The clinical findings in a jaundiced neonate correlate with the severity of bilirubin-induced neurologic dysfunction (BIND). Johnson et al developed the BIND score to help identify an infant who requires more aggressive monitoring and management.
|
Stage of BIND |
Features |
|
IA |
minimal signs; totally reversible with therapy |
|
IB |
progressive signs but reversible with therapy |
|
II |
irreversible signs but severity decreased with prompt and aggressive therapy |
Parameters:
(1) cry pattern
(2) behavior and mental status
(3) muscle tone
|
Parameter |
Finding |
Points |
|
cry pattern |
normal |
0 |
|
|
high-pitched |
1 |
|
|
piercing, shrill, frequency decreased or increased |
2 |
|
|
inconsolable or cries only with stimulation |
3 |
|
behavior and mental status |
normal |
0 |
|
|
sleepy, poor feeding |
1 |
|
|
lethargy, very poor feeding, irritable |
2 |
|
|
semi-coma, intermittent apnea, seizures |
3 |
|
muscle tone |
normal |
0 |
|
|
variable hypotonia |
1 |
|
|
moderate hyper or hypotonia, posturing, bicycling, nuchal or truncal arching |
2 |
|
|
severe hyper or hypotonia, opisthotonus, fever |
3 |
BIND score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
|
BIND Score |
Stage |
|
1 to 3 |
Stage 1A |
|
4 to 6 |
Stage 1B |
|
7 to 9 |
Stage II |
Limitation:
• This assumes that all 3 parameters are affected in to the same degree. An alternative approach is to grade based on the most severe finding.
Purpose: To determine the clinical severity of bilirubin-induced neurologic dysfunction in a jaundiced neonate using the BIND score of Johnson et al.
Specialty: Pedatrics, Gastroenterology
Objective: clinical diagnosis, including family history for genetics, criteria for diagnosis, severity, prognosis, stage, complication detection
ICD-10: P59.8,
