May 21 2020

(CPS, ). Normally, hyperbilirubinemia resolves on its own as the infant processes the bilirubin and excretes it. However, in some infants, it can become. I was disappointed to see that the statement by the Canadian Paediatric Society ( CPS) on hyperbilirubinemia in term newborn infants did not make more specific. The CPS hyperbilirubinemia guidelines are based on universal predischarge bilirubin screening, and use of a nomogram to guide follow-up and treatment.

Author: Taubei Vudocage
Country: Switzerland
Language: English (Spanish)
Genre: Spiritual
Published (Last): 21 February 2017
Pages: 278
PDF File Size: 10.47 Mb
ePub File Size: 1.42 Mb
ISBN: 606-9-82728-234-4
Downloads: 99096
Price: Free* [*Free Regsitration Required]
Uploader: Vusho

Maternal experience with neonatal jaundice. The survey was piloted between December and January Continue reading from June 1, Previous: Further testing may be indicated depending on the infant’s risk. Incidence and causes of severe neonatal hyperbilirubinemia in Canada.

Re: Management of hyperbilirubinemia in term newborn infants

These delays were attributed to both the time required to screen babies and interpret the results, and to decisions to keep babies in hospital for longer when they require follow-up testing but not treatment. Laboratory testing to identity the cause hyperbliirubinemia to be complete in infants with hyperbilidubinemia important hyperbilirubinemia. Difficulties arranging access to total serum bilirubin or transcutaneous bilirubin testing in the community. American Academy of Pediatrics. Reprints are not available from the author.

Total serum bilirubin TSB nomogram for designation of risk in 2, well newborns delivered at 36 or more weeks’ gestation with birth weight of at least 2, g 4 lb, 7 ozor those delivered at 35 or more weeks’ gestation with birth weight of at least 2, g 5 lb, 8 ozbased on hour-specific TSB values. Please review our privacy policy. Cochrane Database Syst Rev. It follows that any service providing phototherapy should be equipped with an irradiance meter.


Suresh and colleagues have suggested that it is not cost-effective to obtain a serum bilirubin level from all infants when they are being discharged. These responses are summarized in Table 7. Leadership from maternal-newborn program leaders. Accessed March 10, Use of phototherapy for neonatal hyperbilirubinemia. CPS cp are reviewed annually, although some may be reaffirmed rather than modified.

From the Department of Paediatrics, St.

Incidence and causes of severe neonatal hyperbilirubinemia in Canada

Infants who receive phototherapy and have an elevated direct-reacting or conjugated bilirubin level cholestatic jaundice may develop bronze baby syndrome.

In addition, the area of skin exposed to the light source will affect clinical effectiveness. Can J Public Health ; One hundred and twenty-one infants Following the final reminder notice, administrators who still had not responded were contacted by telephone and offered the opportunity to conduct the questionnaire verbally over the telephone. Predicting kernicterus in severe unconjugated hyperbilirubinemia. Telephonefaxe-mail moc.

Re: Management of hyperbilirubinemia in term newborn infants

These can be emotionally distressing to parents. The authors are also grateful for input provided by Kevin Coughlin, Sandra Dunn, Melissa Dougherty and Jennifer Medves during the development of the survey questionnaire.

In both Canada and the United States the most common cause for infant readmission is severe hyperbilirubinemia. See Appendix 2 in the original guideline 5 for additional information on measuring the dose of phototherapy, a description of intensive phototherapy, and of light sources used. Although hyperbulirubinemia jaundice is common, acute bilirubin encephalopathy and kernicterus i.

Universal screening for neonatal hyperbilirubinemia is controversial.

Author information Copyright and License information Disclaimer. Transcutaneous bilirubin nomogram for prediction of significant neonatal hyperbilirubinemia. Footnotes This article has been peer reviewed. The high readmission rate within days after initial discharge indicates a need for a more thorough assessment of newborn infants and consideration of strategies to identify at-risk newborns, such as predischarge measurement of serum bilirubin levels.


Qual Saf Health Care. Age of readmission for discharged infants. Pediatr Clin North Am ; The American Academy of Pediatrics has published guidelines for initiating phototherapy Figure 3. However, it has been shown that visual inspection of newborns is not an accurate means of assessing the presence or severity of hyperbilirubinemia.

Phototherapy is an effective treatment for hyperbilirubinemia, but the number needed to treat varies widely depending on sex, gestational age, and time since delivery. Infants who breastfeed exclusively—particularly those who consume inadequate calories—are at increased risk of hyperbilirubinemia.

Worldviews Evid Based Nurs. The CPS endeavours to provide statements that assist with patient care, and welcomes all comments that serve these efforts. Get immediate access, anytime, anywhere.

Acute management of extreme neonatal jaundice — the potential benefits of intensified phototherapy and interruption of enterohepatic bilirubin circulation. As part of a larger project investigating the impact of the CPS hyperbilirubinemia guidelines in Ontario, we conducted a hospital survey to investigate hospital response to the guidelines. Severe neonatal hyperbilirubinemia was identified in 73 infants before they were discharged from hospital.

Efforts to counter this problem target system-based causes such as the limitations of visual assessment of jaundice, failure to recognize the severity of hyperbilirubinemia based on age in hours, lack of appropriate follow-up after early discharge and delays in treatment 5.