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We provide a predictive TcB tool that could allow for a noninvasive, risk-based approach to neonatal hyperbilirubinemia.

We provide data on TcB levels for the first 120 postnatal hours from a large population of white, healthy, term and near-term neonates. We also present a percentile-based TcB nomogram designated for noninvasive and hour-specific evaluation of neonatal hyperbilirubinemia.

Pediatric health care professionals have marked deficiencies in their knowledge on pulse oximetry, particularly in regard to the principles underlying the method and its limitations. Strategies that are directed at improving knowledge on pulse oximetry are urgently needed at all levels of experience in pediatric care.

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reactive thrombocytosis was a frequent finding in young infants with SBI. Thrombocytosis >450,000 cells/mm3, in combination with leucocytosis, elevated CRP and pyuria, may help in early recognition of febrile young infants at risk for SBI.

WHAT'S KNOWN ON THIS SUBJECT: Although the natural course of bilirubin levels has been extensively studied in general neonatal populations, there is a paucity of data regarding bilirubin trends in neonates before the development of significant hyperbilirubinemia. WHAT THIS STUDY ADDS:This study provides data on the natural course of transcutaneous bilirubin before the development of significant hyperbilirubinemia, and on the effect of different demographic and perinatal risk factors on the rate of bilirubin increase in neonates with borderline bilirubin values. abstract OBJECTIVES: To provide data on the natural course of transcutaneous bilirubin (TcB) levels in neonates before the development of significant hyperbilirubinemia, and to assess the effect of different demographic and perinatal factors on the rate of TcB increase. METHODS:We analyzed 2454 TcB measurements from 419 neonates before the development of significant hyperbilirubinemia. Mean TcB values and TcB percentiles for designated times were calculated, and the effect of different risk factors on the rate of TcB increase was assessed. TcB percentile curves were plotted for comparison on a population-based TcB nomogram.RESULTS: Blood incompatibilities and glucose-6-phosphate dehydrogenase deficiency were associated with higher rates of TcB increase during the first 36 to 48 postnatal hours, whereas smaller gestational age, increased weight loss, and exclusive breastfeeding had a similar but later effect. Compared with general population norms, a different pattern of TcB increase was noted in neonates who developed significant hyperbilirubinemia, but with a substantial overlap of TcB values during the first 24 to 48 postnatal hours. CONCLUSIONS:We provide data on the natural course of TcB levels before the development of significant hyperbilirubinemia in a white population of term and near-term neonates. Smaller gestational age, blood incompatibilities, glucose-6-phosphate dehydrogenase deficiency, increased weight loss, and exclusive breastfeeding significantly affected the rate of TcB increase in a time-dependent manner. These findings may assist in assessing the risk for significant hyperbilirubinemia and planning appropriate follow-up strategies for neonates with borderline bilirubin levels. Pediatrics 2012;130:e898-e904 AUTHORS: Greece KEY WORDS hyperbilirubinemia, jaundice, neonates, transcutaneous bilirubin ABBREVIATIONS AAP-American Academy of Pediatrics G6PB-glucose-6-phosphate dehydrogenase TcB-transcutaneous bilirubin TSB-total serum bilirubin www.pediatrics.org/cgi/

SAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.