Neurotoxicity is the major consequence of neonatal hyperbilirubinemia. The serum bilirubin level required to cause jaundice varies with. There are now suggested operational thresholds to initiate phototherapy Phototherapy Jaundice is a yellow discoloration of the skin and eyes caused by hyperbilirubinemia (elevated serum bilirubin concentration). In such infants, although risk increases with increasing hyperbilirubinemia, there is no level of hyperbilirubinemia that is considered safe treatment is given based on age and clinical factors. read more, or hypoxia) are at greater risk and intervention may be done at lower levels. In preterm infants, hypothermia increases morbidity and mortality. read more, hypothermia Hypothermia in Neonates Hypothermia is defined by the World Health Organization as a core temperature < 36.5° C (97.7° F). Signs are multiple, nonspecific, and include diminished spontaneous activity, less vigorous sucking. read more, and/or ill (eg, with sepsis Neonatal Sepsis Neonatal sepsis is invasive infection, usually bacterial, occurring during the neonatal period. Complications include perinatal asphyxia, meconium aspiration, polycythemia. read more, small for gestational age Small-for-Gestational-Age (SGA) Infant Infants whose weight is < the 10th percentile for gestational age are classified as small for gestational age. Previously, any infant weighing < 2.5 kg was termed. Prematurity is defined by the gestational age at which infants are born. However, infants who are premature Preterm Infants An infant born before 37 weeks gestation is considered preterm. Consequences of hyperbilirubinemiaĪmong healthy term infants, the threshold for concern typically is considered to be a level > 18 mg/dL ( > 308 micromol/L) see figure Risk of hyperbilirubinemia in neonates Risk of hyperbilirubinemia in neonates ( 1 General reference Jaundice is a yellow discoloration of the skin and eyes caused by hyperbilirubinemia (elevated serum bilirubin concentration). There are numerous causes, which are identified by laboratory testing, hepatobiliary scan. For further discussions of cholestasis and disorders of bilirubin excretion in the neonatal period see neonatal cholestasis Neonatal Cholestasis Cholestasis is failure of bilirubin secretion, resulting in conjugated hyperbilirubinemia and jaundice. Almost all hyperbilirubinemia in the immediate neonatal period is unconjugated, which is termed indirect bilirubin, based on older laboratory measurement methods conjugated bilirubin is termed direct bilirubin. Slightly more than half of all neonates become visibly jaundiced in the first week of life. With increasing bilirubin levels, jaundice seems to advance in a head-to-foot direction, appearing at the umbilicus at about 15 mg/dL (257 micromol/L) and at the feet at about 20 mg/dL (342 micromol/L). The serum bilirubin level required to cause jaundice varies with skin tone and body region, but jaundice usually becomes visible on the sclera at a level of 2 to 3 mg/dL (34 to 51 micromol/L) and on the face at about 4 to 5 mg/dL (68 to 86 micromol/L). Jaundice is a yellow discoloration of the skin and eyes caused by hyperbilirubinemia (elevated serum bilirubin concentration).
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