Neonatal jaundice: Difference between revisions

Revision as of 06:43, 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:

@@ Line 61: / Line 61: @@
 <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)&nbsp;?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)&nbsp;?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)&nbsp;?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>
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 PHOTOTHERAPY GUIDELINES
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 DONALDSON 10/07 (from UpToDate), Mistry, DeBonis
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