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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Reliability of transcutaneous bilirubin devices in preterm infants: A systematic review
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Reliability of transcutaneous bilirubin devices in preterm infants: A systematic review

机译：经皮胆红素装置在早产儿中的可靠性：系统评价

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BACKGROUND AND OBJECTIVE: Transcutaneous bilirubin (TcB) devices are widely used for the estimation of serum bilirubin levels in term and near-term infants. Our objective was to review the diagnostic accuracy of TcB devices in preterm infants. METHODS: Medline, Embase, Cochrane library, Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched (from database inception date until December 2012). Additional citations were identified by using the bibliographies of selected articles and from conference proceedings. The studies were included if they compared TcB with total serum bilirubin in preterm infants before phototherapy and presented data as correlation coefficients or as Bland- Altman difference plots. Data were extracted by 1 reviewer and checked for accuracy by the second reviewer. An assessment tool (quality assessment of diagnostic accuracy studies) was used for risk of bias assessments. RESULTS: Twenty-two studies met the inclusion criteria; 21 studies reported results as correlation coefficients, with pooled estimates of r = 0.83 for each site of measurement. Pooled estimates in infants ,32 weeks' gestation were similar to the overall preterm population (r = 0.89 [95% confidence interval: 0.82-0.93]). For the 2 commonly used TcB devices (ie, JM103 and BiliCheck), the results were comparable at the forehead site, although the JM103 device exhibited better correlation at the sternum. Analysis of the Bland- Altman plots (13 studies) revealed negligible bias in measurement at the forehead or sternum site by using either the JM-103 or BiliCheck device; however, the JM-103 device exhibited better precision than the BiliCheck (SD for TcB - Total serum bilirubin differences: 24.3 and 31.98 mmol/L, respectively). CONCLUSIONS: The TcB devices reliably estimated bilirubin levels in preterm infants and could be used in clinical practice to reduce blood sampling. Pediatrics 2013;132:871-881.
机译：背景与目的：经皮胆红素（TcB）装置被广泛用于评估足月和近期婴儿的血清胆红素水平。我们的目的是回顾TcB设备在早产儿中的诊断准确性。方法：检索Medline，Embase，Cochrane文库，护理和相关健康文献的累积索引以及Scopus（从数据库开始日期到2012年12月）。通过使用选定文章的参考书目和会议论文集来确定其他引用。如果他们将光疗前早产儿的TcB与总血清胆红素进行比较，并以相关系数或Bland-Altman差异图的形式提供数据，则纳入研究。由一位审阅者提取数据，并由第二名审阅者检查其准确性。评估工具（诊断准确性研究的质量评估）用于偏差评估的风险。结果：22项研究符合纳入标准; 21项研究将结果报告为相关系数，每个测量位置的合并估计值r = 0.83。婴儿在妊娠32周时的汇总估算值与总早产人群相似（r = 0.89 [95％置信区间：0.82-0.93]）。对于两种常用的TcB装置（即JM103和BiliCheck），尽管JM103装置在胸骨处表现出更好的相关性，但在额头部位的结果是可比的。对Bland-Altman图的分析（13项研究）表明，使用JM-103或BiliCheck装置在前额或胸骨部位的测量偏差可忽略不计。但是，JM-103装置显示出比BiliCheck更好的精度（SD的TcB-总血清胆红素差异：分别为24.3和31.98 mmol / L）。结论：TcB设备可以可靠地估计早产儿的胆红素水平，可用于临床实践以减少血液采样。儿科2013; 132：871-881。

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