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Comparison of Skin Sites for Estimating Serum Total Bilirubin in In-Patients and Out-Patients: Chest Is Superior to Brow

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Abstract

OBEJECTIVE: To compare transcutaneous bilirubin readings from the chest and forehead of inpatient and outpatient infants to investigate whether one site is more accurate for estimating serum bilirubin concentration.

METHODS: In all, 31 infants were followed with serum and transcutaneous bilirubins using BiliChek™ at two skin sites.

RESULTS: For inpatients average chest bilirubin was 0.4 mg/dl (7 μmol/l) higher than serum while brow was 0.3 mg/dl (5μmol/l) lower. For outpatients, skin readings from both sites underestimated serum values. Chest estimates were 0.6 mg/dl (10 μmol/l) lower; brow was 2.1 mg/dl (36 μmol/l) lower (p<0.0001). Correlation coefficients and mean differences between skin and serum values for Hispanic and non-Hispanic infants were similar.

CONCLUSIONS: In our inpatients, chest and brow readings approximated serum values. After discharge, brow readings were lower than serum values by almost 20%, while chest readings were underestimated by 5%. We recommend using the chest for transcutaneous bilirubin estimates.

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This work was supported in part by the University of New Mexico Clinical Research Center (NIH NCRR GCRC Grant 5M01 RR0997) and the Wellspring Pharmaceutical Corporation, Neptune, NJ, USA.

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Poland, R., Hartenberger, C., McHenry, H. et al. Comparison of Skin Sites for Estimating Serum Total Bilirubin in In-Patients and Out-Patients: Chest Is Superior to Brow. J Perinatol 24, 541–543 (2004). https://doi.org/10.1038/sj.jp.7211141

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