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- W1569282602 abstract "Jaundice is common in healthy newborn infants. It is the result of normal adaptive physiological processes and generally peaks in severity between 3 and 5 days after birth and then resolves over the next 7 to 10 days. When bilirubin rises to toxic levels, bilirubin encephalopathy and subsequent kernicterus can occur. Phototherapy is a well-established and safe treatment of neonatal jaundice. A recent increase nationwide in the number of infants with kernicterus has made prevention of severe hyperbilirubinemia a national priority. Clinical estimation of jaundice severity is notoriously inaccurate. This fact coupled with early discharge of newborns, often before bilirubin levels have peaked, makes hospital-based risk assessment an essential intervention before discharge.In 1994, the American Academy of Pediatrics (AAP) first published a clinical practice guideline to provide a framework for the prevention and management of hyperbilirubinemia (1). The guideline, however, has not reduced the number of cases of bilirubin-induced neurological damage (2, 3). Consequently, in 2004, the AAP published new guidelines for the management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. Key recommendations of the guideline include the following:2. Establish nursery protocols for the identification and evolution of hyperbilirubinemia… .4. Recognize that visual estimation of the degree of jaundice can lead to errors, particularly in darkly pigmented infants.5. Interpret all bilirubin levels according to the infant's age in hours.6. Recognize that infants at less than 38 weeks' gestation, particularly those who are breastfed, are at higher risk of developing hyperbilirubinemia and require closer surveillance and monitoring.7. Perform a systematic assessment on all infants before discharge for the risk of severe hyperbilirubinemia… .9. Provide appropriate follow-up based on the time of discharge and the risk assessment (4)." @default.
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- W1569282602 date "2005-07-01" @default.
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- W1569282602 title "The Challenge of Preventing Neonatal Bilirubin Encephalopathy: A New Nursing Protocol in the Well Newborn Nursery" @default.
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- W1569282602 doi "https://doi.org/10.1080/08998280.2005.11928070" @default.
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