What is bhutani nomogram?

The Bhutani Nomogram is used to determine the level of risk based on the Infant’s hours of age and serum bilirubin result. Predischarge bilirubin in high risk zone. Jaundice observed in the first 24 hours of life. Blood group incompatibility with positive direct Coomb’s test or other hemolytic disease.

How do you investigate neonatal jaundice?

In most cases, a bilirubinometer is used to check for jaundice in babies. Blood tests are usually only necessary if your baby developed jaundice within 24 hours of birth or the reading is particularly high. The level of bilirubin detected in your baby’s blood is used to decide whether any treatment is needed.

What is Kramer’s rule jaundice?

Kramer’s rule describes the relationship between serum bilirubin levels and the progression of skin discolouration (see Table 1 and Figure 1). Trained primary health workers may use this as a screening tool.

When should neonatal jaundice be further investigated?

The most important investigation is to determine whether the infant with prolonged jaundice has liver disease or benign jaundice. The timing of initial investigations should occur between two to four weeks of age (1,6,7).

What are the side effects of phototherapy?

Side effects — Phototherapy is very safe, but it can have temporary side effects, including skin rashes and loose stools. Overheating and dehydration can occur if a baby does not get enough breast milk or formula. Therefore, a baby’s skin color, temperature, and number of wet diapers should be closely monitored.

When should phototherapy be started?

Phototherapy should be instituted when the total serum bilirubin level is at or above 15 mg per dL (257 mol per L) in infants 25 to 48 hours old, 18 mg per dL (308 mol per L) in infants 49 to 72 hours old, and 20 mg per dL (342 mol per L) in infants older than 72 hours.

What is the treatment of neonatal jaundice?

Phototherapy. Phototherapy is treatment with a special type of light (not sunlight). It’s sometimes used to treat newborn jaundice by lowering the bilirubin levels in your baby’s blood through a process called photo-oxidation. Photo-oxidation adds oxygen to the bilirubin so it dissolves easily in water.

What is the management of jaundice?

There’s no treatment for jaundice as such, but disease can be managed by managing symptoms and causes of jaundice. In treating pre-hepatic jaundice, the objective is to prevent the rapid breakdown of red blood cells that’s causing the level of bilirubin to build up in the blood.

What are the complications of neonatal jaundice?

This yellow coloring is called jaundice. When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby’s blood. It can cause athetoid cerebral palsy and hearing loss.

What causes jaundice in a preterm infant?

Jaundice in preterm, as well as full term, infants results from (a) an increased bilirubin load in the hepatocyte, (b) decreased hepatic uptake of bilirubin from the plasma, and/or (c) defective bilirubin conjugation. Hyperbilirubinaemia in preterm infants is more prevalent, more severe, and its course more protracted than in term neonates.

What to know about hyperbilirubinemia in late preterm?

The screening, evaluation, and management of hyperbilirubinemia in the late preterm and term infant are discussed separately.

When to use a nomogram for bilirubin risk?

When using this nomogram, remember that “risk” refers to the risk of a subsequent bilirubin level in that infant >95th percentile for age.

When to use premie bilirecs in newborns?

Premie BiliRecs is designed to help clinicians appropriately prescribe phototherapy or exchange transfusion for infants < 35 weeks post-menstrual age. Required values include the patient’s post-menstrual age* and total bilirubin in either US (mg/dl) or SI (µmol/L) units. This tool is NOT intended for use in infants <48 hours of age.