[Maggi315]

Hi,<br>
I am looking for help finding references to jaundice levels and when light therapy is indicated. I know there is work out of Hershey and Lancaster in PA about this, higher levels that are OK. But there are still some who are treating at 14. I have read that much higher is OK, that the levels could possibly serve a "protective" function.<br><br>
Anyone have any studies/references in their saved stuff? I had some saved online with my old laptop before it crashed, now I can't find them.<br><br>
Thanks!

 

[mwherbs]

here is probably a paper to find -- it is a systems approach, published by folks in your state even.... and below that is a link to a full text article on what you asked for-----<br><br>
J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):444-55.<br><br>
A systems approach for neonatal hyperbilirubinemia in term and near-term<br>
newborns.<br><br>
Bhutani VK, Johnson LH, Schwoebel A, Gennaro S.<br><br>
School of Medicine at Stanford University, Stanford, California, and Newborn<br>
Pediatrics, Pennsylvania Hospital, Philadelphia 19107, USA.<br><br>
OBJECTIVE: To propose and implement a family-centered systems approach to manage newborn jaundice for safer outcomes. DESIGN: Observational study for known adverse outcomes. SETTING: Semiprivate urban birthing hospital.<br>
PATIENTS/PARTICIPANTS: 31,059 well babies discharged as healthy from a cohort of 41,961 live births (1990-2000). INTERVENTIONS: Incremental implementation of a systems approach that incorporated a hospital policy to (a) authorize nurses to obtain a bilirubin (total serum/transcutaneous) measurement for clinical jaundice, (b) universal predischarge total serum bilirubin (at routine metabolic screening), and (c) targeted follow-up, using the bilirubin nomogram (hour-specific, percentile-based total serum bilirubin/transcutaneous bilirubin). MAIN OUTCOME MEASURES: Known adverse outcomes assessed for early- and late-onset severe hyperbilirubinemia before, during, and after systems approach implementation. RESULTS: Adverse outcomes decreased for well babies:<br>
exchange transfusion, intensive phototherapy, and readmission. During the study period, there were no "never events" (total serum bilirubin greater than or equal to 30 mg/dl), while "close calls" (total serum bilirubin greater than or equal to 25 mg/dl) were 1 in 15,000 as compared to a reported incidence of 1 in 625. CONCLUSIONS: Reduced adverse events, significant reduction in close calls, and no never events met family expectations for safer experiences with this approach.<br><br>
PMID: 16881988 [PubMed - indexed for MEDLINE]<br><br>
-----------------------------------------------------------<br>
ok here is what you want I think- it is a full text article about ped practice- within the article are the bili levels/ age like 24-48 hrs greater than or equal to 15.... in any case it compares what peds do to what is recommended thru APA--<br><br><a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16519797" target="_blank">http://www.pubmedcentral.nih.gov/art...medid=16519797</a>

 

[Reha]

I just wanted to say that this is a hot topic in my area as well. I just helped a woman (through LLL) whose doctors were treating her 3-4 day old with 24 hour phytotherapy (with breaks only every 3 hours for nursing) at bili. levels of 13. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:

 

[mwherbs]

a baby that old with a level 13 would not be one to do photo therayp for-- maybe a preme? -- look at the article from the peds-- they do have published standards...

 

[Doula Gina]

From the American Academy of Family Physicians:<br><br><a href="http://www.aafp.org/afp/20020215/599.html" target="_blank">http://www.aafp.org/afp/20020215/599.html</a>

 

[tamagotchi]

Grrrrrr. They kept my DS in the hospital an extra 5 days for jaundice even though his bili level never went up to 15. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: