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Can transcutaneous bilirubin levels obtained from covered skin replace serum bilirubin measurement in neonates undergoing phototherapy? Cover

Can transcutaneous bilirubin levels obtained from covered skin replace serum bilirubin measurement in neonates undergoing phototherapy?

Asian Biomedicine
Volume 19 (2025): Issue 4 (August 2025)
By: M. Fatih Ozden,  Dilek Kahvecioglu,  Melda Tas,  Aslihan Kose Cetinkaya and  Ahmet Oktem  
Open Access
|Aug 2025

Figures & Tables

Figure 1.

TcB measurements after PT. (A) TcB measurement at the exposed area and (B) TcB measurement under the covered shield. The neonate’s face is shown with full, explicit written informed consent obtained from the parents for publication of this identifiable image. The parents were informed about the nature, purpose, and extent of the publication, including digital distribution. PT, phototherapy; TcB, transcutaneous bilirubin.
TcB measurements after PT. (A) TcB measurement at the exposed area and (B) TcB measurement under the covered shield. The neonate’s face is shown with full, explicit written informed consent obtained from the parents for publication of this identifiable image. The parents were informed about the nature, purpose, and extent of the publication, including digital distribution. PT, phototherapy; TcB, transcutaneous bilirubin.

Figure 2.

Correlation between TSB and covered skin TcB (A) and exposed skin TcB (B) measurement after 24 h of PT. Correlation between TSB and covered skin TcB (C) and exposed skin TcB (D) measurements 8 h after discontinuing PT. The Bland-Altman plot shows the average of the two methods on the X-axis and the absolute difference between the two methods on the Y-axis. PT, phototherapy; TcB, transcutaneous bilirubin; TSB, total serum bilirubin.
Correlation between TSB and covered skin TcB (A) and exposed skin TcB (B) measurement after 24 h of PT. Correlation between TSB and covered skin TcB (C) and exposed skin TcB (D) measurements 8 h after discontinuing PT. The Bland-Altman plot shows the average of the two methods on the X-axis and the absolute difference between the two methods on the Y-axis. PT, phototherapy; TcB, transcutaneous bilirubin; TSB, total serum bilirubin.

Correlation between TSB values and TcB values measured from covered and exposed skin

Before PT ICC (95% CI)After 24 h of PT ICC (95% CI)8 h after PT ICC (95% CI)
TSB vs. exposed skin TcB0.667 (0.513–0.780)0.229 (0.092–0.544)0.432 (0.200–0.613)
TSB vs. covered skin TcB0.665 (0.508–0.778)0.520 (0.326–0.672)0.537 (0.339–0.687)
Exposed vs. covered skin TcB0.828 (0.737–0.890)<0.245 (0.095–0.542)0.557 (0.056–0.784)

Epidemiological characteristics of the neonates receiving PT for hyperbilirubinemia

Characteristics N (%)
Gestational age (weeks), median (range)38 (31–42)
Birth weight (g), mean ± SD3020 ± 556
Sex
  Female 36 (51.4)
  Male 34 (48.6)
Maternal age (years), mean ± SD26.3 ± 5.7
Maternal disease status
  Yes 8 (11.4)
  No 60 (88.6)
Mode of delivery
  NSVD 51 (72.9)
  C/S 19 (27.1)
Age at admission (days), median (range)2 (1–13)
Length of stay (days), median (range)3 (2–27)
Blood incompatibility
  None 25 (35.8)
  ABO incompatibility 41 (58.6)
  Rh incompatibility 3 (4.2)
  ABO + Rh incompatibility 1 (1.4)
DC test
  Negative 47 (67.2)
  Positive 23 (32.8)
Pathological weight loss
  Yes 10 (14.3)
  No 60 (85.7)
Cephalic hematoma
  Yes 2 (2.9)
  No 68 (97.1)

Comparison of TSB and TcB levels from covered and exposed skin measured before, during, and after PT

Mean ± SD
Before PTAt 24th hour of PT8 h after discontinuation of PT
TSB11.91 ± 4.487.67 ± 2.347.90 ± 2.09
Covered skin TcB11.11 ± 3.017.07 ± 2.258.61 ± 2.39
Exposed skin TcB11.14 ± 3.114.13 ± 1.886.85 ± 2.44
DOI: https://doi.org/10.2478/abm-2025-0025 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415
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Language: English
Page range: 183 - 189
Published on: Aug 31, 2025
Published by: Chulalongkorn University
In partnership with: Paradigm Publishing Services
Publication frequency: 6 issues per year
Keywords:
bilirubin,
neonatal jaundice,
newborn,
non-invasive monitoring,
phototherapy,
transcutaneous bilirubinometry
Related subjects:
Medicine,
Assistive professions, nursing,
Basic medical science,
Basic medical science, other,
Clinical medicine,
Clinical medicine, other

© 2025 M. Fatih Ozden, Dilek Kahvecioglu, Melda Tas, Aslihan Kose Cetinkaya, Ahmet Oktem, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.

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