Transcutaneous Bilirubin Measurements in Neonates Post Phototherapy
Transcutaneous Bilirubin Measurements in Neonates Post Phototherapy
Can transcutaneous bilirubin (TcB) measurements be utilised to assess rebound
 hyperbilirubinaemia following phototherapy in neonates?
Jaundice is common in the newborn and may result in the need for babies to be readmitted from
 home for phototherapy, with associated increased costs and significant family distress.

 As well as prolonged hospital stay, neonates on phototherapy require multiple blood tests
 (SBR), generally acquired via heel prick testing. These cause the baby discomfort and samples
 may be insufficient or haemolyzed and require repeating. There is also a delay of one to two
 hours at best in results being received and actioned.

 Jaundice measurements can also be obtained using non-invasive, cheap and reliable meters
 (TcB) that give almost immediate results. The meter takes one to two minutes to get a result
 and can be used at the cotside. TcB causes the baby no significant discomfort.

 TcB meters are commonly used before phototherapy but are not routinely used during or after
 stopping phototherapy. Jaundice commonly worsens after stopping phototherapy due to release
 of bilirubin from tissues and so measuring a "rebound" SBR twelve hours after stopping
 phototherapy and before the baby can go home is routine practice.

 TcB meters tend to underestimate SBR in the first eight hours after stopping phototherapy but
 there is some evidence that thereafter they may provide reliable results. If TcB measurements
 can be used as a reliable predictor for SBR twelve hours after phototherapy, this will reduce
 blood sampling and costs, causing less distress to the baby and their mother, with potential
 for earlier discharge home. The NICE guideline for neonatal jaundice suggests that new
 research is needed to evaluate the accuracy of different transcutaneous bilirubinometers in
 comparison to serum bilirubin levels in all babies.
Inclusion Criteria:

 -  Well neonates

 -  35+0 weeks gestation or greater, over 24 hours old

 -  Inpatients at Princess Royal Maternity (PRM), NHS Greater Glasgow and Clyde

 Exclusion Criteria:

 -  Unwell neonates

 -  Less than 35+0 weeks' gestation

 -  Less than 24 hours old

 -  Mother unable or too distressed to give informed consent