Implementing transcutaneous bilirubinometry in jaundiced newborns: a randomized controlled trial

Pepping, R.M.C. (2015) Implementing transcutaneous bilirubinometry in jaundiced newborns: a randomized controlled trial. thesis, Medicine.

Text PeppingRMC.pdf Restricted to Registered users only Download (1MB)

Abstract

Introduction: Evaluation of hyperbilirubinemia in jaundiced neonates is performed by determining serum bilirubin (SB) through painful blood sampling. The use of non-invasive transcutaneous bilirubinometry instead, may reduce this need for blood sampling, herewith decreasing pain and stress. Methods: A randomized controlled trial including hospitalized jaundiced neonates ≥32weeks gestational age was performed. The intervention group used a transcutaneous bilirubinometer (Dräger Jaundice Meter-103, JM-103) measurement (TcB) on the sternum and the control group used standard care, where the decision to obtain SB was based on visual and clinical assessment. Indication for phototherapy or exchange transfusion was made according to the international guidelines of the American Academy of Pediatrics. When TcB was less than 50μmol/L below the threshold for phototherapy, SB was obtained. The decision to start treatment was always based on an SB value. Results: A total of 176 neonates were randomized. In the intervention group (n=86), 60 neonates (69.8%) had at least one SB taken, versus 87 (96.7%) in the control group (n=90) (difference 26.9; 95%CI 11.7 - 42.0; p<0.001). The number of blood samples per neonate in the intervention group (1.3, SD1.3), was 27% lower than in the control group (1.9, SD1.0) (difference -0.51; 95%CI -0.81 - -0.17; p=0.003). The highest SB value was higher in the intervention group (232 μmol/L, SD53L) than in the control group (209 μmol/L, SD60; 95%CI 4.72 - 42.55; p=0.015). Though this was not considered as clinically relevant; we found no difference in need to treatment, nor treatment duration or hospitalization length, exchange transfusions did not occur. Conclusion: The use of transcutaneous bilirubinometry is safe, feasible and reduces invasive blood sampling in jaundiced neonates with 27%.

Item Type:	Thesis (Thesis)
Supervisor name:	Bekhof, J.M.D. PhD. and Paediatrician and Department of Paediatrics, Isala hospital
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:39
Last Modified:	25 Jun 2020 10:39
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/45

Actions (login required)

View Item