Uniform treatment thresholds for hyperbilirubinemia in preterm infants: Background and synopsis of a national guideline

Imhoff, Deirdre E. van; Dijk, Peter H.; Hulzebos, Christian V.

doi:10.1016/j.earlhumdev.2011.04.004

Cited by 39 publications

(29 citation statements)

References 32 publications

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“…As mentioned before, it would be interesting to perform aEEG recordings in preterm infants with much higher TSB levels. Because of the national implementation of lower treatment thresholds for preterm infants with unconjugated hyperbilirubinemia, this is no longer possible in The Netherlands [25]. To date, long-term follow-up has not been performed.…”

Section: Discussionmentioning

confidence: 99%

Moderate Unconjugated Hyperbilirubinemia Causes a Transient but Delayed Suppression of Amplitude-Integrated Electroencephalographic Activity in Preterm Infants

Horst¹,

Bos²,

Duijvendijk³

et al. 2012

Neonatology

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Background: Unconjugated hyperbilirubinemia occurs frequently in preterm infants and may result in bilirubin encephalopathy. Amplitude-integrated electroencephalography (aEEG) is used to evaluate brain function in newborns. Objectives: To investigate the influence of total serum bilirubin (TSB) on the aEEG amplitude of preterm infants and to evaluate aEEG as a noninvasive method to identify acute bilirubin encephalopathy. Methods: We performed a prospective observational study of 34 infants with a gestational age (GA) of 26–31 6/7 weeks. Infants had aEEG recordings on the 1st–5th, 8th and 15th day after birth. Infants with asphyxia, intraventricular hemorrhage >grade I or circulatory insufficiency were excluded. aEEG was evaluated by calculating the mean 5th, 50th and 95th centiles of the aEEG amplitudes. Results: TSB peaked on the 4th day after birth. There was no synchronous relationship between TSB and aEEG amplitudes. The 5th, 50th, and 95th aEEG amplitude centiles on the 8th day correlated negatively with the TSB peak value (r = –0.37, p = 0.048; r = –0.60, p = 0.001; r = –0.44, p = 0.017, respectively), irrespective of GA. The 5th and 50th aEEG amplitude centiles increased with increasing GA (r = 0.45, p < 0.001, and r = 0.26, p < 0.001, respectively) and postnatal age (r = 0.25, p < 0.001, and r = 0.16, p = 0.023, respectively). Conclusions: TSB had no direct effect on aEEG amplitudes in preterm infants. There is, however, a delayed effect on electrocerebral activity in the 2nd week after birth.

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Section: Discussionmentioning

confidence: 99%

Moderate Unconjugated Hyperbilirubinemia Causes a Transient but Delayed Suppression of Amplitude-Integrated Electroencephalographic Activity in Preterm Infants

Horst¹,

Bos²,

Duijvendijk³

et al. 2012

Neonatology

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“…25 Compared with both the NICE 11 and Norwegian 5 guidelines, we recommend phototherapy at lower bilirubin levels although our thresholds are similar to the Dutch recommendations. 2 A long-term follow-up of a large population of such infants might identify which of these suggested approaches is preferred.…”

Section: New Recommendationsmentioning

confidence: 99%

“…[2][3][4][5][6][7] The AAP guideline 1 has been widely adopted in the United States and elsewhere but there is no similar guideline in the United States for the treatment of infants <35 weeks gestation. In lieu of such direction, neonatal intensive care units (NICUs) have established their own criteria for the use of phototherapy and exchange transfusion in these infants, most often based on birth weight or gestational age.…”

Section: Introductionmentioning

confidence: 99%

An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation

et al. 2012

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We provide an approach to the use of phototherapy and exchange transfusion in the management of hyperbilirubinemia in preterm infants of <35 weeks of gestation. Because there are limited data for evidence-based recommendations, these recommendations are, of necessity, consensusbased. The recommended treatment levels are based on operational thresholds for bilirubin levels and represent those levels beyond which it is assumed that treatment will likely do more good than harm. Long-term follow-up of a large population will be needed to evaluate whether or not these recommendations should be modified.

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“…However, international guidelines for preterm infants are lacking and rather local or national guidelines for preterm infants are used, such as the consensus-based guideline on hyperbilirubinemia for preterm infants of 35 or less weeks of gestational age in The Netherlands (www.neonatologiestudies.nl/main/richtlijnen) [38].…”

Section: Treatmentmentioning

confidence: 99%

Kernicterus, Bilirubin Induced Neurological Dysfunction and New Treatments for Unconjugated Hyperbilirubinemia

Hulzebos

Tiribelli

Cuperus³

et al. 2012

Neonatology

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Uniform treatment thresholds for hyperbilirubinemia in preterm infants: Background and synopsis of a national guideline

Cited by 39 publications

References 32 publications

Moderate Unconjugated Hyperbilirubinemia Causes a Transient but Delayed Suppression of Amplitude-Integrated Electroencephalographic Activity in Preterm Infants

Moderate Unconjugated Hyperbilirubinemia Causes a Transient but Delayed Suppression of Amplitude-Integrated Electroencephalographic Activity in Preterm Infants

An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation

Kernicterus, Bilirubin Induced Neurological Dysfunction and New Treatments for Unconjugated Hyperbilirubinemia

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