There's a percentage of free bilirubin that's passing through the skin to be captured by transcutaneous bilirubinometer (TcB) measurements, but we cannot say that everything is passing homogeneously,” states Dr. De Luca, it is multi-factorial, involving variables such as: gestational age, skin temperature, and other medical comorbidities.
As far as diagnostics are concerned, Dr. De Luca states that TcB measurements with devices such as the BiliChek are practical tools for the prevention of trauma associated with bilirubin measurements, adding, “In my research, TcB was useful for reducing blood samples in upwards of fifty percent of patients; it enables us to read skin bilirubin and use it as a clinical parameter."
“From one side it allows us to avoid some blood samples, but from another side it has given us some new insight into jaundice physiopathology,” states Dr. De Luca; using 2nd generation TcB devices to measure the free or unbound skin bilirubin levels may best reflect a newborns risk of bilirubin neurotoxicity. Non-invasive TcB devices provide us with information that allows us to make a correlation, states Dr. De Luca, “which is very interesting because otherwise we have something that is not so easily measurable.”
Dr. De Luca urges that more work needs to be done by replicating his research and studying the findings in more detail. “If there's a rationale behind this history to let us suspect - at the very least - that brain bilirubin could be a little bit more predictable by skin bilirubin testing,” then that's a clinical win.