Transcutaneous measurement assists screening, while total serum bilirubin guides treatment decisions.
Transcutaneous bilirubin measurement
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A handheld device quantifies subcutaneous tissue yellowness and provides a transcutaneous bilirubin (TcB) level that approximates total serum bilirubin (TSB).
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TcB provides objective measurements and avoids the subjectivity and interobserver and intraobserver variation of visual assessment.
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Routine TcB measurement reduces blood sampling to confirm TSB.
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The source identifies high TSB levels, the period during and after phototherapy, and prematurity as settings in which TcB and visual assessment are unreliable.
When to measure serum bilirubin
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Measure TSB when jaundice reaches the legs or beyond, or when visually estimated bilirubin or TcB approaches the phototherapy range.
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TSB measurement has marked interlaboratory variability, but treatment decisions should always be based on TSB levels.