RT Journal Article
SR Electronic
T1 PO-0628 Reducing Serum Bilirubin Determinations In Outpatient Newborns By Screening With Transcutaneous Bilirubinometry
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP A459
OP A460
DO 10.1136/archdischild-2014-307384.1270
VO 99
IS Suppl 2
A1 R Joseph
A1 A Chinnadurai
A1 WSY Yeo
A1 PA Nkouibert
A1 MS George
A1 ESY Chan
A1 WE Tang
A1 J Mathews
A1 J Lee
YR 2014
UL http://adc.bmj.com/content/99/Suppl_2/A459.3.abstract
AB Background and aim We have previously shown that using Transcutaneous bilirubin (TCB) values that are 90% of the age specific SBvalue (SBPh) for phototherapy can markedly reduce the need for invasive serum bilirubin (SB) in Day 1–3 inpatient babies. This study aims to determine if the same principle can be applied in older babies in the outpatient setting. Methods Three to 14 day olds with jaundice at an outpatient care centre in Singapore and needing a SB measurementwere enrolled after obtaining written informed consent. Their TCB level was determined with a commercial bilirubinometer. Correlations and Bias was determined. Using ROC curves, the TCB values that identified the need for an SB were determined. Results 1072 paired SB and TCB values were obtained from a Chinese (39%), Malay (35%), Indian (14%) and Others (12%) cohort. Spearman’s correlation coefficientsby age groups ranged from 0.882(2–5 days) to 0.95 (> 14 days). The mean bias (SD) was -8(23.2) and the limits of agreement were -54.4 to 38.4 from the Bland Altman analysis. TCB values that were 90% of the SBPh yielded accuracy and sensitivity rates (%) of 90 and 100 in the < 96 h age group and 96 and 83 in the older group. The efficiency (% of SB avoided) was 89 and 96% respectively in the two age groups. Conclusion TCB measurements that are a predetermined fraction of the SBPh can efficiently reduce SB determinations in the newborn period. The fraction is influenced also by the operational context.