Avoiding painful blood sampling in neonates by transcutaneous bilirubinometry

Background Transcutaneous bilirubinometry, Bilicheck (kindly provided by Oxygen Care Company, Dublin) is a non-invasive, screening method for determining bilirubin levels in neonates. It has not previously been validated in Irish babies. Aims To determine the clinical accuracy and precision of Bilicheck measurements in comparison to total serum bilirubin (TSB) measurements in Irish neonates, and to determine whether Bilicheck is a useful non-invasive screening method of avoiding blood tests in neonates. Methods Correlation data were obtained from 53 neonates between simultaneous TSB and Bilicheck readings. Bilicheck was used to screen 100 neonates who were assessed as requiring serum bilirubin measurement. TSB was only performed on neonates whose Bilicheck was above the phototherapy line of a recognised serum bilirubin chart. Results Bilicheck and TSB were significantly correlated (r=0.890). Bland and Altman analysis showed that on average, Bilicheck read 30mumol/l lower than TSB. Of 100 jaundiced neonates screened by Bilicheck, blood sampling was avoided in 70 because Bilicheck did not meet phototherapy guidelines. Conclusions There is a good correlation between TSB and Bilicheck, although the latter tends to under-read by 30mumol/l. Bilicheck may be a useful screening device to decrease the risks and discomfort associated with blood sampling in neonates.