RESidENcy PROGRAM Scholarly and Community Medicine Projects

TcB Nomogram for Newborns >35 weeks GA 10
TcB - Benefits
● ↓ hospital readmission – prospective trial by Petersen et al –
6603 newborns; readmission rates/1000 newborns for
significant hyperbili ↓ from 4.5 to 1.8 13
● ↓ painful lab draws – 20-50% decrease in TSB draws in
preterm babies >34 weeks14 p
● Accurate - National Academy of Clinical Biochemistry
Laboratory Medicine practice guidelines concluded TcB
meters currently available in US provide results comparable
to laboratory TSB15 Simultaneous Tcb vs TSB measurements 12
TcB - Limitations
● Affected by wide variety of factors -
● Sun or phototherapy exposure
– Studies in adults indicate that possible to have accurate TcB
measurements in sun-exposed pts16 – Variability reduced by using sternal measurments17 ● Dermal thickness
● Hgb Concentration – drops by 10% in 1 st week
● Location of application
Management of Hyperbilirubinemia
● Primary prevention 6
● Advise mothers to nurse 8-12 times per day
● AAP recommends AGAINST supplementing with
water or dextrose water in non-dehydrated non dehydrated breast
fed infants
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