Neonatal jaundice: Difference between revisions
Line 28: Line 28:
##rH/ ABO incompatibility
##rH/ ABO incompatibility


== <span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">Work-Up</font></span> ==
==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)


<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">1) Tbil</font></span>
==Phototherapy Guidelines==
 
<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)&nbsp;?blood resorption</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)&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>
 
PHOTOTHERAPY GUIDELINES


{| cellpadding="1" cellspacing="1" width="200" border="1"
{| cellpadding="1" cellspacing="1" width="200" border="1"

Revision as of 06:48, 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

  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. Iindirect (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

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

Retrieved from "https://www.wikem.org/w/index.php?title=Neonatal_jaundice&oldid=1086"