By Emily Branson

Transcutaneous Bilirubin

Assessment

Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old

red blood cells. Bilirubin is then removed from the body

through the stool and gives stool its normal color.

Bilirubin

Newborn bilirubin levels are monitored to help prevent bilirubin encephalopathy (kernicterus)Irreversible brain damage caused by an

elevation of indirect bilirubin.Less than 100 cases in the United States per year

60% of newborns have elevated bilirubin levels Only 20% of those newborns require medical

attention

Bilirubin

Many newborn bilirubin levels are determined with the use of blood draws (serum levels). While this test is extremely accurate, it has

some major disadvantages. Higher costsMore timeStress to babyStress to parents

Serum Bilirubin Assessment

Transcutaneous bilirubin meters produce light at several wavelengths.They then measure its reflection after

interacting with the bilirubin in the subcutaneous microcirculation.

At Ball Memorial, transcutaneous bilirubin is usually checked on a newborn’s forehead.

Transcutaneous Bilirubin Assessment

There are some MAJOR benefits to using transcutaneous bilirubin tests instead of checking serum bilirubin levels: Less money

Each use saves approximately $2Less time

Results are calculated almost immediatelyThere is no need to wait over an hour for serum levels to

return from the labLess trauma

No sticksNo blood

The use of transcutaneous bilirubin has decreased serum bilirubin by 60%-80%!

Transcutaneous Bilirubin

Studies have found that the two correlate more closely when the bilirubin levels are low (<8).

To best compare the two, they should be done simultaneously. When there is a large difference, it is generally

because there is a large gap in time between when the transcutaneous bilirubin is calculated and when the bilirubin serum levels are drawn. Bilirubin levels have a tendency to vary greatly

throughout the day.

How do they compare?

"BiliChek." Noninvasive Transcutaneous Bilirubinometer- Philips. Philips, 7 Feb. 2013. Web. 9 Oct. 2015. <http://www.healthcare.philips.com/main/products/mother_and_child_care/post_natal_care/well_baby/jaundice_management/bilichek/#&&/wEXAQUOY3VycmVudFRhYlBhdGgFEERldGFpbHM6T3ZlcnZpZXdwGB6s7Z5i1iyK2qCyu ZlAjHM5w==>.

Case-Lo, Christine. "Bilirubin Blood Test." Healthline. Web. 9 Oct. 2015.

 Hoppenot, C., and G. A. Emmett. "Neonatal Bilirubin

Triage With Transcutaneous Meters: When Is a Blood Draw Necessary?" Hospital Pediatrics 2.4 (2012): 215-20. Print.

References