Neonatal jaundice: Difference between revisions

Revision as of 06:45, 12 March 2011

Risk Factors

Isoimmune hemolytic disease
G6PD deficiency
Asphyxia
Significant lethargy
Temperature instability
Sepsis
Acidosis
Albumin <3 g/d (if measured)

Diagnosis

DIRECT- conjugated, post- liver

obstructive:

- congenital biliary atresia

- neuroblastoma

- cholesterol cysts

CELLULAR:

- hepatitis

- galactosemia

- sepsis

- TORCHS

- tyrosinemia

- alpha 1 antitrypsis deficiency

INDIRECT- unconjugated, pre-liver

- sepsis

- hypotension

- rH/ ABO incompatibility

Work-Up

1) Tbil

2) Dbil

3) CBC (for hemolytic anemia)

4) Coombs or T&S (mom & baby)

5) ?blood resorption

6) ?septic

7) ?Decreased gastric motility

8) Physiologic/breast milk (none @ birth presents 1st week)

PHOTOTHERAPY GUIDELINES

Age	Low	Med	High
Birth	7.0	5.0	4.0
24h	11.5	9.0	8.0
48h	15	14	10
72h	17.5	15	14
96h	20	17.5	14.5
5+day	21	17.5	15

Low Risk: >=38wk + no risk factors

Med Risk: (>=38wk + risk factors) or (35-37 wk and no risk factors)

High Risk: 35-37wk + risk factors

see http://bilitool.org/

Source

DONALDSON 10/07 (from UpToDate), Mistry, DeBonis

Authors:

@@ Line 1: / Line 1: @@
-== <span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">Risk Factors:</font></span> ==
+==Risk Factors==
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">1) Isoimmune hemolytic disease</font></span>
+#Isoimmune hemolytic disease
+#G6PD deficiency
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">2) G6PD deficiency</font></span>
+#Asphyxia
+#Significant lethargy
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">3) Asphyxia</font></span>
+#Temperature instability
+#Sepsis
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">4) Significant lethargy</font></span>
+#Acidosis
+#Albumin <3 g/d (if measured)
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">5) Temperature instability</font></span>
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">6) Sepsis</font></span>
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">7) Acidosis</font></span>
-<span class="Apple-style-span" style="line-height: normal;  border-collapse: collapse"><font color="#000000">8) Albumin <3 g/d (if measured)</font></span>
 == Diagnosis ==