Screening methods for neonatal hyperbilirubinemia: benefits, limitations, requirements, and novel developments

Abstract

Severe neonatal hyperbilirubinemia (SNH) is a serious condition that occurs worldwide. Timely recognition with bilirubin determination is key in the management of SNH. Visual assessment of jaundice is unreliable. Fortunately, transcutaneous bilirubin measurement for screening newborn infants is routinely available in many hospitals and outpatient settings. Despite a few limitations, the use of transcutaneous devices facilitates early recognition and appropriate management of neonatal jaundice. Unfortunately, however, advanced and often costly screening modalities are not accessible to everyone, while there is an urgent need for inexpensive yet accurate instruments to assess total serum bilirubin (TSB). In the near future, novel icterometers, and in particular optical bilirubin estimates obtained with a smartphone camera and processed with a smartphone application (app), seem promising methods for screening for SNH. If proven reliable, these methods may empower outpatient health workers as well as parents at home to detect jaundice using a simple portable device. Successful implementation of ubiquitous bilirubin screening may contribute substantially to the reduction of the worldwide burden of SNH. The benefits of non-invasive bilirubin screening notwithstanding, any bilirubin determination obtained through non-invasive screening must be confirmed by a diagnostic method before treatment.

Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

“…Surprisingly, in their study, there was a tendency to overestimate jaundice in dark-skinned children and to underestimate it in fair-skinned children [30]. Several methods attempted to increase the sensitivity and specificity of visual assessment of jaundice in order to be utilized in low-income countries, such as the two-color Bilistrip and the six-color Bili-Ruler [31][32][33]. Currently, in the era of smartphones, different applications for detecting jaundice are being developed such as the BiliCam [34].…”

Assistência de enfermagem em recém-nascidos com icterícia

“…Porém, somente as características de exames físicos não são suficientes para a elaboração do diagnóstico precoce no RN com icterícia, sendo necessário a quantificação da hiperbilirrubinemia no sangue (Alkhater et al, 2021;Yan et al, 2022). Logo, a realização de exames laboratoriais é algo fundamental e deve ser feito de forma rotineira ao RN, com intuito de detectar o aumento ou a redução desse composto no sangue durante os tratamentos, assim, exames através do hemograma, apresentam um resultado mais fidedigno (Hulzebos et al, 2021;Yan et al, 2022). Research, Society andDevelopment, v. 11, n. 16, e490111638677, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i16.38677 6 Durante a gestação a bilirrubina no sangue é filtrada pela placenta e excretado pelo fígado da mãe, e após o nascimento, os recém-nascidos, fisiologicamente são os responsáveis pela sua excreção, contudo, estão mais propensos a icterícias devido a imaturidade do fígado (Abbey et al, 2019;Yan et al, 2022).…”

Comparing the accuracy of NEORUBIN NEO-2020 jaundice meter, Dräger JM103 jaundice meter and conventional blood testing for estimating total serum bilirubin in infants with jaundice in Malaysia

“…This invasive approach also has potential long-term consequences as many infants are small in size and may have underlying blood-related conditions reducing the amount of blood in them. Neonatal hyperbilirubinemia can also be diagnosed through visual estimation, but this is not reliable to assess the actual condition of the patient [2]. Therefore, non-invasive methods such as transcutaneous bilirubinometry that is both painless and accurate can be bene cial.…”