BIND score: A system to triage infants readmitted for extreme hyperbilirubinemia

Hameed, Numan Nafie; Hussein, Mustafa Amir

doi:10.1016/j.semperi.2020.151354

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…35 In our study, the high mortality and morbidities including the poor outcomes of respiratory support in preterm infants <32 weeks may be related to the maternal-child healthcare system being hampered by many years of long-term conflicts. 36 These data emphasize the need for a global, synergistic quest for solutions. 37…”

Section: Discussionmentioning

confidence: 99%

Timely Respiratory Support Can Improve Clinical Outcomes of Premature Infants in a Country with Limited Medical Resources due to Chronic Conflicts

Saugstad,

Hameed,

Khaleel

2024

Newborn

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Introduction:The children of Iraq have suffered greatly from military conflicts and economic sanctions since 1991. Recent years have shown some improvement in neonatal and infant mortality but more efforts are needed; prematurity and associated respiratory distress syndrome (RDS) remain the two leading causes. In this study, we investigated the efficiency of timely institution of nasal continuous positive airway pressure (nCPAP) in stabilizing these infants. These data are needed for the optimum allocation of financial resources to improve the healthcare outcomes of infants. Patients and methods: This prospective cross-sectional study was carried out over 6 months from April 1st to September 30th, 2022. Inborn preterm infants born between 26 and 32 +0 weeks' gestation who required respiratory support after delivery or immediately after admission were included. The data for the initial course of respiratory support and outcomes were assessed. Results: In our cohort of 123 infants, nCPAP significantly increased the likelihood of clinical stabilization in infants with a gestational age (GA) >28 weeks (p = 0.022), birth weight (BW) ≥1500 gm (p = 0.016), use of antenatal steroids (p = 0.002), Apgar score at 5 minutes of life (p = 0.022), mild radiographic findings (p = 0.007), and sepsis without prolonged rupture of membranes (p = 0.027). Nasal continuous positive airway pressure also reduced the need for surfactant (p = 0.001) and mortality (p = 0.0001). Conclusion: Early institution of nCPAP improved the respiratory status of premature infants who were born at a gestational age from >28 to ≤32 weeks, had birth weight ≥1500 gm, had received antenatal steroids, had a 5-minute Apgar score >7, and had sepsis but no PROM. The success of early nCPAP reduced the need for surfactant and mechanical ventilation, and the risk of pulmonary hemorrhage and mortality.

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Section: Discussionmentioning

confidence: 99%

Timely Respiratory Support Can Improve Clinical Outcomes of Premature Infants in a Country with Limited Medical Resources due to Chronic Conflicts

Saugstad,

Hameed,

Khaleel

2024

Newborn

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“…Based on the peak total serum bilirubin level, neonates with hyperbilirubinemia were classified into 3 groups according to previous literature: mildly increased total serum bilirubin group (205 μmol/L < total serum bilirubin < 342 μmol/L, n = 30) 19 ; severely increased TSB group (342 µmol/L ≤ total serum bilirubin < 428 μmol/L, n = 25) 20 ; and extremely increased TSB group (total serum bilirubin ≥ 428 µmol/L, n = 10). 21 Neonates were also divided into an ABE group (n = 29) and a non-ABE group (n = 36) according to the bilirubin-induced neurologic dysfunction (BIND) scale score. 21 Bilirubin-induced neurologic dysfunction scoring scale was performed within 12 hours of admission, and then up to 3 times per day for each neonate until completion of the conventional brain MRI scan.…”

Section: Methodsmentioning

confidence: 99%

“…21 Neonates were also divided into an ABE group (n = 29) and a non-ABE group (n = 36) according to the bilirubin-induced neurologic dysfunction (BIND) scale score. 21 Bilirubin-induced neurologic dysfunction scoring scale was performed within 12 hours of admission, and then up to 3 times per day for each neonate until completion of the conventional brain MRI scan. Bilirubin-induced neurologic dysfunction scoring scale includes the assessment of crying pattern, behavioral and mental status, and muscle tone.…”

Section: Methodsmentioning

confidence: 99%

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

Liu

Zhang

et al. 2023

J Child Neurol

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Background: This study was designed to investigate the diagnostic value of relative signal intensity of globus pallidus on T1-weighted magnetic resonance imaging (MRI) in neonatal acute bilirubin encephalopathy (ABE). Methods: Participants who were recruited in hospital from April 2019 to May 2020 were grouped into mildly increased total serum bilirubin (TSB) group (n = 30), severely increased TSB group (n = 25), or extremely increased TSB group (n = 10) based on the total serum bilirubin level. Bilirubin-induced neurologic dysfunction scale score was used to determine if participants had acute bilirubin encephalopathy. All neonates underwent conventional brain MRI and the relative signal intensity of globus pallidus was measured on T1-weighted images. The diagnostic value of these 3 indices was assessed by receiver operating characteristic curve analysis. Results: There was a significant correlation between relative signal intensity of globus pallidus and total serum bilirubin level in neonates with hyperbilirubinemia (r = 0.551, P < .001). Relative signal intensity of globus pallidus in the extremely increased TSB group was significantly higher than that in severely increased TSB, mildly increased TSB, and healthy control groups. Relative signal intensity of globus pallidus in the acute bilirubin encephalopathy group was significantly higher than that in the non-acute bilirubin encephalopathy group ( P < .01). The area under the receiver operating characteristic curve of the relative signal intensity of globus pallidus was 0.765 ( P < .01), with sensitivity of 0.655 and specificity of 0.861. The area under the curve of the total serum bilirubin and visual inspection of globus pallidus signal was 0.621 and 0.579, respectively. The area under the curve of relative signal intensity was significantly greater than that of total serum bilirubin and visual inspection ( P = .04 for both). Conclusion: Relative signal intensity of globus pallidus, which is an objective assessment, has the potential to be used as a diagnostic tool for acute bilirubin encephalopathy.

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“…If phototherapy is ineffective, ETT within 2 weeks after birth may be performed, even a second transfusion in some cases. Hyperbilirubinemia may even progress into ABE ( 10 ), a preventable outcome if phototherapy failure could be identified early.…”

Section: Introductionmentioning

confidence: 99%

The development and validation of a predictive model for neonatal phototherapy outcome using admission indicators

Liu

Tang²,

Li³

et al. 2022

Front. Pediatr.

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Delayed exchange transfusion therapy (ETT) after phototherapy failure for newborns with severe hyperbilirubinemia could lead to serious complications such as bilirubin encephalopathy (BE). In this current manuscript we developed and validated a model using admission data for early prediction of phototherapy failure. We retrospectively examined the medical records of 292 newborns with severe hyperbilirubinemia as the training cohort and another 52 neonates as the validation cohort. Logistic regression modeling was employed to create a predictive model with seven significant admission indicators, i.e., age, past medical history, presence of hemolysis, hemoglobin, neutrophil proportion, albumin (ALB), and total serum bilirubin (TSB). To validate the model, two other models with conventional indicators were created, one incorporating the admission indicators and phototherapy failure outcome and the other using TSB decrease after phototherapy failure as a variable and phototherapy outcome as an outcome indicator. The area under the curve (AUC) of the predictive model was 0.958 [95% confidence interval (CI): 0.924–0.993] and 0.961 (95% CI: 0.914–1.000) in the training and validation cohorts, respectively. Compared with the conventional models, the new model had better predictive power and greater value for clinical decision-making by providing a possibly earlier and more accurate prediction of phototherapy failure. More rapid clinical decision-making and interventions may potentially minimize occurrence of serious complications of severe neonatal hyperbilirubinemia.

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BIND score: A system to triage infants readmitted for extreme hyperbilirubinemia

Cited by 8 publications

References 21 publications

Timely Respiratory Support Can Improve Clinical Outcomes of Premature Infants in a Country with Limited Medical Resources due to Chronic Conflicts

Timely Respiratory Support Can Improve Clinical Outcomes of Premature Infants in a Country with Limited Medical Resources due to Chronic Conflicts

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

The development and validation of a predictive model for neonatal phototherapy outcome using admission indicators

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