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Review
. 2003 Nov;88(6):F459-63.
doi: 10.1136/fn.88.6.f459.

Treatment of jaundice in low birthweight infants

M J Maisels  1 , J F Watchko
Affiliations
Review

Treatment of jaundice in low birthweight infants

M J Maisels et al. Arch Dis Child Fetal Neonatal Ed. 2003 Nov.

Abstract

Exchange transfusion and phototherapy remain the staples of intervention for the jaundiced newborn. Clinical management of the jaundiced low birthweight infant is discussed.

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Figures

Figure 1
Figure 1
Number of infants in different populations with birth weight < 1500 g who received exchange transfusions between 1974 and 1997. Note 1: a total of 215 newborns < 1500 g in the National Institute of Child Health and Human Development (NICHHD) cooperative phototherapy trial assigned to the control group (did not receive phototherapy). Seventy seven of 215 patients (35.8%) received a total of 161 exchange transfusions. In the phototherapy group, 17 of 196 (8.7%) infants received exchange transfusions. These data are included to illustrate the frequency of exchange transfusion before the introduction of phototherapy.16 Note 2: of a total of 1338 live births < 1500 g in the Netherlands (1983), 37 infants (2.8%) required at least one exchange transfusion.59 Note 3: of 833 live births (500–1500 g) in a 17 county region in North Carolina, two infants required an exchange transfusion (0.24%).10 Note 4: no exchange transfusions were performed in 1213 live births < 1500 g at William Beaumont Hospital, Royal Oak, MI between 1988 and 1997.11
Figure 2
Figure 2
Relation between average spectral irradiance and decrease in serum bilirubin concentration. Full term infants with non-haemolytic hyperbilirubinaemia were exposed to special blue lights (Phillips TL 52/20 W) of different intensities. Spectral irradiance was measured as the average of readings at the head, trunk, and knees. Drawn from the data of Tan.40
Figure 3
Figure 3
Effect of light source and distance from the light source to the infant on average spectral irradiance. Measurements were made across the 425–475 nm band using a commercial radiometer (Olympic Bilimeter Mark II). The phototherapy unit was fitted with eight 24 inch fluorescent tubes. Curves were plotted using linear curve fitting (True Epistat; Epistat Services, Richardson, Texas, USA). The best fit is described by the equation y = AeBx.12
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References

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