Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health
Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health
Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health
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Transcutaneous Bilirubin (TcB) Measurements<br />
• Instantaneous, non-invasive, safe, reliable, easy, cost effective (fewer TSBs)<br />
• Measures tissue bilirubin, not TSB--yellow color of blanched skin, subcutaneous tissue<br />
– Chest (most accurate)<br />
– Forehead (usual site-ease)<br />
– Much more accurate than visual estimation of TSB<br />
• Valid screening test for hyperbilirubinemia with good correlation with Total Serum<br />
Bilirubin(TSB)-may underestimate TSB by 2-3mg/dL<br />
• Compare with TSB measurements (laboratory)-quality control<br />
• May use for all races and for preterm (at least > 29 weeks), full term infants<br />
• TcB results NOT reliable under photo<strong>the</strong>rapy (ok if >24 hours off photo<strong>the</strong>rapy? or covered<br />
area?), marked hirsutism (e.g. Hispanic), dark skinned? or >15mg/dL<br />
• Always obtain TSB if to initiate <strong>the</strong>rapy or if TcB >13-15 mg/dL<br />
– TcB value is at 70% of value to start photo<strong>the</strong>rapy<br />
– TcB at or above <strong>the</strong> 75 th percentile on hour specific nomogram (high intermediate or<br />
high risk zone)
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