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A multi-center evaluation of a device for measurement of bilirubin binding capacity in neonates: the effects of gestational age, Intralipid exposure and illness severity

Journal of Perinatology volume 39, pages 883–888 (2019)Cite this article

Subjects

Abstract

Objective

Measure daily bilirubin-binding capacity (BBC) variation using an automated, not as-yet FDA approved, Point-of-Care hematofluorometer. Measure the effects of prematurity, clinical instability and exposure to Intralipid on BBC.

Subjects

Convenience sample of 109 infants from well-baby and intensive care nurseries. Gestational ages 28–41 weeks. 261 specimens obtained from postnatal ages 1–4 days. Unstable neonates were defined by need for at least noninvasive respiratory support and FiO2 ≥ 0.25.

Results

Median interday variation was 2.9 ± 5.1 mg/dL. BBC (0.254 mg/dL/wk) and albumin (0.037 g/dL/wk) increased for each week of gestation. BBC was lower in unstable compared to well infants (26.1 ± 7.6 mg/dL v 28.6 ± 6.3 mg/dL). BBC was not significantly different in infants receiving or not receiving IL.

Conclusions

BBC measurements using the device had acceptable intraspecimen reproducibility and interday variability. BBC may be helpful in guiding the assessment of aggressive versus conservative management decisions in preterm and sick infants with hyperbilirubinemia.

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Acknowledgements

We would like to acknowledge Andrew Paoletti for his assistance with statistics.

Funding:

This work was funded by: (1) Bilirubin-binding capacity to assess bilirubin load in preterm infants 1R21HD0823319-1A (NIH/NICHD) (Bhutani). (2) Point-of-care system for determination of bilirubin capacity in neonates SBIR 121769 (Aviv/Bhutani). (3) Louis I. Weisberg, MD Memorial Neonatology Research Fund

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Authors and Affiliations

  1. Department of Pediatrics, Einstein Medical Center Philadelphia, Philadelphia, PA, USA

    David L. Schutzman

  2. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Vinod K. Bhutani, Martin E Castillo Cuadrado, Angelo A Lamola & Ronald J. Wong

  3. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Ivan Frantz & Evelyn Obregon

Authors
  1. David L. Schutzman
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  2. Vinod K. Bhutani
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  3. Martin E Castillo Cuadrado
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  4. Angelo A Lamola
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  5. Ivan Frantz
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  6. Evelyn Obregon
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  7. Ronald J. Wong
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Contributions

VKB and AL were responsible for the study concept, design, data interpretation and critical review of the manuscript. IF, EO and MC were responsible for data collection and interpretation, and critical review of the manuscript. DLS was responsible for data collection and interpretation and preparation of the manuscript. RJW was responsible for study design, data interpretation and critical revision of the manuscript.

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Correspondence to David L. Schutzman.

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Schutzman, D.L., Bhutani, V.K., Castillo Cuadrado, M. et al. A multi-center evaluation of a device for measurement of bilirubin binding capacity in neonates: the effects of gestational age, Intralipid exposure and illness severity. J Perinatol 39, 883–888 (2019). https://doi.org/10.1038/s41372-019-0365-2

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