Neonatal jaundice: Difference between revisions

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==<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">Risk Factors:</font></span>==
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">1) Isoimmune hemolytic disease</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">2) G6PD deficiency</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">3) Asphyxia</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">4) Significant lethargy</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">5) Temperature instability</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">6) Sepsis</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">7) Acidosis</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">8) Albumin <3 g/d (if measured)</font></span>
==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
==<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">Work-Up</font></span>==
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">1) �Tbil</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">2) �Dbil</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">3) �CBC (for hemolytic anemia)</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">4) �Coombs or T&S (mom & baby)</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">5) �?blood resorption</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">6) �?septic</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">7) �?Decreased gastric motility</font></span>
<span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">8) �Physiologic/breast milk (none @ birth presents 1st week)</font></span>
PHOTOTHERAPY GUIDELINES
{| class="pbNotSortable" width="200" cellspacing="1" cellpadding="1"
| 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
|}
<nowiki>*Total serum bilirubin (mg/dL)</nowiki>
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/ <font color="#14456e">http://bilitool.org/</font>]
<nowiki>**Option #2: Provide conventional photoRx at home with levels 2-3mg/dL lower without RF.</nowiki>
Bilitool.org
==Source==
DONALDSON 10/07�(from UpToDate), Mistry, DeBonis
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==Risk Factors:==
==Risk Factors:==


Revision as of 06:40, 12 March 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

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


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

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