The American Academy of Pediatrics issued guidelines for the management of newborn infants with jaundice. These can reduce the risk of the serious neurological complications associated with severe hyperbilirubinemia.
Parameters:
(1) total serum bilirubin
(2) age of the infant in hours
Exclusion: Clinical jaundice at <= 24 hours, since this indicates an underlying disorder
Therapeutic modalities to consider:
(1) phototherapy
(2) exchange transfusion
Age in Hours
Total Serum Bilirubin
Management
25 - 48 hours
< 12 mg/dL
monitor
12 - 14.9 mg/dL
consider phototherapy
15 - 19.9 mg/dL
phototherapy
20 - 24.9 mg/dL
exchange transfusion if intensive phototherapy fails
>= 25.0 mg/dL
exchange transfusion and intensive phototherapy
49 - 72 hours
< 15 mg/dL
monitor
15 - 17.9 mg/dL
consider phototherapy
18 - 14.9 mg/dL
phototherapy
25 - 29.9 mg/dL
exchange transfusion if intensive phototherapy fails
>= 30.0 mg/dL
exchange transfusion and intensive phototherapy
> 72 hours
< 17 mg/dL
monitor
17 - 19.9 mg/dL
consider phototherapy
20 - 24.9 mg/dL
phototherapy
25 - 29.9 mg/dL
exchange transfusion if intensive phototherapy fails
>= 30.0 mg/dL
exchange transfusion and intensive phototherapy
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