Transcutaneous bilirubin nomograms: A systematic review of population differences and analysis of bilirubin kinetics

Daniele De Luca, Gregory L. Jackson, Ascanio Tridente, Virgilio P. Carnielli, William D. Engle

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives: To compare available nomograms in the literature defining trends in bilirubin levels across populations with different risk factor profiles and to study a mathematical bilirubin kinetics model describing the natural course of jaundice and the bilirubin rate of rise needed to cross percentile curves. Data Sources: We searched PubMed for publications between March 1999 and March 2009 that created transcutaneous nomograms. We performed the same search among abstracts presented in the past 2 years at meetings of the Pediatric Academic Societies or the European Society for Paediatric Research. Study Selection: Inclusion criteria were gestational age of at least 35 weeks among study subjects, the use of an electronic transcutaneous bilirubinometer, and creation of a nomogram based on hour-specific bilirubin values. Four articles met the selection criteria. Data Extraction: Jaundice risk factors were analyzed, and raw data were analyzed using nonlinear regression to describe trends in bilirubin levels and kinetics. The bilirubin exaggerated rate of rise needed to cross percentile curves was calculated. Data Synthesis: Significant differences in bilirubin values exist across populations, and there is substantial variability in rates of rise. Hispanic neonates demonstrate higher rates of rise and later plateaus. Bilirubin rates of rise tend to plateau and become null (equilibrium between bilirubin production and elimination) at about 96 hours of life. Rates of rise needed to cross percentile curves decrease over time but are lower (approximately 0.11 mg/dL/h [to convert bilirubin level to micromoles per liter, multiply by 17.104]) in the first48hoursof lifethanpreviously thought. Conclusions: Transcutaneous bilirubin levels plateau and then decrease after about 96 hours of life in healthy neonates, with some differences across populations. A bilirubin rate of rise higher than in the previous period implies that bilirubin production exceeds eliminationandindicates high risk for subsequent hyperbilirubinemia in neonates.

Original languageEnglish (US)
Pages (from-to)1054-1059
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Volume163
Issue number11
DOIs
StatePublished - Nov 2009

Fingerprint

Nomograms
Bilirubin
Population
Newborn Infant
Jaundice
Patient Selection
Hyperbilirubinemia
Information Storage and Retrieval
Hispanic Americans
PubMed
Gestational Age
Publications

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Transcutaneous bilirubin nomograms : A systematic review of population differences and analysis of bilirubin kinetics. / De Luca, Daniele; Jackson, Gregory L.; Tridente, Ascanio; Carnielli, Virgilio P.; Engle, William D.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 163, No. 11, 11.2009, p. 1054-1059.

Research output: Contribution to journalArticle

De Luca, Daniele ; Jackson, Gregory L. ; Tridente, Ascanio ; Carnielli, Virgilio P. ; Engle, William D. / Transcutaneous bilirubin nomograms : A systematic review of population differences and analysis of bilirubin kinetics. In: Archives of Pediatrics and Adolescent Medicine. 2009 ; Vol. 163, No. 11. pp. 1054-1059.
@article{114e77be81fb41e5963d49a72fa751fe,
title = "Transcutaneous bilirubin nomograms: A systematic review of population differences and analysis of bilirubin kinetics",
abstract = "Objectives: To compare available nomograms in the literature defining trends in bilirubin levels across populations with different risk factor profiles and to study a mathematical bilirubin kinetics model describing the natural course of jaundice and the bilirubin rate of rise needed to cross percentile curves. Data Sources: We searched PubMed for publications between March 1999 and March 2009 that created transcutaneous nomograms. We performed the same search among abstracts presented in the past 2 years at meetings of the Pediatric Academic Societies or the European Society for Paediatric Research. Study Selection: Inclusion criteria were gestational age of at least 35 weeks among study subjects, the use of an electronic transcutaneous bilirubinometer, and creation of a nomogram based on hour-specific bilirubin values. Four articles met the selection criteria. Data Extraction: Jaundice risk factors were analyzed, and raw data were analyzed using nonlinear regression to describe trends in bilirubin levels and kinetics. The bilirubin exaggerated rate of rise needed to cross percentile curves was calculated. Data Synthesis: Significant differences in bilirubin values exist across populations, and there is substantial variability in rates of rise. Hispanic neonates demonstrate higher rates of rise and later plateaus. Bilirubin rates of rise tend to plateau and become null (equilibrium between bilirubin production and elimination) at about 96 hours of life. Rates of rise needed to cross percentile curves decrease over time but are lower (approximately 0.11 mg/dL/h [to convert bilirubin level to micromoles per liter, multiply by 17.104]) in the first48hoursof lifethanpreviously thought. Conclusions: Transcutaneous bilirubin levels plateau and then decrease after about 96 hours of life in healthy neonates, with some differences across populations. A bilirubin rate of rise higher than in the previous period implies that bilirubin production exceeds eliminationandindicates high risk for subsequent hyperbilirubinemia in neonates.",
author = "{De Luca}, Daniele and Jackson, {Gregory L.} and Ascanio Tridente and Carnielli, {Virgilio P.} and Engle, {William D.}",
year = "2009",
month = "11",
doi = "10.1001/archpediatrics.2009.187",
language = "English (US)",
volume = "163",
pages = "1054--1059",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "11",

}

TY - JOUR

T1 - Transcutaneous bilirubin nomograms

T2 - A systematic review of population differences and analysis of bilirubin kinetics

AU - De Luca, Daniele

AU - Jackson, Gregory L.

AU - Tridente, Ascanio

AU - Carnielli, Virgilio P.

AU - Engle, William D.

PY - 2009/11

Y1 - 2009/11

N2 - Objectives: To compare available nomograms in the literature defining trends in bilirubin levels across populations with different risk factor profiles and to study a mathematical bilirubin kinetics model describing the natural course of jaundice and the bilirubin rate of rise needed to cross percentile curves. Data Sources: We searched PubMed for publications between March 1999 and March 2009 that created transcutaneous nomograms. We performed the same search among abstracts presented in the past 2 years at meetings of the Pediatric Academic Societies or the European Society for Paediatric Research. Study Selection: Inclusion criteria were gestational age of at least 35 weeks among study subjects, the use of an electronic transcutaneous bilirubinometer, and creation of a nomogram based on hour-specific bilirubin values. Four articles met the selection criteria. Data Extraction: Jaundice risk factors were analyzed, and raw data were analyzed using nonlinear regression to describe trends in bilirubin levels and kinetics. The bilirubin exaggerated rate of rise needed to cross percentile curves was calculated. Data Synthesis: Significant differences in bilirubin values exist across populations, and there is substantial variability in rates of rise. Hispanic neonates demonstrate higher rates of rise and later plateaus. Bilirubin rates of rise tend to plateau and become null (equilibrium between bilirubin production and elimination) at about 96 hours of life. Rates of rise needed to cross percentile curves decrease over time but are lower (approximately 0.11 mg/dL/h [to convert bilirubin level to micromoles per liter, multiply by 17.104]) in the first48hoursof lifethanpreviously thought. Conclusions: Transcutaneous bilirubin levels plateau and then decrease after about 96 hours of life in healthy neonates, with some differences across populations. A bilirubin rate of rise higher than in the previous period implies that bilirubin production exceeds eliminationandindicates high risk for subsequent hyperbilirubinemia in neonates.

AB - Objectives: To compare available nomograms in the literature defining trends in bilirubin levels across populations with different risk factor profiles and to study a mathematical bilirubin kinetics model describing the natural course of jaundice and the bilirubin rate of rise needed to cross percentile curves. Data Sources: We searched PubMed for publications between March 1999 and March 2009 that created transcutaneous nomograms. We performed the same search among abstracts presented in the past 2 years at meetings of the Pediatric Academic Societies or the European Society for Paediatric Research. Study Selection: Inclusion criteria were gestational age of at least 35 weeks among study subjects, the use of an electronic transcutaneous bilirubinometer, and creation of a nomogram based on hour-specific bilirubin values. Four articles met the selection criteria. Data Extraction: Jaundice risk factors were analyzed, and raw data were analyzed using nonlinear regression to describe trends in bilirubin levels and kinetics. The bilirubin exaggerated rate of rise needed to cross percentile curves was calculated. Data Synthesis: Significant differences in bilirubin values exist across populations, and there is substantial variability in rates of rise. Hispanic neonates demonstrate higher rates of rise and later plateaus. Bilirubin rates of rise tend to plateau and become null (equilibrium between bilirubin production and elimination) at about 96 hours of life. Rates of rise needed to cross percentile curves decrease over time but are lower (approximately 0.11 mg/dL/h [to convert bilirubin level to micromoles per liter, multiply by 17.104]) in the first48hoursof lifethanpreviously thought. Conclusions: Transcutaneous bilirubin levels plateau and then decrease after about 96 hours of life in healthy neonates, with some differences across populations. A bilirubin rate of rise higher than in the previous period implies that bilirubin production exceeds eliminationandindicates high risk for subsequent hyperbilirubinemia in neonates.

UR - http://www.scopus.com/inward/record.url?scp=70350716449&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350716449&partnerID=8YFLogxK

U2 - 10.1001/archpediatrics.2009.187

DO - 10.1001/archpediatrics.2009.187

M3 - Article

C2 - 19884597

AN - SCOPUS:70350716449

VL - 163

SP - 1054

EP - 1059

JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

IS - 11

ER -