Neonatal jaundice

Revision as of 23:16, 29 October 2010 by Robot (talk | contribs) (Created page with "==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/...")
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

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

DIRECT- conjugated, post- liver

obstructive:

- congenital biliary atresia

- neuroblastoma

- cholesterol cysts


CELLULAR:

- hepatitis

- galactosemia

- sepsis

- TORCHS

- tyrosinemia

- alpha 1 antitrypsis deficiency


INDIRECT- unconjugated, pre-liver

- sepsis

- hypotension

- 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


  • Total serum bilirubin (mg/dL)

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/


    • Option #2: Provide conventional photoRx at home with levels 2-3mg/dL lower without RF.

Bilitool.org


Source

DONALDSON 10/07 (from UpToDate), Mistry, DeBonis