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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los bilirrubin&#243;metros transcut&#225;neos son instrumentos que permiten detectar y monitorizar la hiperbilirrubine-mia neonatal&#44; reduciendo el n&#250;mero de extracciones sangu&#237;neas necesarias para su control&#46; Estos dispositivos&#44; de uso rutinario&#44; presentan&#44; no obstante&#44; un amplio rango de error que debe ser evaluado&#46; Nos planteamos establecer la precisi&#243;n y validez en nuestro medio de un bilirrubin&#243;metro transcut&#225;neo cl&#225;sico&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal&#44; observacional&#44; descriptivo sobre una muestra de 117 determinaciones simult&#225;neas de bilirrubina transcut&#225;nea y s&#233;rica&#44; en 82 neonatos ict&#233;ricos&#46; An&#225;lisis de la concordancia entre mediciones repetidas y de distintas localizaciones&#46; Desarrollo de modelos predictivos de la bilirrubina s&#233;rica y an&#225;lisis de la validez de dichas predicciones&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Todos los puntos de medici&#243;n presentaron una concordancia entre medidas repetidas excelente &#40;coeficiente de correlaci&#243;n intraclase superior a 0&#44;92&#41;&#46; Las mediciones en frente ten&#237;an un coeficiente de correlaci&#243;n lineal de 0&#44;75&#59; en estern&#243;n variaba en funci&#243;n de la ausencia o presencia de fototerapia &#40;0&#44;86 y 0&#44;54&#44; respectivamente&#41;&#46; Los intervalos de error en los que se encontraban las predicciones de bilirrubina s&#233;rica eran de &#177;2 mg&#47;dl para valores bajos y &#177;4 mg&#47;dl para valores altos &#62; 15 mg&#47;dl&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El bilirrubin&#243;metro transcut&#225;neo evaluado presenta una alta precisi&#243;n&#44; pero su validez debe ser cuestionada por la existencia de un importante margen de error respecto a la bilirrubina s&#233;rica&#44; especialmente en los pacientes con concentraciones elevadas&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Transcutaneous bilirubinometers are useful in screening and monitoring neonatal hyperbilirubinemia&#46; These instruments reduce the number of blood samples needed&#44; but their validity has been questioned&#46; The aim of this study was to evaluate the accuracy and reliability of a classic transcutaneous bilirubinometer&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Descriptive observational cross-sectional study of a sample of 117 simultaneous measurements of transcutaneous and serum bilirubin in 82 jaundiced newborn infants&#46; We analyzed the agreement between repeat measurements and measurements in different sites&#46; We developed predictive models of serum bilirubin and analyzed their validity&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">All points of measurement displayed excellent agreement between repeat measures &#40;intraclass correlation coefficient higher than 0&#46;92&#41;&#46; Forehead measurements had a linear correlation coefficient of 0&#46;75&#59; in the sternum linear correlation coefficient varied according to the absence or presence of phototherapy &#40;0&#46;86 and 0&#46;54 respectively&#41;&#46; The error intervals in which predictions of serum bilirubin were found were &#35;&#43; 2 mg&#47;dl for low values and &#35;&#43; 4 mg&#47;dl for high values &#40;&#35;&#62; 15 mg&#47;dl&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Reliability of the transcutaneous bilirubinometer evaluated was high&#44; but the substantial degree of error in serum bilirubin make its accuracy questionable&#44; especially in patients with high levels&#46;</p>"
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Vol. 52. Núm. 6.
Páginas 561-568 (junio 2000)
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Vol. 52. Núm. 6.
Páginas 561-568 (junio 2000)
Acceso a texto completo
Evaluación de un instrumento de medición de la bilirrubina transcutánea
Evaluation of a transcutaneous bilirubinometer
Visitas
13304
C. Ochoa Sangrador
Autor para correspondencia
cochoas@meditex.es

Correspondencia' Servicio de Pediatría. Hospital Virgen de la Concha. Avda. Requejo, 35. 49029 Zamora.
, V.M. Marugán Isabel, R. Tesoro González, M.T. García Rivera, M.T. Hernández Calvo
Servicio de Pediatría. Hospital Virgen de la Concha. Zamora.
Este artículo ha recibido
Información del artículo
Objetivo

Los bilirrubinómetros transcutáneos son instrumentos que permiten detectar y monitorizar la hiperbilirrubine-mia neonatal, reduciendo el número de extracciones sanguíneas necesarias para su control. Estos dispositivos, de uso rutinario, presentan, no obstante, un amplio rango de error que debe ser evaluado. Nos planteamos establecer la precisión y validez en nuestro medio de un bilirrubinómetro transcutáneo clásico.

Método

Estudio transversal, observacional, descriptivo sobre una muestra de 117 determinaciones simultáneas de bilirrubina transcutánea y sérica, en 82 neonatos ictéricos. Análisis de la concordancia entre mediciones repetidas y de distintas localizaciones. Desarrollo de modelos predictivos de la bilirrubina sérica y análisis de la validez de dichas predicciones.

Resultados

Todos los puntos de medición presentaron una concordancia entre medidas repetidas excelente (coeficiente de correlación intraclase superior a 0,92). Las mediciones en frente tenían un coeficiente de correlación lineal de 0,75; en esternón variaba en función de la ausencia o presencia de fototerapia (0,86 y 0,54, respectivamente). Los intervalos de error en los que se encontraban las predicciones de bilirrubina sérica eran de ±2 mg/dl para valores bajos y ±4 mg/dl para valores altos > 15 mg/dl).

Conclusiones

El bilirrubinómetro transcutáneo evaluado presenta una alta precisión, pero su validez debe ser cuestionada por la existencia de un importante margen de error respecto a la bilirrubina sérica, especialmente en los pacientes con concentraciones elevadas.

Palabras clave:
Ictericia neonatal
Bilirrubinómetro transcutàneo
Validez
Precisión
objective

Transcutaneous bilirubinometers are useful in screening and monitoring neonatal hyperbilirubinemia. These instruments reduce the number of blood samples needed, but their validity has been questioned. The aim of this study was to evaluate the accuracy and reliability of a classic transcutaneous bilirubinometer.

Method

Descriptive observational cross-sectional study of a sample of 117 simultaneous measurements of transcutaneous and serum bilirubin in 82 jaundiced newborn infants. We analyzed the agreement between repeat measurements and measurements in different sites. We developed predictive models of serum bilirubin and analyzed their validity.

Results

All points of measurement displayed excellent agreement between repeat measures (intraclass correlation coefficient higher than 0.92). Forehead measurements had a linear correlation coefficient of 0.75; in the sternum linear correlation coefficient varied according to the absence or presence of phototherapy (0.86 and 0.54 respectively). The error intervals in which predictions of serum bilirubin were found were #+ 2 mg/dl for low values and #+ 4 mg/dl for high values (#> 15 mg/dl).

Conclusions

Reliability of the transcutaneous bilirubinometer evaluated was high, but the substantial degree of error in serum bilirubin make its accuracy questionable, especially in patients with high levels.

Key words:
Neonatal jaundice
Transcutaneous bilirubinometer
Accuracy
Reliability
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