Covered Skin Bilirubin Measurement during Phototherapy, in Comparison with Total Serum Bilirubin in Full Term Neonates

Background: Jaundice is a prevalent problem among neonates. Patients undergoing phototherapy need a close followup of their serum bilirubin levels to determine the treatment response. To make a comparison between transcutaneous bilirubin measurements (TcB) from covered skin areas during phototherapy and total serum bilirubin (TSB) levels. Methods: This prospective observational study was conducted on 30 fullterm neonates with indirect hyperbilirubinemia requiring phototherapy.  Some parts of the skin (forehead and sternum) were covered in each neonate using the BiliEclipsephoto opaque patch and this covered site was used to measure TcB during phototherapy and compare it with TSB. Both TSB and TcB estimation were performed on icteric newborns before, as well as 24 and 48 h of exposure to phototherapy. Results: As demonstrated by the obtained results, TSB was not significantly different from TcB measured at forehead and sternum before phototherapy. Moreover, no significant difference was detected between TSB and TcB from the covered forehead and sternum in 24 and 48 h of phototherapy initiation. There was a highly significant positive correlation between TSB and covered forehead/sternum TcB during phototherapy. There was no significant difference in both covered forehead and sternum TcB according to different used TcB devices. Conclusion: Measurement of TcB from the covered area of the skin during phototherapy using transcutaneous bilirubin meters is a reliable method to assess TSB in fullterm neonates and could lead to a reduction in blood sampling and its complications.