IEEE J Biomed Health Inform. 2019 Nov;23(6):2347-2353. doi: 10.1109/JBHI.2019.2892946. Epub 2019 Jan 14.
Careful screening of bilirubin level in newborns is mandatory as per American Academy of Pediatrics (2004), to reduce incidents of kernicterus and acute bilirubin encephalopathy. Although, invasive capillary collection of blood and subsequent biochemical test is considered a gold standard for jaundice detection in neonates, transcutaneous bilirubin measurement using various non-invasive instruments is also used sporadically across the globe. The major aim of this study was to develop a non-invasive spectrometry-based technique for measurement of neonatal bilirubin level as an alternative of total serum bilirubin (TSB) test without limitations of other available bilirubinometers.
The instrument comprises of a light source and a spectroscopic detector. A light beam from source incident on the neonatal nail plate through optical fibers. The retro reflected light is acquired using the detector. An indigenously developed software is used to acquire and analyze the optical signal and to calculate the bilirubin value. The instrument was calibrated and validated in reference to TSB on 1033 subjects.
The result (r = 0.95 and P < 0.001) indicates a strong correlation between the bilirubin value obtained from our method and TSB. Time variant analysis of the subjects undergoing phototherapy provided a good correlation (r = 0.98). The repeatability test result shows the mean coefficient of variation is less than 5.0%.
The indigenously developed non-invasive technique successfully detects the bilirubin level in newborns under various physiological conditions with high accuracy and precision.
根据美国儿科学会(2004 年)的规定,对新生儿的胆红素水平进行仔细筛查是强制性的,以降低核黄疸和急性胆红素脑病的发生率。虽然,侵入性毛细血管采集血液和随后的生化测试被认为是新生儿黄疸检测的金标准,但全球范围内也偶尔使用各种非侵入性仪器进行经皮胆红素测量。本研究的主要目的是开发一种基于非侵入性光谱技术的新生儿胆红素水平测量方法,作为替代总血清胆红素(TSB)测试的方法,而没有其他可用胆红素计的局限性。
该仪器包括光源和光谱检测器。光源发出的光束通过光纤照射到新生儿的指甲板上。使用检测器获取反向反射光。一个本土开发的软件用于获取和分析光学信号,并计算胆红素值。该仪器在 1033 名受试者中参照 TSB 进行了校准和验证。
结果(r=0.95,P<0.001)表明,我们的方法获得的胆红素值与 TSB 之间存在很强的相关性。接受光疗的受试者的时间变化分析提供了很好的相关性(r=0.98)。重复性测试结果表明,平均变异系数小于 5.0%。
该本土开发的非侵入性技术能够成功地在各种生理条件下检测新生儿的胆红素水平,具有高精度和高精确度。