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Walk the Even Hospital Database by book and chapter — the raw source passages that ground Ask, DDx, and the rest.
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Clinical Risk Group category. Isoimmune hemolytic disease or G6PD deficiency Asphyxia or lethargy Unstable temperature, sepsis or acidosis Hypoalbuminemia (less than 3 gm/L, a risk factor when considering phototherapy, not transfusion) Sources The American Academy of Pediatric (AAP) Practice Guideline nomograms [1] are used indetermining when exchange transfusion and phototherapy should be initiated. When phototherapy isused, the AAP recommends the use of intensive phototherapy, defined as irradiance in the bluegreen spectrum (wavelength between 430 and 490 nM) greater than or equal to 30 microW/cm2 pernm. For bilirubin levels below the phototherapy thresholds, this assessment tool uses a nomogramfrom the Bhutani study [2], which predicts the likelihood that subsequent serum bilirubin valueswill rise above the 95th percentile. This study only included infants born at or greater than 35weeks gestation with birth weights at or greater than 2000 grams, so the results should only beused in infants of 35 weeks gestation or greater. This nomogram should NOT be used to predictthe natural history of hyperbilirubinemia.
References American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics . 2004 Jul; 114:297-316. Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics . 1999 Jan; 103:6-14. Use of UpToDate is subject to the Subscription and License Agreement . Information on this page may not appear correctly if printed. Legal Notices and Disclaimer All information contained in and produced by the MedCalc 3000 system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer. MedCalc 3000 is Copyright © 1998-2013 Foundation Internet Services