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Contents

Guideline Development Group and acknowledgements iv
1 Guidance summary 1
1.1 Key terms 1
1.2 Key priorities for implementation 1
1.3 Threshold table 3
1.4 Summary of all recommendations 4
1.5 Research recommendations 11
1.6 Treatment threshold graphs 13
1.7 Investigation, phototherapy and exchange transfusion pathways 13
2 Introduction 33
2.1 Neonatal jaundice 33
2.2 Aim of the guideline 35
2.3 Areas outside the remit of the guideline 35
2.4 Who has developed the guideline 35
2.5 Related NICE guidance 35
2.6 Guideline methodology 36
3 Factors that influence hyperbilirubinaemia and kernicterus 41
3.1 Factors that influence hyperbilirubinaemia 41
3.2 Risk factors for kernicterus and/or adverse sequelae 47
4 Early prediction of serious hyperbilirubinaemia 53
4.1 Tests that predict hyperbilirubinaemia 54
4.2 Tests that do not predict hyperbilirubinaemia 63
5 Recognition 70
5.1 Visual/clinical examination 71
5.2 Devices for measuring bilirubin 75
6 Formal assessment for the causes of neonatal hyperbilirubinaemia 87
6.1 Tests to detect underlying disease in all babies with hyperbilirubinaemia 88
6.2 Formal assessment of babies with prolonged jaundice 98
7 Treatment 100
7.1 How to manage hyperbilirubinaemia 100
7.2 Phototherapy 105
7.3 Exchange transfusion 127
7.4 Other treatments 131
7.5 Satisfaction with treatment 140
8 Information 142
Appendix A Scope 145
Appendix B Declarations of interest 149
Appendix C Economic evaluation of alternative testing strategies in the detection of hyperbilirubinaemia 152
Appendix D Cost-effectiveness of intravenous immunoglobulin (IVIG) 165
Appendix E Implementation tools 169
Appendix F Registered stakeholder organisations 172
Appendix G Clinical questions 175
Appendix H Evidence tables 177
Appendix I Search strategies 319
Appendix J Excluded studies 462
Abbreviations, Glossary and References 495

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