Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands.
Institute of Medical Biochemistry and Laboratory Diagnostics and 4th Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Pediatr Res. 2021 Aug;90(2):272-276. doi: 10.1038/s41390-021-01543-1. Epub 2021 May 3.
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. IMPACT: Key message: Screening methods for neonatal hyperbilirubinemia facilitate early recognition and timely treatment of severe neonatal hyperbilirubinemia (SNH). Any bilirubin screening result obtained must be confirmed by a diagnostic method. What does this article add to the existing literature? Data on optical bilirubin estimation are summarized. Niche research strategies for prevention of SNH are presented. Impact: Transcutaneous screening for neonatal hyperbilirubinemia contributes to the prevention of SNH. A smartphone application with optical bilirubin estimation seems a promising low-cost screening method, especially in low-resource settings or at home.
严重新生儿高胆红素血症（SNH）是一种全球性的严重疾病。及时通过胆红素测定进行识别是 SNH 管理的关键。黄疸的视觉评估不可靠。幸运的是，许多医院和门诊环境都常规提供经皮胆红素测量用于筛查新生儿。尽管存在一些局限性，但经皮设备的使用有助于早期识别和适当管理新生儿黄疸。然而，不幸的是，并非每个人都能获得先进且通常昂贵的筛查方式，而迫切需要廉价但准确的仪器来评估总血清胆红素（TSB）。在不久的将来，新型黄疸计，特别是使用智能手机摄像头获取的光学胆红素估计值，并通过智能手机应用程序（app）进行处理，似乎是筛查 SNH 的有前途的方法。如果这些方法被证明可靠，它们可能会使门诊卫生工作者以及在家中的父母能够使用简单的便携式设备来检测黄疸。广泛实施胆红素筛查可能会大大降低全球 SNH 的负担。尽管非侵入性胆红素筛查具有优势，但任何通过非侵入性筛查获得的胆红素测定值在治疗前都必须通过诊断方法确认。影响：主要信息：新生儿高胆红素血症的筛查方法有助于早期识别和及时治疗严重新生儿高胆红素血症（SNH）。任何胆红素筛查结果都必须通过诊断方法确认。本文为现有文献增添了哪些内容？总结了光学胆红素估计数据。提出了预防 SNH 的利基研究策略。影响：经皮筛查新生儿高胆红素血症有助于预防 SNH。具有光学胆红素估计值的智能手机应用程序似乎是一种有前途的低成本筛查方法，特别是在资源匮乏的环境或在家中。
