Page 450 - 16Neonatal Jaundice_compressed

Neonatal jaundice

How to monitor a baby with jaundice?

When to discharge a baby treated for hyperbilirubinaemia? What follow-up is required?

Bibliographic details Study type & Patient characteristics Results Reviewers Comments Bibliographic details
Evidence level
Author: Study Type: Diagnosis Phototherapy criteria Primary phototherapy
Kaplan M Clinical study Hyperbilirubinaemia < 24 hours 170 micromol/litre Mean TsB at onset:
24–38 hours 205 micromol/litre 251 ± 53 micromol/litre
Year: Evidence Level: Criteria: 48–72 hours 256 micromol/litre
2005 3 Need for phototherapy: according to > 72 hours 291–308 micromol/litre Age at onset
AAP 1997
Country: Babies with risk factors at 17 – 53 ± 29 hours
Israel Setting 34 micromol/litre below these levels
Medical Center Mean duration
126
ID: For readmitted babies 43 ± 23 hours
Demographics: TsB ≥ 308 – 342 micromol/litre
Sample size: 226 Mean TsB at discontinuation
Gender (M/F): 134/92 Bilirubin routinely measured every 12 hours
Mean GA: (checked more if clinical need) 182 ± 20 micromol/litre
39 ± 2 weeks
Mean BW: Phototherapy discontinued at Rebound Jaundice
205 micromol/litre or if TsB did not reach 205 30/196 (15.3%)
3204 ± 445 g once TsB stabilised and became lower than
th
75 centile on the hour specific nomogram Phototherapy after readmission
Mean TsB at onset:
318 ± 22 micromol/litre
Rebound Jaundice criteria
TsB measured between 2 and 36 hours after Age at onset
discontinuation of phototherapy 122 ± 38 hours
If TsB was ≥ 120% of post-phototherapy or
≥ 239 micromol/litre were followed at 12–
24 hour intervals Mean duration
30 ± 9 hours
Phototherapy was r-continued at clinician
discretion but usually not below Mean TsB at discontinuation
256 micromol/litre 182 ± 18 micromol/litre

Rebound Jaundice
0/30 (0.0%)

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