251
Unit 7: Hyperbilirubinemia
Objectives............................................................................................................................ 252
1.. What.Is.Bilirubin?........................................................................................................ 255
2.. How.Is.Bilirubin.Removed.From.the.Body?.............................................................. 255
3.. How.Is.Bilirubin.Measured?........................................................................................ 255
4.. What.Is.Hyperbilirubinemia?...................................................................................... 256
5.. What.Causes.Hyperbilirubinemia?............................................................................ 256
6.. When.Is.Bilirubin.Dangerous.to.the.Brain?............................................................... 257
7.. What.Factors.Influence.Hyperbilirubinemia?............................................................ 257
8.. What.Should.Be.Done.When.a.Baby.Becomes.Jaundiced?..................................... 259
9.. Does.Breastfeeding.Cause.Jaundice?........................................................................ 260
10.. How.Is.Hyperbilirubinemia.Treated?.......................................................................... 260
11.. When.Are.Babies.Treated.With.Phototherapy.for.Hyperbilirubinemia?.................. 261
12.. What.Are.the.Techniques.of.Phototherapy?.............................................................. 263
13.. What.Are.the.Complications.of.Phototherapy?........................................................ 264
14.. When.Is.an.Exchange.Transfusion.Needed?.............................................................. 265
15.. When.Can.Phototherapy.Be.Stopped?...................................................................... 266
16.. When.Is.it.Safe.to.Discharge.a.Baby.With.Hyperbilirubinemia?.............................. 267
Tables.and.Figures
Table 7.1 Guidelines for Initiating Phototherapy in Preterm Neonates ....................... 263
Table 7.2 Bilirubin/Albumin Ratio at Which Exchange Transfusion
Should Be Considered................................................................................. 266
Figure 7.1. Guidelines for Phototherapy for Babies Born at 35 or More
Weeks’ Gestation......................................................................................... 262
Figure 7.2. Guidelines for Exchange Transfusion in Babies Born at 35 or
More Weeks’ Gestation............................................................................... 265
Figure 7.3. Nomogram for Designation of Risk for Severe
Hyperbilirubinemia in Term and Near-Term Well Newborns...................... 267
Recommended.Routines.................................................................................................. 271
Appendix:.. Identification.and.Treatment.of.Jaundice.During
the.First.Week.After.Birth................................................................................274
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