Jaundice neonates CG98 Flashcards Preview

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Flashcards in Jaundice neonates CG98 Deck (6)
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1
Q

What level of bilirubin (micromol/l) to start (A) phototherapy and (B) exchange transfusion at 0 hours and 12 hours and 24 hours and 96 hours after birth?

A

0 hours >100 photo AND exchange transfusion

12 hours >150 phototherapy, >200 exchange transfusion

24 hours >200 phototherapy, >300 exchange transfusion

96 hours+ >350 phototherapy, >450 exchange transfusion

2
Q

RFs for hyperbilirinaemia

A

Gestation age <38w

Previous sibling requiring phototherapy

Exclusive breastfeeding

Visible jaundice in first 24 hrs life

3
Q

How to measure bilirubin level?

A

For babies <24 hrs old or <35w prem, use serum bilirubin

For babies >35w gest age or >24 hrs old, use transcutaneous bilirubinometer, then use serum if above thresholds

4
Q

Care during phototherapy?

A

Monitor temp and hydration

Encourage parents to interact and cuddle

Eye protection

5
Q

What increases risk of kernicterus?

A

> 340 bilirubin

Rapidly rising bilirubin

Clinical features of bilirubin encephalopathy

6
Q

What other Ix for underlying disease?

A

all babies:
Packed cell volume
Blood group
Coombs test

consider:
FBC
Glucose-6-phosphate dehydrogenase
Cultures of blood, urine, LP