| Autor: |
Maisels, M J, Coffey, M P, Kring, E |
| Předmět: |
|
| Zdroj: |
Journal of Perinatology; Sep2015, Vol. 35 Issue 9, p739-744, 6p, 4 Charts, 3 Graphs |
| Abstrakt: |
Objective:In infants <35 weeks' gestation, we sought to define the transcutaneous bilirubin (TcB) levels at which a total serum bilirubin (TSB) level suggesting the need for phototherapy is unlikely to occur and a TSB measurement can, therefore, be avoided.Study Design:Nursing staff performed 896 TcB measurements within 1 h of a TSB on 225 neonates 26 0/7-34 6/7 weeks' postmenstrual age (PMA). Generalized linear models were fit with generalized estimating equations (GEEs) to model the probability of having a TSB level at or above the phototherapy initiation cutpoint as a function of the TcB; these methods allow for multiple tests per infant.Results:The mean difference between TcB and TSB measurements was <1 mg dl−1 for each PMA category. When the TcB was at least 3 mg dl−1 below the TSB cutpoint for phototherapy, there was a ⩾98% probability that the TSB was not at, or above, the recommended phototherapy level. The single exception to this was a phototherapy level of 6 mg dl−1 for infants of 28 0/7-29 6/7 weeks' PMA, where a TcB of 4 mg dl−1 below the phototherapy level (ie a TcB ⩽2 mg dl−1) was necessary to achieve ⩾98% probability.Conclusion:Our data support the use of routine TcB screening for infants 28-34 6/7 weeks' gestation. TcB screening in the neonatal intensive care unit can identify infants who require a TSB to confirm or exclude the need for phototherapy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
