More research is lacked to determi...

More research is lacked to determine whether the use of standardized data charts used to plat results from bilirubin measurements based in succession hours since birth can help physicians do a better piece of work of predicting potentially serious cases of jaundice in newborns, according to a novel evidence report released by the Agency for Healthcare Research and Quality (AHRQ). "Management of Neonatal Hyperbilirubinemia" is available online at www.ahrq.gov/clinic/tp/ neonataltp.htm or at calling the AHRQ at 800-358-9295

Although the report did not directly address the appropriateness of universal screening for hyperbilirubinemia, it did examine strategies for identifying the condition. High bilirubin evens are a major cause for readmission of newborns to the hospital in the first brace weeks of life.

Jaundice affects more than undivided half of the infants born in the United States each year however generally resolves without any clinical intervention. However, in rare instances, one infants with a bilirubin on a level greater than 20 mg by dL (342 [micro]mol per L) could make known kernicterus. The current practice for diagnosing and treating significant hyperbilirubinemia begins with a visual assessment of the infant for jaundice. If significant hyperbilirubinemia is suspected, a children test is performed to determine the flat of bilirubin. Phototherapy (light therapy) is then given to infants with high bilirubin of the same heights Six to 10 healthy, denomination or near-term infants with a bilirubin greater than 15 mg by dL (256.5 [micro]mol per L) have to be treated with phototherapy to thwart one infant's bilirubin level from rising above 20 mg by dL.

Researchers reviewed the literature to determine whether measurements through noninvasive instruments are reliable in identifying infants who ne line tests to confirm high bilirubin plains They found that measurements on several noninvasive devices traditionally used to examine the pigment of an infant's skin correlated well with bilirubin plains directly measured from blood. They conclud that these devices could be under the orders of as reliable screening tools to determine which infants should have children tests performed and, if necessary, be treated with phototherapy. This could lead to earlier detection of potentially serious cases of hyperbilirubinemia and may decrease the ne for invasive offspring tests in infants found to be at lower risk. Additional research is emergencyed to validate newer noninvasive measurement devices and to address issues of cost-effectiveness and reproducibility in clinical practice.

COPYRIGHT 2003 American Academy of Family Physicians

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