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PubMed · 2358901

Transcutaneous bilirubinometer: intermeter reliability.

Abstract

This study examined intermeter reliability on two transcutaneous bilirubinometers on 30 white prephototherapy infants between 36 and 42 weeks' gestation with birthweights greater than 2500 g. All infants were screened with both meters, on the forehead, within a 5-minute period. Meter readings were taken within 30 minutes following infant heelstick for serum bilirubin. The Pearson correlations between serum bilirubin and jaundice meter measurements were .75 for meter 1 and .76 for meter 2. The correlation between jaundice meter indices from the two meters was .87, leaving 13% of the variance in one meter not accounted for by the correlation with the other meter. An examination of the differences between the two meters revealed that in the upper range (greater than or equal to 16) meter 1 was always higher than meter 2 by, on the average, 2.6 points (SD = 1.3). In readings of 15 or less, the differences between the meters were inconsistent. Additionally, in 16 of 30 cases, the action levels from the two meters led to the same conclusion; in the remaining 14 cases, meter 1 gave a positive reading (indicating the need to determine serum bilirubin) while meter 2 gave an equivocal reading (indicating user discretion in deciding whether serum bilirubin should be determined). These data indicate that each meter should be individually evaluated to determine action indices, and that jaundice meters should not be used interchangeably on the same infant.

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BibTeXRIS

L P Brown, L Arnold, D Allison, B Jacobsen, M E Klein, D Charsha. 1990. Transcutaneous bilirubinometer: intermeter reliability.. https://pubmed.ncbi.nlm.nih.gov/2358901/

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Bilirubin↗

Solvent partition of 14C-unconjugated bilirubin to remove labeled polar contaminants.

Polar derivatives contaminating unconjugated bilirubin (UCB) are customarily extracted with weak alkali. As UCB degrades rapidly at alkaline pH, regeneration of polar derivatives may limit purification. This problem is especially important when trying to eliminate radiolabeled contaminants from 14C-UCB. As polar derivatives of UCB should have a much greater aqueous to CHCl3 partition ratio (PR) than UCB even at neutral pH, where degradation of UCB is minimal, 14C-UCB in CHCl3 was serially extracted with an aqueous buffer at pH 7.0 to determine whether labeled derivatives could be preferentially removed. A single extraction of customarily purified 14C-UCB removed 0.18+/-0.06% of the radioactivity as labeled derivatives. Subsequent serial extractions yielded a stable, 67% lower 14C-PR with only 0.03% of radioactivity as labeled derivatives. Reverse-phase high-performance liquid chromatography (HPLC) of phases from later extractions revealed, however, that up to 1.1% of the disintegration per minute (dpm) in CHCl3 phases and up to 50% in aqueous phases were polar impurities. HPLC of partition phases spiked with purified 14C-UCB revealed that these impurities derived from incomplete extraction of the least polar impurities and their regeneration during HPLC. In the dark under argon, 14C-UCB in CHCl3or dimethyl sulfoxide (DMSO) solution degraded very slowly to polar derivatives. Extraction of impurities from a solution of 14C-UCB in CHCl3 is best done using pH 7.0 buffer, with removal of over 80% of the labeled contaminants remaining after customary purification by alkaline extraction.

Bilirubin↗