CONTEMPORARY PEDIATRICS
December 1998, Vol.15, No. 12
NEW PEDIATRIC PRODUCTS OF '98
No more heel sticks for bilirubin measurements
As parents and pediatricians know, newborn infants frequently become jaundiced, and even a conservative management approach calls for daily monitoring of bilirubin levels in some newborns.
Several years ago, the American Academy of Pediatrics (AAP) issued new guidelines for instituting phototherapy and performing exchange transfusions, resulting in fewer babies' being subjected to phototherapy. For decades, manufacturers have attempted to develop a device that can reliably measure bilirubin levels transcutaneously, which would significantly reduce the number of inconvenient and painful heel sticks. Now the FDA has approved just such a device: The new Colormate TLc-BiliTest is likely to change pediatricians' management of hyperbilirubinemia.
Using a light source and optical filters, the handheld instrument measures the incremental changes of the yellow content of the skin (Figure 3). It is accurate on skin of all races, premature infants, and when used under phototherapy lights. For each set of tests, the operator places over the unit's sensor a $10 TLc-Lensette, which acts as an individual calibration and verification standard, then takes a color measurement from three different sites -- cheek, forehead, and chest of back. The device calculates the bilirubin level in mg/dl. Measurements can be downloaded to either a palmtop of laptop computer and printed for inclusion in the patient's record. The device can be battery powered or rely on an external power source, with a battery backup.
For FDA approval the BiliTest was used on 2,441 newborns of various races and gestational ages. Correlation between BiliTest and serum measurements in infants undergoing phototherapy was 91%; in untreated infants the correlation was 95%. The BiliTest system, which includes the sensor, computer of palmtop, and printer, sells for about $3000, and should be widely used in hospital nurseries, pediatricians' offices, and by home care agencies. END
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Contemporary Pediatrics® contributes to the continuing education of pediatricians with articles that are practical, timely, and authoritative. Experts in various pediatric specialties explain to clinicians how best to apply the latest findings and techniques to patient care. The focus is on the prevention, diagnosis, and treatment of clinical problems from birth through adolescence. Also discussed are socioeconomic and practice management issues that affect clinical pediatrics.
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