectrophotometric methods or by skin-reflectance measurements.

The three methods of spectrophotometric analysis are the direct spectrophotometric method, the Malloy-Evelyn method, and the Jendrassik-Grof method.

Categories

(i) Multi-wavelength Spectral Reflectance meters.
(ii) Two-wavelength (460 nm, 540 nm) Spectral Reflectance meters.

(a) Multi-wavelength Spectral Reflectance meters

 

The major components that provide spectral reflectance in newborns are melanin, dermal maturation, hemoglobin and bilirubin. Most bilirubin meters only analyze certain wavelengths; As a result, dermal maturation and melanin content will interfere with the outcome.

With these meters, separate analysis for each patient population was required. To overcome this problem the multi-reflectance spectral bilirubin meter has been designed.

This instrument performs spectral analysis at more than 100 different wavelengths and by subtracting the spectral combination of known components, bilirubin absorption is quantified. This technique eliminates the need for separate charts for different populations.

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(b) Two-wavelength Spectral Reflectance meters

Blood samples are required for spectrophotometric analysis. The analysis technique depends on both the type or types of bilirubin being measured and the age of the patient (newborn or adult).

A light-emitting sensor is placed on the baby’s skin (preferably on the forehead or sternum). The reflected light is split into two beams by a dichroic mirror, and wavelengths of 455 nm and 575 nm are measured by optical detectors.

Transcutaneous bilirubin measurement is a non-invasive method for measuring serum bilirubin levels.

Transcutaneous bilirubinometer works by directing light into the skin and measuring the intensity of the wavelength of the light coming back. Transcutaneous Bilirubinometer

Transcutaneous bilirubin devices that estimate the amount of serum bilirubin have been found non-invasively to reduce the need for blood from newborns.

The meter analyzes the spectrum of the optical signal reflected from the subcutaneous tissue of the newborn.

These optical signals are converted into electrical signals by a photocell. These are analyzed by a microprocessor to determine the amount of serum bilirubin.

A bilirubin-meter is an instrument designed to determine the amount of bilirubin in blood or other clinical specimen. Aims to facilitate easy and quick assessment of hyperbilirubinemia in newborns. Most newborns with jaundice should continue to breastfeed.

Breastfeeding more often improves a mother’s milk supply and, in turn, may improve the infant’s caloric intake and hydration, thus reducing elevated bilirubin. 

Transcutaneous bilirubin meters, although not as accurate as measuring serum bilirubin, are more accurate than visual inspection alone, are non-invasive, can be used in the community, and provide immediate results.

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The accuracy of using TCB values ​​to detect newborns requiring phototherapy is 92.5%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) are 78.3, 94.2, 62.1, and 97.3%, respectively.

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