Neonatal jaundice: Difference between revisions

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##tyrosinemia
##tyrosinemia
##alpha 1 antitrypsis deficiency
##alpha 1 antitrypsis deficiency
#Iindirect (unconjugated, pre-liver)
#Indirect (unconjugated, pre-liver)
##sepsis
##sepsis
##hypotension
##hypotension

Revision as of 22:28, 13 June 2011

Risk Factors

  1. Isoimmune hemolytic disease
  2. G6PD deficiency
  3. Asphyxia
  4. Significant lethargy
  5. Temperature instability
  6. Sepsis
  7. Acidosis
  8. Albumin <3 g/d (if measured)

Diagnosis

  1. Direct (conjugated, post- liver obstructive)
    1. congenital biliary atresia
    2. neuroblastoma
    3. cholesterol cysts
  2. Cellular
    1. hepatitis
    2. galactosemia
    3. sepsis
    4. TORCHS
    5. tyrosinemia
    6. alpha 1 antitrypsis deficiency
  3. Indirect (unconjugated, pre-liver)
    1. sepsis
    2. hypotension
    3. rH/ ABO incompatibility

Work-Up

  1. Tbil
  2. Dbil
  3. CBC (for hemolytic anemia)
  4. Coombs or T&S (mom & baby)
  5. ?blood resorption
  6. ?septic
  7. Decreased gastric motility
  8. Physiologic/breast milk (none @ birth presents 1st week)

Phototherapy Guidelines

Age Low Med High
Birth 7.0 5.0 4.0
24h 11.5 9.0 8.0
48h 15 14 10
72h 17.5 15 14
96h 20 17.5

14.5

5+day 21 17.5 15

Low Risk: >=38wk + no risk factors

Med Risk: (>=38wk + risk factors) or (35-37 wk and no risk factors)

High Risk: 35-37wk + risk factors

see http://bilitool.org/

Source

UpToDate