Clinical Chemistry
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Clinical Chemistry 55: 1280-1287, 2009. First published May 14, 2009; 10.1373/clinchem.2008.121889
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(Clinical Chemistry. 2009;55:1280-1287.)
© 2009 American Association for Clinical Chemistry, Inc.

Mini-Review

Hyperbilirubinemia and Transcutaneous Bilirubinometry

Samar N. El-Beshbishi1, Karen E. Shattuck2, Amin A. Mohammad3 and John R. Petersen3,a

1 Department of Medical Parasitology, Mansoura University, Mansoura, Egypt; 2 Department of Pediatrics; and 3 Department of Pathology, University of Texas Medical Branch, Galveston, TX.

aAddress correspondence to this author at: Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Rm. 5.156, JSA, Galveston, TX 77555-0551. Fax 409-772-1350; e-mail jrpeters{at}utmb.edu


Abstract

Background: Neonatal jaundice or hyperbilirubinemia is a common occurrence in newborns. Although most cases of neonatal jaundice have a benign course, severe hyperbilirubinemia can lead to kernicterus, which is preventable if the hyperbilirubinemia is identified early and treated appropriately.

Content: This review discusses neonatal jaundice and the use of transcutaneous bilirubin (TcB) measurements for identification of neonates at risk of severe hyperbilirubinemia. Such a practice requires appropriate serial testing and result interpretation according to risk level from a nomogram that provides bilirubin concentrations specific for the age of the neonate in hours. In this context, we have evaluated the potential impact on clinical outcome and limitations of TcB methods in current use.

Summary: TcB measurement is a viable option in screening neonates to determine if they are at risk for clinically significant hyperbilirubinemia. Total serum bilirubin should be measured by a clinical laboratory if a newborn is shown to be at higher risk for clinically significant hyperbilirubinemia. In addition, external quality assessment to identify biases and operator training issues should be part of any TcB monitoring program.






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Copyright © 2009 by the American Association for Clinical Chemistry.