Jones Denise F, McRea Abigail R, Knowles James D, Lin Feng-Chang, Burnette Erin, Reller Lara A, Lohr Jacob A
1 North Carolina Children's Hospital, Chapel Hill, NC, USA.
2 University of North Carolina at Chapel Hill, NC, USA.
Clin Pediatr (Phila). 2017 Oct;56(11):1013-1017. doi: 10.1177/0009922817701170. Epub 2017 Apr 3.
The American Academy of Pediatrics recommends screening newborns ≥35 weeks' gestation with total serum bilirubin (TSB) or transcutaneous bilirubin (TcB) to detect hyperbilirubinemia. Retrospective studies show TcB measurements strongly correlate with TSB; however, few prospective trials document this relationship. Furthermore, Dräger's newest TcB instrument, JM-105, remains unstudied in the United States. We measure TcB on foreheads and sternums of newborns using JM-105 and Bilichek devices within 30 minutes of TSB measurement. We find best overall TcB/TSB correlation with JM-105 on the sternum (mean TcB-TSB difference: -0.21 ± 1.15 mg/dL). Correlations between paired measurements for TcB on the sternum using JM-105 were 0.93 for all TSB levels (n = 178), 0.82 for TSB > 10 (n = 19), 0.69 for TSB > 12 (n = 11), and 0.52 for TSB > 15 (n = 6). TcB accuracy via JM-105 on the sternum significantly differed among races ( P < .001). For 5% of paired measurements, TcB with JM-105 on the sternum underestimated TSB by ≥2 mg/dL, and for <1% by ≥3 mg/dL.
美国儿科学会建议，对妊娠≥35周的新生儿进行血清总胆红素（TSB）或经皮胆红素（TcB）筛查，以检测高胆红素血症。回顾性研究表明，TcB测量值与TSB密切相关；然而，前瞻性试验很少记录这种关系。此外，德格最新的TcB仪器JM-105在美国尚未得到研究。我们在测量TSB后30分钟内，使用JM-105和Bilichek设备测量新生儿前额和胸骨的TcB。我们发现，JM-105测量胸骨处的TcB与TSB的总体相关性最佳（平均TcB-TSB差值：-0.21±1.15mg/dL）。使用JM-105测量胸骨处TcB的配对测量值之间的相关性，对于所有TSB水平（n=178）为0.93，对于TSB>10（n=19）为0.82，对于TSB>12（n=11）为0.69，对于TSB>15（n=6）为0.52。通过JM-105测量胸骨处的TcB准确性在不同种族间存在显著差异（P<.001）。在5%的配对测量中，使用JM-105测量胸骨处的TcB低估TSB≥2mg/dL，<1%的测量低估TSB≥3mg/dL。
