Transcutaneous bilirubin – comparing the accuracy of BiliChek^® and JM 103^® in a regional postnatal unit

Abstract

Objective. Transcutaneous bilirubin (TcB) has the potential to reduce serum bilirubin sampling. During a recent survey on the use of TcB in postnatal units in the Republic of Ireland, we identified that only 58% of the 19 units were using TcB and that only two devices were in use, the BiliChek^® and JM 103^®. We aimed to evaluate and compare these two devices in a regional postnatal unit.

Methods. To evaluate and compare the accuracy of the BiliChek^® and JM 103^®, we studied simultaneous TcB and total serum bilirubin (TSB) measurements from a population of jaundiced term and near term infants. We evaluated each device with regard to correlation with TSB and potential to safely reduce serum bilirubin testing.

Results. Both TcB devices strongly correlated with TSB (r = 0.88 for BiliChek^® and r = 0.70 for JM 103^®). The BiliChek^® and JM 103^® were accurate up to cut-off values of 200 μmol/L and 180 μmol/L, respectively. Using Bhutani's nomogram, 100% sensitivity was achieved using the 75th percentile for BiliChek^® and the 40th percentile for JM 103^®.

Conclusion. Both TcB devices correlated closely with moderately increased TSB levels and are suitable screening tools to identify jaundiced infants that require a serum bilirubin, with upper limit cut-off values. Both devices reduced the need for TSB levels. We found the BiliChek^® slightly more accurate than the JM 103^® for our study population. TcB however, is not in widespread use.

Keywords:

• Jaundice
• hyperbilirubinaemia
• infant
• neonate

Acknowledgments

We would like to acknowledge the support of all the midwifery staff of Galway University Hospital for their help in patient enrolment, the parents and infants who participated and those units who responded to our national survey. We would also like to thank Mr. Colin Kirkham, Statistician of the Rotunda Hospital, Dublin 1.