Evaluation of a point-of-care direct spectrophotometric method for measurement of total serum bilirubin in term and near-term neonates

Barko, H. A.; Jackson, Greg; Engle, William D.

doi:10.1038/sj.jp.7211436

Cited by 18 publications

(10 citation statements)

References 24 publications

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“…The estimated cost of materials for the prototype reader is less than EUR 150, plus a few cents for each test strip. Newer ‘on-site’ systems utilizing blood gas analyzers [22] or spectrophotometry [23] are more costly, immobile (and hence not truly point-of-care) and may require blood centrifugation.…”

Section: Discussionmentioning

confidence: 99%

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

et al. 2012

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Background: Severe neonatal hyperbilirubinemia, with consequent encephalopathy, remains a common cause of morbidity and death in many regions of the world. Poor access to clinical laboratory resources and screening programs to measure plasma bilirubin levels is a major contributor to delayed treatment in developing countries, and the cost of existing point-of-care screening instruments precludes their dissemination. Objectives: We are evaluating the accuracy of a low-cost, minimally invasive point-of-care system (Bilistick) requiring a 25-µl blood sample that could be used in low-resource environments to evaluate patients with neonatal jaundice. Methods: We compared plasma bilirubin levels in divided blood samples by clinical laboratories and by Bilistick at two medical centers serving term and near-term newborns from ethnically different populations. Results: 118 neonates with bilirubin levels ranging from 24.8 to 501.0 µmol/l were analyzed. The mean bilirubin concentration (±SD) was 215.6 ± 85.5 µmol/l for Bilistick and 226.1 ± 86.4 µmol/l by laboratory determination. Pearson’s correlation coefficient between all paired results was 0.961, and the Bland-Altman analysis showed a mean difference of 10.3 µmol/l with a 95% interval of agreement of –38.0 to 58.7 µmol/l. Conclusion: Bilistick is a minimally invasive method for measuring total bilirubin concentration over a wide range of values and should provide an affordable and accurate system for pre-discharge and follow-up screening of jaundiced infants, particularly in low-resource environments.

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Section: Discussionmentioning

confidence: 99%

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

et al. 2012

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“…Advantages of the noninvasive measuring technique are real-time results, cost-eff ectiveness and avoidance of pain and local infection. Minolta JM-103 TcB assessment demonstrates signifi cant accuracy compared to TSB and can be used as a screening test to identify the need for blood sampling for TSB levels in term and near-term newborn infants [3][4][5][6][7] . Ho et al (2006) reported that combining the use of TcB JM-103 and the 75th centile in Bhutani's nomogram as the cut-off level can identify all cases of signifi cant hyperbilirubinemia in term and near-term newborns 8 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of transcutaneous bilirubinometry in preterm infants of gestational age 32-34 weeks

Stillova¹,

Matasová²,

Mikitova³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims:The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site.Methods: Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, diff erences between TSB and TcB, their CI95%, and correlation coeffi cients (r) between TcB and TSB were evaluated.Results: The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be signifi cant and close. Minimal diff erences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels.Conclusions: Noninvasive measurement by Minolta JM-103 demonstrated signifi cant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.

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“…The remaining sample was centrifuged to separate plasma, and the TSB was measured by a laboratory reference standard using the direct spectrophotometric method for measuring total bilirubin (UNISTAT; Reichert Technologies). The UNISTAT has been shown to have strong correlation with diazo measurement of TSB with a mean difference of −0.37 mg/dL and mean absolute difference of 0.60 mg/dL ( 12 ). After spotting blood on the collection pad, the lateral flow cards were allowed to flow for 2 min and then absorbance was measured using a laboratory spectrometer (Cary 5000 UV-VIS; Agilient).…”

Section: Resultsmentioning

confidence: 99%

“…After the collection pad was filled, the nurse collected additional drops of blood into a tube. Collected blood was centrifuged (2,000

g , 5 min) Galaxy MiniStar; VWR) and plasma was then pipetted out of the sample and measured using the UNISTAT bilirubinometer laboratory reference standard described earlier ( 12 ).…”

Section: Resultsmentioning

confidence: 99%

Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings

Keahey

Simeral

Schroder

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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SignificanceNeonatal jaundice, a condition caused by the accumulation of bilirubin in the bloodstream, affects approximately half of all newborns. In high-resource settings, babies with elevated serum bilirubin levels are identified through routine hospital laboratory testing. When identified, jaundice is easily treated using blue-light phototherapy. Low-cost, rugged phototherapy lights have been developed and shown to be effective in low-resource settings. However, jaundice regularly goes undetected in these settings due to a lack of diagnostic tools to measure bilirubin levels. Left untreated, jaundice can lead to permanent neurological damage and mortality, the vast majority of which currently occurs in low-resource settings. In this paper, we present a low-cost method to measure total bilirubin at the point of care in low-resource settings.

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Evaluation of a point-of-care direct spectrophotometric method for measurement of total serum bilirubin in term and near-term neonates

Cited by 18 publications

References 24 publications

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

Evaluation of transcutaneous bilirubinometry in preterm infants of gestational age 32-34 weeks

Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings

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