The accuracy of repeated use of BiliCal for transcutaneous bilirubin measurement in term newborns using BiliCheck device

Background: Transcutaneous bilirubin (TcB) measurement provides an accurate estimate of total serum bilirubin (TSB) values in healthy term infants. TcB measurement is quick, simple, and less invasive. BiliCheck is a device which is validated to measure TcB using a disposable single use probe to calibrate the device. The aim of this prospective observational study is to evaluate the accuracy of BiliCheck device for measurement of TcB when BiliCal is reused twice and three times in the same newborn. Methods: Healthy jaundiced term newborns required TSB measurement more than once were included in the study. BiliCheck was used to measure TcB within 10 minutes of TSB measurement using the same Bilical up to 3 measurements for the same newborn. Pearson correlation of each TSB and TcBpair as well as the Bland-Altman analyses was used to assess the level of the first, second and third TSB and TcB pair's variability. Results: TcB was measured twice using the same BiliCal in 225 newborns and three times in 95 newborns. Mean TSB was 149.5 +/- 44.3, 177 +/- 44.6, 192.6 +/- 39.3 umol/l and mean TcB was 159 +/- 46.5, 183 +/- 47.7, 186.5 +/- 40 umol/l when TSB and TcB were measured for the 1st, 2nd and 3rd time respectively. There was a significant correlation between TSB and TcB when BiliCal was used for 1st, 2nd and 3rd time (r = 0.83, 0.82, 0.71 respectively). The mean difference of (TcB-TSB) was 9.8 +/- 26.9, 5.2 +/- 29.2,-0.3 +/- 1.8 umol respectively. Conclusion: TcB level measured by BiliCheck has an excellent correlation with TSB not only when the disposable probe, BiliCal, is used for the first time but also when it is reused for the second and third time.