Israel transcutaneous bilirubin nomogram predicts significant hyperbilirubinemia

Abstract

The risk of significant hyperbilirubinemia increased progressively with increasing percentile. Newborns >75th percentile groups are at high risk for phototherapy and should be closely monitored.

Hiperbilirrubinemia severa en Recién Nacidos, factores de riesgo y secuelas neurológicas

“…La determinación de la bilirrubina transcutánea en forma seriada usando nomogramas conocidos permitiría alertar, sobretodo cuando hay cambios importantes de los niveles 31 . Para el riesgo tardío es necesaria una mayor coordinación con nivel primario y el control precoz postalta, especialmente de los prematuros tardíos, cuyo control debiera ser antes de las 72 h del egreso, como se ha señalado en el nuevo programa de atención infantil del Ministerio de Salud 32 .…”

Variation in Transcutaneous Bilirubin Nomograms across Population Groups

“…In recent years, the ready availability of modern TcB measuring devices has made the evaluation of neonatal jaundice more objective and more accurate than subjective visual assessment and "has taken the guesswork out of jaundice evaluation." 17 In contrast to the single serum-based nomogram, an abundance of hour-specific nomograms constructed from TcB measurements have been published [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] (Table I; available at www.jpeds.com). This is not surprising as, unlike serum bilirubin testing, TcB sampling does not involve painful blood drawing procedures, and gathering TcB data for nomogram construction is, therefore, relatively easy.…”

“…In Israel, where the population is heterogenous, we recently constructed a nomogram in which the main ethnic groups of the population (Ashkenazi Jewish, Sephardic Jewish, Arab, Ethiopian) were included, with the intention that potential discrepancies between the groups would be counterbalanced by pooling the results, with a resultant representative nomogram. 32 It is noteworthy that the many and differing TcB nomograms available today all lead to the single Bhutani et al nomogram 14 for risk and hour-specific bilirubin assessment and to the AAP serum-based graphs for determining the indications for phototherapy and exchange transfusion (although some countries do use local guidelines for therapy). Presuming that the results noted in our TcB nomogram analysis are based on ethnic, population and breastfeeding differences, it is likely that if more serum-based bilirubin nomograms were developed, similar variation would be found.…”

Factors to consider before implementing telemedicine protocols to manage neonatal jaundice

“…Hour-specific TcB nomograms have been set up and used as a screening method for late preterm and term infants. 4) However, further studies are needed to confirm a reliable correlation between TB and TcB at levels of 15 mg/dL and higher as well as among preterm infants.…”

“…The BiliChek (Philips Children’s Medical Ventures, Monroeville, PA, USA) and the JM-103 Jandice Meter (Konica Minolta/AirShields JM 103 Jandice Meter and Draeger Medical AG and Co., Lubeck, Germany) are two popular devices used. Hour-specific TcB nomograms have been set up and used as a screening method for late preterm and term infants [ 4 ]. However, further studies are needed to confirm a reliable correlation between TB and TcB at levels of 15 mg/dL and higher as well as among preterm infants.…”