Jaundice in Full-Term and Near-Term Babies Who Leave the Hospital within 36 Hours: The Pediatrician’s Nemesis

Mj, Maisels; Tb, Newman

doi:10.1016/s0095-5108(18)30116-7

Cited by 66 publications

(42 citation statements)

References 20 publications

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“…1 Management of NHB has become more challenging because newborn infants are discharged early and unreliable post-discharge follow-up increases the risk of severe NHB and even bilirubin encephalopathy in these infants. 2 Estimation of jaundice by visual assessment of the skin or sclera is quick, but correlates poorly with total serum bilirubin (TSB) measurement when used in newborn infants with mixed ethnicity and racial backgrounds. Thus, lower thresholds for starting phototherapy (PHT) may be appropriate.…”

Section: Introductionmentioning

confidence: 99%

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

et al. 2011

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Objective: To determine whether transcutaneous bilirubin (TcB) from covered skin (TcB-C) during and after discontinuing phototherapy (PHT) is reliable in treating neonatal jaundice.Study Design: In this prospective observational study, before starting PHT, part of the forehead was covered. TcB-C and TcB from exposed skin (TcB-E) to PHT were measured before starting PHT, on a 12-hourly basis while receiving PHT and 6 h after stopping PHT. We used ANOVA (analysis of variance) and Bonferroni's t-tests.Result: A total of 39 infants were enrolled (mean gestation 39 weeks, 51% males and 80% Hispanic).

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Section: Introductionmentioning

confidence: 99%

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

et al. 2011

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“…6 -10 Kernicterus has been described in a small subset of these infants. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] For these reasons, early identification of newborn infants at risk for developing severe hyperbilirubinemia and possible bilirubin-induced neurologic dysfunction has become a public health issue. Attempts to ad-dress this issue have included documentation of clinical and epidemiologic risk factors, [27][28][29][30][31] development of a practice parameter by the American Academy of Pediatrics, 32 and definition of a set of minimal standards for early discharge and subsequent followup.…”

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confidence: 99%

Noninvasive Measurement of Total Serum Bilirubin in a Multiracial Predischarge Newborn Population to Assess the Risk of Severe Hyperbilirubinemia

et al. 2000

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ABSTRACT. Background. Jaundice in near-term and term newborns is a frequent diagnosis that may prompt hospital readmission in the first postnatal week. Hyperbilirubinemia, when excessive, can lead to potentially irreversible bilirubin-induced neurotoxicity. Predischarge risk assessment (at 24 -72 hours of age) for subsequent excessive hyperbilirubinemia is feasible by a laboratory-based assay of total serum bilirubin (TSB).Hypothesis. Noninvasive, transcutaneous, point-ofcare measurement of transcutaneous bilirubin (TcB) predischarge by multiwavelength spectral analysis, using a portable BiliCheck device (SpectRx Inc, Norcross, GA), is clinically equivalent to measurement of TSB in a diverse, multiracial term and near-term newborn population and predictive of subsequent hyperbilirubinemia.Methodology. We evaluated a hand-held device that uses multiwavelength spectral reflectance analysis to measure TcB (BiliCheck). The study population (490 term and near-term newborns) was racially diverse (59.1% white, 29.5% black, 3.46% Hispanic, 4.48% Asian, and 3.46% other) and was evaluated at 2 separate institutions using multiple (11) devices. The postnatal age ranged from 12 to 98 hours and the ranges of birth weights and gestational ages were 2000 to 5665 g and 35 to 42 weeks, respectively. All transcutaneous evaluations were performed contemporaneously and paired with a heelstick TSB measurement. All TSB assays were performed by high performance liquid chromatography, as well as by diazo dichlorophenyldiazonium tetrafluoroborate techniques.Results. TSB values ranged from .2 to 18.2 mg/dL (mean ؎ standard deviation: 7.65 ؎ 3.35 mg/dL). The overall correlation of TSB (by high performance liquid chromatography technique) to TcB (by BiliCheck devices) was linear and statistically significant (r ‫؍‬ .91; r 2 ‫؍‬ .83; TcB ‫؍‬ .84; TSB ‫؍‬ ؉.75; standard error of regression line ‫؍‬ 1.38; P < .001; n ‫؍‬ 490 infants; 1788 samples). Similar regression statistics were evident in subset populations categorized by race (white: r ‫؍‬ .91 [n ‫؍‬ 289 infants]; black: r ‫؍‬ .91 [n ‫؍‬ 145 infants]) as well as by gestation (term: r ‫؍‬ .91 [n ‫؍‬ 1625 samples]; near-term: r ‫؍‬ .89 [n ‫؍‬ 163 samples]). Intradevice precision was determined to be .59 mg/dL (2-3 measurements per infant with 1 device; n ‫؍‬ 210 infants; 510 samples in a separate subset). Interdevice evaluation of 11 devices determined the precision to be .68 mg/dL (2-4 devices used for measurements per patient).In 23 of 419 of the study population infants who were in the 24-to 72-hour age range, the predischarge TSB values designated them to be at high risk for subsequent excessive hyperbilirubinemia (above the 95th percentile track on the hour-specific bilirubin nomogram). For these infants, the paired BiliCheck TcB values were all above the 75th percentile track (negative predictive value ‫؍‬ 100%; positive predictive value ‫؍‬ 32.86%; sensitivity ‫؍‬ 100%; specificity ‫؍‬ 88.1%; likelihood ratio ‫؍‬ 8.43).Conclusions. Our data demonstrate the accuracy and reproducibil...

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“…[3] Günümüzde ekonomik nedenlerden dolayı doğum sonu annelerin erken taburcu edilmesinin ön plana çıkması yenidoğanların hastaneden erken ayrılması-na yol açmıştır. [4][5][6][7][8][9][10][11][12] Bu durum yenidoğan döneminde ilk günlerde görülen problemlerin (hiperbilirubinemi, beslenme problemleri…vs) evde ortaya çıkmasına, sonuçta gözden kaçmasına ya da hastaneye başvuruda geç kalınmasına, yenidoğanların hastaneye yeniden yatışına neden olmaktadır. [13][14][15] Son zamanlarda görül-müştür ki ciddi hiperbilirubinemi term, sağlıklı, anne sütü alan yenidoğanlarda da görünür neden olmadan ortaya çıkabilmekte ve kernikterus gelişebilmektedir.…”

Section: Discussionunclassified

“…[4][5][6][7][8][9][10] Erken taburcu edilme, anne ve bebek arasındaki yakınlaşmanın erken dönemde sağlanması ve uzun süre hastanede kalmanın getirdiği maliyet yükünün azaltılması açısından önemlidir. Diğer taraftan ise, yenidoğanlarda oldukça sık görülen ve nörotoksisite riski olan hiperbilirubineminin takibini zorlaştırmaktadır.…”

Section: Introductionunclassified

The predictive value of 6-12th hour and 24th hour bilirubin levels in determining significant hyperbilirubinemia among healthy term neonates

Özgürhan¹,

Yiğit²,

Korğalı³

et al. 2013

J Kartal TR

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ÖzetAmaç: Bu çalışmada, term bebeklerde 6-12. saat ve 24. saatteki bilirübin değerlerinin oluşabilecek belirgin hiperbilirü-bineminin göstergesi olup olmadığı değerlendirildi. Gereç ve Yöntem:Çalışmaya sağlıklı, term hiperbilirübine-mi tanısı alan yenidoğanlar alındı. Serum total bilirubin öl-çümleri yaşamın ilk 6-12. saatleri arasında yapıldı. Takip eden günlerde 24, 48, 72 ve 96. saatlerde tekrarlandı. Olguların 6-12. saatler arasındaki ve 24. saatteki bilirubin değerleri ROC analizi ile belirgin hiperbilirubineminin göstergesi olup olmadığı açısından değerlendirildi. Bulgular: Çalışmada 134'ü (%48.5) erkek, 142'si (%51.5) kız 276 yenidoğan değerlendirildi. Klinik sarılık 240 (%86) olguda görüldü. Otuz yedi (%13.4) olguda belirgin hiperbilirubinemi gelişti. 6.-12. saatler arasındaki 3.9 mg/dl'nin üzerin-deki bilirubin değerleri %67.6 duyarlılık, %64.9 özgüllük ile (p<0.002) anlamlı bulundu. Pozitif prediktif değer %22.9, negatif prediktif değer %92.8 idi. 24. saatteki 7.7 mg/dl'nin üze-rindeki bilirubin değerleri %78.4 duyarlılık, %77.8 özgüllük ile (p<0.001) anlamlı bulundu. Pozitif prediktif değer %35.4, negatif prediktif değer %95.9 idi. 24. saatteki bilirubin değerlerinin 6-12. saatler arasındaki bilirubin değerlerine göre belirgin hiperbilirubineminin göstergesi olmak açısından daha anlamlı olduğu tespit edildi.Sonuç: Erken taburcu edilen yenidoğanlarda 24. saatteki bilirubin değerleri ileriki günlerde gelişebilecek belirgin hiperbilirubineminin göstergesi olarak anlamlı bir ölçüttür.Anahtar sözcükler: Hiperbilirubinemi; total bilirübin düzeyi; yenidoğan. Summary Background:The predictive value of 6-12th and 24th hour bilirubin levels in determining significant hyperbilirubinemia among healthy term neonates was evaluated in this study.

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Jaundice in Full-Term and Near-Term Babies Who Leave the Hospital within 36 Hours: The Pediatrician’s Nemesis

Cited by 66 publications

References 20 publications

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

Noninvasive Measurement of Total Serum Bilirubin in a Multiracial Predischarge Newborn Population to Assess the Risk of Severe Hyperbilirubinemia

The predictive value of 6-12th hour and 24th hour bilirubin levels in determining significant hyperbilirubinemia among healthy term neonates

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