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Transcutaneous bilirubinometer use and practices surrounding jaundice in 150 California newborn intensive care units

Abstract

Objectives

Transcutaneous bilirubin measurements (TcBs) provide a noninvasive method for screening infants for hyperbilirubinemia and have been used extensively in term and late preterm newborns in well baby nurseries, offices, and outpatient clinics. Several studies have also demonstrated the utility of TcBs as a screening tool for infants > 28 weeks’ gestation and their ability to reduce the need for blood sampling. The objectives of this study are to identify how often TcBs are used among California Newborn Intensive Care Units (NICUs) in preterm, late preterm and term infants, and other aspects of jaundice management.

Methods

We conducted a survey on TcB use and practices relating to jaundice management in 150 California NICUs between April and October 2016.

Results

TcB screening is routinely used in 28% (42/150) of NICUs. Only 7% (11/150) of NICUs use TcB in preterm infants < 28 weeks. Practice varied similarly across NICU levels of care. Among the subset of NICUs that responded to questions related to phototherapy and screening practices, prophylactic phototherapy was used in 38% (23/59) and 90% (55/61) screened for glucose-6-phosphate dehydrogenase deficiency based on race, ethnicity, and/or family history.

Conclusion(s)

Despite studies validating the accuracy of TcB in preterm infants > 28 weeks, only 28% of California NICUs routinely use TcB devices. TcB screening in infants < 28 weeks gestation is not widely used and no recommendation can be made in this regard until there is more experience with its application using a standardized protocol in these infants and on a large scale.

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Acknowledgements

We want to thank all 150 NICU Directors of California for their support. We want to thank CAN (California Association of Neonatologists) for their support in completing the survey.

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Correspondence to Dilip R. Bhatt.

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Conflict of interest

M. Jeffrey Maisels is a consultant to Draeger Inc (Telford, PA), the supplier of the JM-103 and JM-105 transcutaneous bilirubinometers. The remaining authors declare no conflicts of interest.

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Bhatt, D.R., Kristensen-Cabrera, A.I., Lee, H.C. et al. Transcutaneous bilirubinometer use and practices surrounding jaundice in 150 California newborn intensive care units. J Perinatol 38, 1532–1535 (2018). https://doi.org/10.1038/s41372-018-0154-3

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