{"id":2451,"date":"2010-06-07T03:00:00","date_gmt":"2010-06-07T03:00:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/hbped\/"},"modified":"2025-05-14T19:08:51","modified_gmt":"2025-05-14T19:08:51","slug":"hbped","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/hbped\/","title":{"rendered":"Phototherapy and Exchange Transfusion in Neonatal Hyperbilirubinaemia"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>In unconjugated hyperbilirubinemia, the ultimate goal is the prevention of kernicterus and its potentially devastating effects.<br \/>\nPhototherapy represented an important advance in the treatment of jaundice, enabling the effective and relatively rapid reduction of high bilirubin levels and facilitating the prevention of kernicterus.<br \/>\nExchange transfusion is the only alternative to phototherapy for controlling hyperbilirubinaemia.<br \/>\n<!--more--><br \/>\n<strong>American Academy of Pediatrics recommendations for phototherapy<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td rowspan=\"3\">Risk category<\/td>\n<td colspan=\"5\" align=\"center\">Total serum bilirubin (mg\/dL)<\/td>\n<\/tr>\n<tr align=\"center\">\n<td colspan=\"5\">Age (h)<\/td>\n<\/tr>\n<tr>\n<td align=\"center\">24<\/td>\n<td align=\"center\">36<\/td>\n<td align=\"center\">48<\/td>\n<td align=\"center\">72<\/td>\n<td align=\"center\">96<\/td>\n<\/tr>\n<tr>\n<td>High risk (35\u201337 weeks + risk factors<sup>a<\/sup>)<\/td>\n<td align=\"center\">8<\/td>\n<td align=\"center\">9<\/td>\n<td align=\"center\">11<\/td>\n<td align=\"center\">13<\/td>\n<td align=\"center\">14<\/td>\n<\/tr>\n<tr>\n<td>Medium risk (&gt;\/=38 weeks + risk factors or 35\u201337<br \/>\nweeks and well)<\/td>\n<td align=\"center\">10<\/td>\n<td align=\"center\">12<\/td>\n<td align=\"center\">13<\/td>\n<td align=\"center\">15<\/td>\n<td align=\"center\">17<\/td>\n<\/tr>\n<tr>\n<td>Low risk (&gt;38 weeks and well)<\/td>\n<td align=\"center\">12<\/td>\n<td align=\"center\">13<\/td>\n<td align=\"center\">15<\/td>\n<td align=\"center\">18<\/td>\n<td align=\"center\">20<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><sup>a<\/sup> Risk factors are defined as isoimmune hemolytic disease, G6PD deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis.<\/p>\n<p><strong>American Academy of Pediatrics recommendations for exchange transfusion<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 62.0606%;\" rowspan=\"3\">Risk category<\/td>\n<td style=\"width: 37.8182%;\" colspan=\"5\" align=\"center\">Total serum bilirubin (mg\/dL)<\/td>\n<\/tr>\n<tr align=\"center\">\n<td style=\"width: 37.8182%;\" colspan=\"5\">Age (h)<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center; width: 8.12122%;\" align=\"center\">24<\/td>\n<td style=\"text-align: center; width: 6.54542%;\" align=\"center\">36<\/td>\n<td style=\"text-align: center; width: 8.00004%;\" align=\"center\">48<\/td>\n<td style=\"text-align: center; width: 7.87878%;\" align=\"center\">72<\/td>\n<td style=\"text-align: center; width: 7.27273%;\" align=\"center\">96<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 62.0606%;\">High risk (35\u201337 weeks + risk factors<sup>a<\/sup>)<\/td>\n<td style=\"text-align: center; width: 8.12122%;\">15<\/td>\n<td style=\"text-align: center; width: 6.54542%;\">16<\/td>\n<td style=\"text-align: center; width: 8.00004%;\">17<\/td>\n<td style=\"text-align: center; width: 7.87878%;\">18<\/td>\n<td style=\"text-align: center; width: 7.27273%;\">19<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 62.0606%;\">Medium risk (&gt;\/=38 weeks + risk factors or 35\u201337 weeks and well)<\/td>\n<td style=\"text-align: center; width: 8.12122%;\">16.5<\/td>\n<td style=\"text-align: center; width: 6.54542%;\">18<\/td>\n<td style=\"text-align: center; width: 8.00004%;\">19<\/td>\n<td style=\"text-align: center; width: 7.87878%;\">20<\/td>\n<td style=\"text-align: center; width: 7.27273%;\">22<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 62.0606%;\">Low risk (&gt;38 weeks and well)<\/td>\n<td style=\"text-align: center; width: 8.12122%;\">19<\/td>\n<td style=\"text-align: center; width: 6.54542%;\">21<\/td>\n<td style=\"text-align: center; width: 8.00004%;\">22<\/td>\n<td style=\"text-align: center; width: 7.87878%;\">24<\/td>\n<td style=\"text-align: center; width: 7.27273%;\">25<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><sup>a<\/sup> Risk factors are defined as isoimmune hemolytic disease, G6PD deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Rennie JM, Sehgal A, De A, Kendall GS, Cole TJ. Range of UK practice regarding thresholds for phototherapy and exchange transfusion in neonatal hyperbilirubinaemia. Arch Dis Child Fetal Neonatal Ed. 2009 Sep;94(5):F323-7.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19000996\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Colletti JE, Kothari S, Jackson DM, Kilgore KP, Barringer K. An emergency medicine approach to neonatal hyperbilirubinemia. Emerg Med Clin North Am. 2007 Nov;25(4):1117-35\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17950138\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297-316.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15231951\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: May 26, 2010<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[441],"tags":[1309,1310,1311,1312,447,667,1313],"class_list":["post-2451","post","type-post","status-publish","format-standard","hentry","category-pediatrics","tag-exchange-transfusion","tag-hiperbilirrubinemia","tag-hyperbilirubinaemia","tag-luminoterapia","tag-neonatal","tag-pediatrics","tag-phototherapy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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