Management Of Hyperbilirubinaemia Flashcards
What is the aim of photoherapy?
To prevent bilirubin encephalopathy
Phototherapy is regarded as?
Both prophylactic and curative
Who should phototherapy be given to?
- All LBW infants as soon as jaundice is noticed.
- All infants with extensive bruising.
- To those with cephalhaematomas.
- Full-term infants with Total serum bilirubin approaching exchange level.
When should phototherapy be discontinued?
What to do throughout therapy?
As soon as there is a sustained fall in the unconjugated bilirubin level.
Maintain adequate hydration with frequent breastfeeds.
What are the side effects of phototherapy?
Hyperthermia
Loose stools
Skin rashes
When can intravenous immunoglobulin be considered?
How much do you give?
What is the mechanism of action of IVIG?
In hemolytic disease when the bilirubin level is rising.
IVIG is given at 1gm/kg over 8hrs on 3 consecutive days.
IVIG binds to the red cell antibodies, preventing further haemolysis.
When is Exchange transfusion required?
May be required at a lower level of total serum bilirubin if risk factors are present.
How does phototherapy work in treating neanatal jaundice?
Photo isomerization- converts bilirubin into soluble form, lumirubin which can be excreted in the urine.
What are complications of phototherapy?
Hyperthermia
Rash
Diarrhea
