An evidence‐based view on hyperbilirubinaemia

Dijk, Peter H.; Hulzebos, Christian V.

doi:10.1111/j.1651-2227.2011.02544.x

Cited by 19 publications

(23 citation statements)

References 45 publications

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“…Phototherapy and exchange transfusion are well-established as the most effective treatments for severe hyperbilirubinaemia [ 4 , 5 ]. The proposed actionable TSB/TcB levels for phototherapy and exchange transfusion reflecting available evidence on current practices for the care of jaundiced infants in LMICs are presented in Table 3 [ 17 , 22 , 52 ]. We adopted the tabular format in the Kenya 2013 guidelines (see Additional file 1 : Table S1) for ease of reference at all levels of care.…”

Section: Reviewmentioning

confidence: 99%

Management of late-preterm and term infants with hyperbilirubinaemia in resource-constrained settings

et al. 2015

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Hyperbilirubinaemia is a ubiquitous transitional morbidity in the vast majority of newborns and a leading cause of hospitalisation in the first week of life worldwide. While timely and effective phototherapy and exchange transfusion are well proven treatments for severe neonatal hyperbilirubinaemia, inappropriate or ineffective treatment of hyperbilirubinaemia, at secondary and tertiary hospitals, still prevails in many poorly-resourced countries accounting for a disproportionately high burden of bilirubin-induced mortality and long-term morbidity. As part of the efforts to curtail the widely reported risks of frequent but avoidable bilirubin-induced neurologic dysfunction (acute bilirubin encephalopathy (ABE) and kernicterus) in low and middle-income countries (LMICs) with significant resource constraints, this article presents a practical framework for the management of late-preterm and term infants (≥35 weeks of gestation) with clinically significant hyperbilirubinaemia in these countries particularly where local practice guidelines are lacking. Standard and validated protocols were followed in adapting available evidence-based national guidelines on the management of hyperbilirubinaemia through a collaboration among clinicians and experts on newborn jaundice from different world regions. Tasks and resources required for the comprehensive management of infants with or at risk of severe hyperbilirubinaemia at all levels of healthcare delivery are proposed, covering primary prevention, early detection, diagnosis, monitoring, treatment, and follow-up. Additionally, actionable treatment or referral levels for phototherapy and exchange transfusion are proposed within the context of several confounding factors such as widespread exclusive breastfeeding, infections, blood group incompatibilities and G6PD deficiency, which place infants at high risk of severe hyperbilirubinaemia and bilirubin-induced neurologic dysfunction in LMICs, as well as the limited facilities for clinical investigations and inconsistent functionality of available phototherapy devices. The need to adjust these levels as appropriate depending on the available facilities in each clinical setting and the risk profile of the infant is emphasised with a view to avoiding over-treatment or under-treatment. These recommendations should serve as a valuable reference material for health workers, guide the development of contextually-relevant national guidelines in each LMIC, as well as facilitate effective advocacy and mobilisation of requisite resources for the optimal care of infants with hyperbilirubinaemia at all levels.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0358-z) contains supplementary material, which is available to authorized users.

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Section: Reviewmentioning

confidence: 99%

Management of late-preterm and term infants with hyperbilirubinaemia in resource-constrained settings

et al. 2015

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“…Accurate prediction and timely discovery lead to prompt treatment, which is critically important. Universal bilirubin screening in neonates is increasingly valued, with accurate, noninvasive TcB an effective tool (Dijk & Hulzebos, 2012). Universal bilirubin screening in neonates is increasingly valued, with accurate, noninvasive TcB an effective tool (Dijk & Hulzebos, 2012).…”

Section: Universal Bilirubin Screeningmentioning

confidence: 99%

“…Transcutaneous bilirubin screening is noninvasive, practical, and effective; when followed by appropriate treatment, it saves lives and prevents permanent neurological debility. Lack of adequate phototherapy and facilities, severity of hyperbilirubinemia complicated by genetic factors, and systems defi cits make ET a more common treatment in developing countries (Dijk & Hulzebos, 2012;Slusher et al, 2011). Appropriate assessment and teaching regarding breastfeeding, and ensuring mother/baby competence in feeding prior to discharge is essential for prevention of kernicterus.…”

Section: Exchange Transfusionmentioning

confidence: 99%

Strategies for Neonatal Hyperbilirubinemia

Wells¹,

Ahmed

Musser

2013

McN: The American Journal of Maternal/Child Nursing

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"Common" neonatal jaundice can lead to dangerous levels of hyperbilirubinemia, causing neurological damage and even death. This article outlines evidence-based assessment techniques, management guidelines, and treatments for neonatal hyperbilirubinemia, addressing complexities that have arisen with new technologies and research results. We also explicate the role of the nurse in both prevention and care of patients and families who are affected by hyperbilirubinemia and jaundice.

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“…Kernicterus refers to the yellow staining of brain by bilirubin together with evidence of neuronal injury. 2,3 The major maternal factors contributing to NNJ are hemolytic disease due to ABO, Rh incompatibility, use of oxytocin, instrumental deliveries, prematurity, birth …”

Section: Introductionmentioning

confidence: 99%