BILLI METER

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.

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.
What is bilirubin
Measurement Techniques Of Bilirubin And Serum-Bilirubin
Level

Bilirubin Assay Kit (Total and Direct, Colorimetric)

• 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).
 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.

Bili Capture optical imaging

• It is done with conjunctival image was captured using a camera.

• This image is then shared on 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.

How Does a Transcutaneous Bilirubinometer Work?

Principle of bilicheck
 • 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.

• The available meters can be divided into 2 categories:

(i) Multi wavelength Spectral Reflectance meters (Bilicheck)
(ii) Two-wavelength (460 nm, 540 nm) Spectral Reflectance
meters (Minolta, Bili-test)
• The 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 skin.

Limitations of Transcutaneous Bilirubinometers

• TcB can be affected by a variety of factors, such as phototherapy

and exposure to sunlight.

• Dermal thickness and the melanin content of the skin.

• Limit the use of TcB to infants <10 days old.

• A clean, disposable tip is required for each measurement.(BiliChek)

Conclusion

• Non-invasive TcB measurements are a desirable modality since it is

a quick, non-invasive technique to screen for hyperbilirubinemia.

• As a substitute to TSB for inspecting jaundiced neonates.

• It 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

checking place