Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health

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Neonatal Hyperbilirubinemia • Summary – Most common condition affecting newborn infants (60-70% become jaundiced) requiring evaluation and management – Represents imbalance between bilirubin production and hepatic/enteric clearance – Visual estimation of TSB is fraught with hazard – Most frequent reason for re-hospitalization of infants during first 7 to 10 days post birth (particularly if breast fed) – Benign transitional phenomenon of no overt clinical impact for great majority of infants, but can be catastrophic very rarely – New evidence suggests combining a predischarge, hour specific TSB/TcB level (nomogram) with TWO risk factors, Gestational Age
Ten Key Recommendations for Preventing and Managing Neonatal Hyperbilirubinemia • Promote and support successful breast feeding • Establish nursery protocols for the jaundiced infant including TcB measurements, TSB determinations, and physician contact • Interpret TcB/TSB levels by age in HOURS, NOT DAYS • Measure TcB/TSB in infants jaundiced ≤24 hours of age • Remember, visual assessment of bilirubin level is NOT reliable, particularly in darkly pigmented infants and/or if under phototherapy • Late preterm infants must NOT be treated as full term infants; they are more prone to higher bilirubin levels that remain high longer
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Perinatal Symposium--2012 “Neonat
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Neonatal Hyperbilirubinemia • Pat
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Neonatal Indirect-Unconjugated Hype
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Neonatal Hyperbilirubinemia Bilirub
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Neonatal Hyperbilirubinemia • Gen
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Neonatal Hyperbilirubminemia TSB LE
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Important Risk Factors-Significant
Page 17 and 18: Breastfeeding versus Breast Milk Ja
Page 19 and 20: Adequacy of Breast Feeding • Adeq
Page 21 and 22: Neonatal Hyperbilirubinemia: ABO In
Page 23 and 24: » EVALUATION-NEONATAL JAUNDICE
Page 25 and 26: 2 3 1 4 5 Neonatal Jaundice Dermal
Page 27 and 28: Neonatal Hyperbilirubinemia-Patholo
Page 29 and 30: Additional Evaluation of Neonatal H
Page 31 and 32: Monitoring with Transcutaneous Bili
Page 33 and 34: Transcutaneous Bilirubinometry Scre
Page 35 and 36: Common Causes of Prolonged (3 weeks
Page 37 and 38: Neonatal Hyperbilirubinemia • Pat
Page 39 and 40: Maisels MJ, Mcdonagh AF. Mechanism
Page 41 and 42: Factors Related to Efficacy of Phot
Page 43 and 44: Mangement Under Phototherapy (Conti
Page 45 and 46: Bili Tool • Risk for development
Page 47 and 48: Phototherapy-Hospital, Home • Bil
Page 49 and 50: PREVENTION - SEVERE HYPERBILIRUBINE
Page 51 and 52: Patient 2 (Continued) In the ER, th
Page 53 and 54: Kernicterus • Can occur in health
Page 55 and 56: Kernicterus • Can NOT associate a
Page 57 and 58: Predictive Ability of a Pre Dischar
Page 59 and 60: Predischarge Risk Zone Bilirubin Le
Page 61 and 62: Hyperbilirubinemia in the Newborn I
Page 63 and 64: Commentary on Hyperbilirubinemia in
Page 65 and 66: Screening of Infants for Hyperbilir
Page 67: » SUMMARY
Page 71 and 72: Maroon and Gold Summary Points •
Page 74 and 75: References: General American Academ
Page 76 and 77: References: Breast Feeding de Almei
Page 78 and 79: References Bilirubin Predischarge S
Page 80: References: Kernicterus Davidson L,
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Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health

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