ABSTRACT
Objective To assess the accuracy of automated image－based bilirubin ( AIB ) of newborns or early infants obtained using a smartphone application called BiliScan for Newborn Jaundice . Method Jaundiced neonates (gestational age≥35 weeks) and early infants (postnatal age≤60 days) from out－patient or in－patient of our hospital during November 2016 to September 2017 were prospectively included.The total serum bilirubin ( TSB ), transcutaneous bilirubin ( TcB ) and AIB on chest were completed simultaneously on hospitalization , pre phototherapy, 0 h and 12 ～24 h after cessation of phototherapy for in－patients, and after diagnosis of breast－feeding jaundice for out－patients participants.The AIB were all detected by smartphone with an application of BiliScan for Newborn Jaundice .Statistical analysis was performed by SPSS 20.0.Result A total of 296 sets of data were enrolled from 194 neonates or infants in this study.The accuracy of AIB was not inferior to the TcB (The difference between the mean of the absolute value of AIB －TSB and the absolute value of TcB －TSB was 0.77 mg/dl, 95% confidence interval were 0.63 ～0.91 mg/dl).These results of the subgroups from male and female term infants , postnatal age＞2 days and the value of TSB≤20 mg/dl were similar to the overall results.However, in the subgroup of TSB＞20 mg/dl, the accuracy of AIB was lower than that of TcB compared to TSB.There were good correlation (r＝0.824) and consistency (96.5% samples lay within the 95% limits of agreement ) between AIB and TSB.In the subgroup of 10 mg/dl ＜TSB≤20 mg/dl, the correlation and consistency between AIB and TSB were better than those of the subgroups of TSB ≤10 mg/dl and TSB ＞20 mg/dl. Furthermore, TSBs of 97.5% neonates were not beyond AIB plus 3.80 mg/dl.Conclusion When 10 mg/dl＜TSB≤20 mg/dl, the accuracy of AIB was not inferor to TcB , and the correlation and consistency between AIB and TSB were relatively superior.The application BiliScan for Newborn Jaundice was suitable for dynamic monitoring moderate jaundice of neonates and early infants at home.
ABSTRACT
Objective To study the value of platelet parameters within the first week of life in predicting drug intervention failure of haemodynamically significant patent ductus arteriosus ( hsPDA ) in preterm infants.Method The preterm infants admitted to NICU of the Affiliated Xuzhou Hospital to the Southeast University from Nov 2010 to Jul 2016 were studied.All preterm infants with hsPDA were treated with ibuprofen or acetaminophen , and were assigned into the success group and the failure group .The following data were retrospectively collected: platelet parameters included platelet counts , plateletocrit , platelet distribution width , mean platelet volume , and platelet-large cell ratio in blood cell analysis of venous blood in the first 24 hours and the 4~7 days of life.Echocardiography was done 72 hours after the usage of ibuprofen or acetaminophen treatment .Result There were 107 preterm infants with hsPDA in our study , 76 infants in the success group and 31 infants in the failure group.Among the platelet parameters in the first 24 hours and the 4~7 days of life, there were significant difference only in the plateletocrit in the 4~7 days after birth between the success group and the failure group ( 0.21%±0.13% vs.0.15%±0.07%, P=0.024).The smaller birth weight , the respiratory distress syndrome , and the smaller plateletocrit in the 4~7 days of life were the independent risk factors for the drug intervention failure of hsPDA in preterm infants .The area under the receiver operating characteristic curves of the plateletocrit in the 4 ~7 days of life for predicting the drug intervention failure of hsPDA in preterm infants was 0.630 (95%CI 0.502~0.757, P=0.036).The best prediction cutoff value of the plateletocrit in the 4~7 days of life was 0.125%(sensitivity was 35.5%, specificity was 92.1%) .Conclusion The smaller birth weight , with respiratory distress syndrome, and the smaller plateletocrit in the 4~7 days of life were the independent risk factors of the drug intervention failure of hsPDA in preterm infants .The value of the plateletocrit in the 4 ~7 days of life in predicting the drug intervention failure of hsPDA in preterm infants was lower .