Neonatal jaundice: Difference between revisions

Revision as of 06:42, 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

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

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

Authors:

Neonatal jaundice: Difference between revisions

Revision as of 06:42, 12 March 2011

Contents

Risk Factors:

Diagnosis

Work-Up

Source

Neonatal�Jaundice[/rename.php?renamepage=Neonatal%C2%A0Jaundice �]

Page Tools

Insert links

@@ Line 1: / Line 1: @@
-==<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">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">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">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">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">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">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">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">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>
+<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==
+== Diagnosis ==
 DIRECT- conjugated, post- liver
@@ Line 51: / Line 51: @@
 - 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">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">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">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">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">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">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">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">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>
+<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"
+{| class="pbNotSortable" cellpadding="1" cellspacing="1" width="200"
+|-
 | Age
 | Low
@@ Line 100: / Line 101: @@
 | 20
 | 17.5
 |
 .5
 |-
 | 5+day
@@ Line 108: / Line 110: @@
 | 15
 |}
-<nowiki>*Total serum bilirubin (mg/dL)</nowiki>
 Low Risk: >=38wk + no risk factors
@@ Line 119: / Line 119: @@
 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>
+== Source ==
-Bilitool.org
-==Source==
-DONALDSON 10/07�(from UpToDate), Mistry, DeBonis
+DONALDSON 10/07 (from UpToDate), Mistry, DeBonis
 <div id="wikiedit" style="display: none"><div id="editor-panel" class="box">
+= Neonatal�Jaundice[/rename.php?renamepage=Neonatal%C2%A0Jaundice �] =
-=Neonatal�Jaundice[/rename.php?renamepage=Neonatal%C2%A0Jaundice �]=
+{| id="edit-panel" style="table-layout: fixed;  width: 100%"
-{| id="edit-panel" style="table-layout: fixed; width: 100%"
 |-
-|
+| <div id="editframe"></div><div id="edit-toolbar-outer" style="background: none repeat scroll 0% 0% rgb(247, 247, 247);  border-right: 1px solid rgb(221, 221, 221);  border-width: 1px;  border-style: solid;  border-color: rgb(247, 247, 247) rgb(221, 221, 221) rgb(221, 221, 221)"><div id="revcomment_section" style="display: none"><div id="revcomment_top">Describe your changes:[# (hide this)]</div><div class="entry"></div></div><div id="edit-toolbar" class="secondarypagetoolbar"><span id="show_tags" style="float: right;  margin: 5px">Edit tags</span><span id="show_revcomment" style="float: right;  margin: 5px">Describe your changes</span>[#pbedit <span id="saveButton" class="iconbutton savepage">'''Save'''</span>][# <span id="saveAndContinue" class="iconbutton savecontinue" style="position: relative">Save and Continue</span>]<span style="line-height: 30px">or [/w/page/11229516/Neonatal Jaundice?unlock=true Cancel]</span></div><div style="clear: both;  line-height: 1px"><font size="1px">�</font></div><div id="tag-settings" class="page-settings-panel" style="margin-top: 0.75em;  display: none">
-<div id="editframe"></div><div id="edit-toolbar-outer" style="background: #f7f7f7; border: 1px solid #ddd; border-top: 1px solid #f7f7f7"><div id="revcomment_section" style="display: none"><div id="revcomment_top">Describe your changes:[# (hide this)]</div><div class="entry"></div></div><div id="edit-toolbar" class="secondarypagetoolbar"><span id="show_tags" style="float: right; margin: 5px">Edit tags</span><span id="show_revcomment" style="float: right; margin: 5px">Describe your changes</span><span id="autosave_msg" class="aux"></span>[#pbedit <span id="saveButton" class="iconbutton savepage">'''Save'''</span>][# <span id="saveAndContinue" class="iconbutton savecontinue" style="position: relative">Save and Continue</span>]<span style="line-height: 30px">or [/w/page/11229516/Neonatal Jaundice?unlock=true Cancel]</span><span id="save_msg" class="aux loading"></span></div><div style="clear: both; line-height: 1px"><font size="1px">�</font></div><div id="tag-settings" class="page-settings-panel" style="margin-top: 0.75em; display: none">
 {| width="100%"
-| style="width: 4em" |
+|-
+| style="width: 4em" |
 Tags
-|
+|
 e.g. report, new release, planning
 |}
+<div style="clear: both;  line-height: 1px"><font size="1px">�</font></div><div id="tagcloud"></div></div></div>
-<div style="clear: both; line-height: 1px"><font size="1px">�</font></div><div id="tagcloud"></div></div></div>
+| <div id="editor-column" class="thingbar" style="margin-left: 12px"><div id="edit-tools">
-|
+==== Page Tools ====
-<div id="editor-column" class="thingbar" style="margin-left: 12px"><div id="edit-tools">
-====Page Tools====
 [/rename.php?renamepage=Neonatal%C2%A0Jaundice Rename this page] [# Delete this page]<div class="editor-module"><div class="header">
+=== Insert links ===
-===Insert links===
 Insert links to other pages or uploaded files.
+</div><div class="editor-module-tabs">[# Pages] [# Images and files]</div><div class="content"><div id="thingbar-pages" style="display: none"><div style="border-bottom: 1px dotted rgb(187, 187, 187);  padding-bottom: 0.5em;  margin-bottom: 0.5em"><font size="10px">[javascript:void(0); Insert a link to a new page]</font></div>
-</div><div class="editor-module-tabs">[# Pages] [# Images and files]</div><div class="content"><div id="thingbar-pages" style="display: none"><div style="border-bottom: 1px dotted #bbb; padding-bottom: 0.5em; margin-bottom: 0.5em"><font size="10px">[javascript:void(0); Insert a link to a new page]</font></div>
+#<div><center>Loading...</center></div>
+</div><div id="thingbar-images" style="display: none"><div id="thingbar-upload" style="border-bottom: 1px dotted rgb(187, 187, 187);  padding-bottom: 0.5em;  margin-bottom: 0.5em"></div>
-# <div><center><span id="thingbarLoadIcon"></span> Loading...</center></div>
+#No images or files uploaded yet.
+<div style="border-top: 1px dotted rgb(187, 187, 187);  padding-top: 0.5em;  margin-top: 0.5em"><font size="10px">[javascript:void(0); Insert image from URL]</font></div></div></div></div></div>
-</div><div id="thingbar-images" style="display: none"><div id="thingbar-upload" style="border-bottom: 1px dotted #bbb; padding-bottom: 0.5em; margin-bottom: 0.5em"><font size="10px"></font></div>
-# No images or files uploaded yet.
-<div style="border-top: 1px dotted #bbb; padding-top: 0.5em; margin-top: 0.5em"><font size="10px">[javascript:void(0); Insert image from URL]</font></div></div></div></div></div>
 '''Tip:''' To turn text into a link, highlight the text, then click on a page or file from the list above.
 </div>
 |}
 </div></div>
+<br/>[[Category:Peds]]
-==Risk Factors:==
-) Isoimmune hemolytic disease
-) G6PD deficiency
-) Asphyxia
-) Significant lethargy
-) Temperature instability
-) Sepsis
-) Acidosis
-) 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==
-)  Tbil
-)  Dbil
-)  CBC (for hemolytic anemia)
-)  Coombs or T&S (mom & baby)
-)  ?blood resorption
-)  ?septic
-)  ?Decreased gastric motility
-)  Physiologic/breast milk (none @ birth presents 1st week)
-PHOTOTHERAPY GUIDELINES
-Age	Low	Med	High
-Birth	7.0	5.0	4.0
-h	11.5	9.0	8.0
-h	15	14	10
-h	17.5	15	14
-h	20	17.5	14.5
-+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
-[[Category:Peds]]