Bilirubinmeter

Non-invasive bilirubin detection

1. NON-INVASIVE BILIRUBIN MEASUREMENT

2. Outline Introduction What is Bilirubin ? Measurement Techniques of Bilirubin a nd Serum- B ilirubin Level How Does a Transcutaneous Bilirubinometer Work? Limitations of Transcutaneous Bilirubinometers Companies That Produce Bilirubinometer Conclusion

3. Introduction In preterm infants, hyperbilirubinemia is common and can impair the central nervous system. The tests available for measuring bilirubin is to collect blood from heel pricking which is painful. Therefore , there is a need to develop a non-invasive device to detect bilirubin levels .

4. What is Bilirubin ? Bilirubin is an open chain molecule containing four pyrrole-like rings that forms during the breakdown of heme . Bilirubin is excreted in urine and bile and can also be found in low levels in plasma. Eventually , bilirubin is degraded in the liver to be removed from the body.

5. What is Bilirubin ?

6. Measurement Techniques Of Bilirubin And Serum- Bilirubin Level

7. Measurement Techniques Of Bilirubin And Serum- B ilirubin Level Table 1. Bland and Altman comparison and correlation analysis (R, P) and for estimation of the accuracy of bilirubin measurement by transcutaneous bilirubin ( TcB ) using BiliChek and optical imaging ( ToB ) using BiliCapture versus automated laboratory bilirubin measurement (TSB).

8. Measurement Techniques Of Bilirubin And Serum- Bilirubin Level Bilirubin Assay Kit (Total and Direct, Colorimetric) Figure 1. Total and Direct Bilirubin concentrations in Normal Human Serum. Utilizes the Jendrassik-Grof principle to detect bilirubin . Total bilirubin ( unconjugated + conjugated ) concentration is determined in the presence of a catalyst , where bilirubin reacts with a diazo -salt to form azobilirubin , which absorbs at 600 nm . Direct bilirubin ( conjugated ) is determined in the absence of catalyst (550 nm ).

9. Measurement Techniques Of Bilirubin And Serum- Bilirubin Level Transcutaneous Bilirubinometry TcB Transcutaneous bilirubinometry works basically by directing light into the skin and measuring the intensity of the wavelength of light that is returned.

10. Measurement Techniques Of Bilirubin And Serum- Bilirubin Level BiliCapture optical imaging It is done with conjunctival image was captured using a camera . This image is then shared o n tablet with the BiliCapture software installed. With the help of this software, the particular area of interest in the eye showing more yellow color is demarcated and later on estimated for the bilirubin value.

11. How Does a Transcutaneous Bilirubinometer Work? The meter analyzes the spectrum of optical signal reflected from the neonate’s subcutaneous tissues. These optical signals are converted to electrical signal by a photocell. These are analyzed by a microprocessor to generate a serum bilirubin value.

12. How Does a Transcutaneous Bilirubinometer Work? The available meters can be divided into 2 categories : Multi wavelength Spectral Reflectance meters ( Bilicheck ) (ii) Two-wavelength (460 nm, 540 nm) Spectral Reflectance meters (Minolta , Bili-test)

13. How Does a Transcutaneous Bilirubinometer Work? Figure 2. Measurement principle of JM-103. ( Drager Medical )

14. How Does a Transcutaneous Bilirubinometer Work? Figure 3. Measurement principle of BiliChek .

15. How Does a Transcutaneous Bilirubinometer Work? T he basic principle remains the same for each transcutaneous bilirubinometer . The optic head of the meter is gently pressed against the neonates skin (usually forehead or upper part of sternum). For correct measurement, the optic head should make full contact with the ski n. http://www.sumertek.com/bilicare

16. Companies That Produce Bilirubinometer Table 2. Common transcutaneous bilirubinometer available in the market . S.No . Make Principals Dealers Cost 1. Airsheild’s-Minolta Hillrom-Airsheild’s Drager Medical Rs . 1,00,000/- 2. Bilitest Technomedia Lacteromedik Pharmamen Enterprises Rs . 1,20,000/- 3. BiliChek Spectrex Rustagi Surgicals , Phoenix Rs . 1,75,000/- 4. Ohmeda Datex - Ohmeda Phoenix Not launched 5. BiliCare Gerium Mennen Medical Not launched 6. Jaundice Meter JM-105 Minolta / Hill -Rom Air-Shields ) Drager Medical Not launched

17. Limitations of Transcutaneous Bilirubinometers TcB can be affected by a variety of factors, such as phototherapy and exposure to sunlight . D ermal thickness and the melanin content of the skin . L imit the use of TcB to infants < 10 days old . A clean, disposable tip is required for each measurement .( BiliChek )

18. Conclusion Non-invasive TcB measurements are a desirable modality since it is a quick, non-invasive technique to screen for hyperbilirubinemia . A s a substitute to TSB for inspecting jaundiced neonates . I t reduces invasive blood sampling and permits a time effective and reasonably precise estimation of bilirubin levels . None of the actual guidelines suggests the use of TcB measurements as an indication for starting phototherapy.