Hello all,
Putting on the engineer hat, here goes what I know (not much) about the
bilinubirometers:
The spectrum of the light reflected by light changes depending on the
concentration of bilirrubin. This makes sense because the bilirrubin
changes the color of blood and color is related to the predominant
wavelength of the reflected light. These devices produce a pulse of light
and measure the spectrum of the reflected light, thus determining (based on
calibration) the concentration of bilirrubin.
I have heard of these devices, have not seen one but I had my fellow
engineer husband explain how they might work (my husband does research
using optics and fluids).
I found an interesting paper comparing the use of two of these devices and
heel prick. One of the devices cited in the paper claims to correct the
spectrum for darker skin color.
Best regards,
Veronica Garea LLLL (and PhD, Eng Physics)
GALM Bariloche
IBFAN Bariloche - LLL Argentina
A comparison of transcutaneous bilirubinometers: SpectRx BiliCheck versus
Minolta AirShields
C M Wong, P J E van Dijk and I A Laing
Simpson Memorial Maternity Pavilion, Lauriston Place, Edinburgh EH3 9YW,
Scotland, UK
Archives of Disease in Childhood Fetal and Neonatal Edition 2002;87:F137-F140
http://fn.bmjjournals.com/cgi/content/full/87/2/F137
ABSTRACT
Background: Two devices are available for making transcutaneous estimates
of serum bilirubin (SBR): the Minolta AirShields JM102 and the new SpectRx
BiliCheck.
Objectives: (a) To measure how well the readings produced by these devices
agree with SBR measured in the laboratory; (b) to estimate for each device,
the proportion of infants with clinical jaundice who would require blood
sampling if the device was used as a screening tool to detect infants with
SBR 250 µmol/l.
Design: Prospective cohort study of jaundiced infants who required SBR
at 20 days of postnatal age. Those who had received phototherapy or
exchange transfusion were excluded.
Setting: Tertiary neonatal service in South-East Scotland.
Interventions: Within 30 minutes of SBR sampling, transcutaneous
bilirubinometry was performed using one Minolta and two SpectRx devices
(designated A and B).
Results: Sixty four neonates were enrolled, 19 of which were preterm (31–35
weeks). The 95% confidence intervals of a device reading corresponding to
SBR were ± 66.7, ± 67.9, and ± 66.4 µmol/l respectively. Using the devices
to identify all SBR 250 µmol/l would reduce SBR sampling by 23%, 16%, and
20% respectively.
Conclusions: Given that SBR levels range from 50 to 400 µmol/l in jaundiced
infants, the 95% confidence intervals of the devices are wide at ± 67
µmol/l. The SpectRx can be used as a screening tool for hyperbilirubinaemia
but there is no advantage in using it over the Minolta.
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