12/14/2023 0 Comments Tsb meaning measurement![]() ![]() TcB measurements obtained before the initiation of phototherapy or more than 24 hours after phototherapy discontinuation were classified as ‘without phototherapy’. TcB values assessed simultaneously at the forehead and sternum by a physician (Lim G.) within one hour before or after blood sampling for TSB analysis using a Minolta Air Shields Jaundice Meter (JM-103, Dräger Medical, Lübeck, Germany). The study was performed via retrospective chart review in the NICU of the Ulsan University Hospital, a tertiary referral center from September 2018 to August 2019. In the present study, we aimed to confirm the accuracy of TcB under phototherapy, as well as determine whether the forehead or sternum as the assessment site results in a more accurate TcB assessment under phototherapy in sick infants admitted to the neonatal intensive care unit (NICU). Various assessment sites have been used, including the forehead, sternum, interscapular space, hipbone, and lower abdomen, with the forehead and sternum as the most frequently used sites. This difference in results could be due to differences in assessment sites, target patients, presence of a skin patch, and devices used. Although several recent studies regarding TcB assessment after the application of phototherapy have reported its good reliability, other studies have reported a low reliability. ![]() Furthermore, there is doubt regarding its accuracy under phototherapy because phototherapy converts bilirubin through the skin. However, the accuracy of TcB in infants receiving phototherapy is lower due to skin bleaching. By contrast, total serum bilirubin (TSB) assessment requires blood sampling, which is an invasive and painful procedure. In healthy newborns, transcutaneous bilirubin (TcB) assessment has been widely used for screening, as it does not require blood sampling and provides a quick result. The American Academy of Pediatrics (AAP) recommends screening for jaundice and its risk factors before newborns leave the hospital. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum. TcB was more accurate in infants not receiving phototherapy. Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead ( r = 0.751) was a better match to the TSB than was TcB at the sternum ( r = 0.668). Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value ( r = 0.925 and 0.915, respectively). Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. ![]()
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