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Transcutaneous screening for hyperbilirubinemia in neonates (Protocol)
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Uthman, Olalekan A., Okwundu, Charles I. and Smith, Johan (2014) Transcutaneous screening for hyperbilirubinemia in neonates (Protocol). Cochrane Database of Systematic Reviews (4). pp. 1-7. doi:10.1002/14651858.CD011060 ISSN 1469-493X.
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Official URL: http://dx.doi.org/10.1002/14651858.CD011060
Abstract
Description of the condition
Hyperbilirubinemia is a term used to describe elevated levels of
bilirubin in the blood. In newborns, hyperbilirubinemia becomes
clinically apparent as jaundice, a yellow coloration of the skin and
the sclera, at serum bilirubin levels > 5 mg/dL (Porter 2002). Hyperbilirubinemia is very common in both term and preterm newborn
infants (occurring in around 60% of newborns) and results
from a predisposition to produce bilirubin and the newborn’s limited
ability to excrete it (Lauer 2011). Jaundice or hyperbilirubinemia
is the most common cause of hospital readmission in the
neonatal period (Soskolne 1996; Maisels 1998; Escobar 2005).
Most cases of newborn jaundice are mild and self limited. However,
in rare cases, infants can have very high levels of bilirubin that
can lead to bilirubin encephalopathy and kernicterus (Newman
2006). The threshold concentration of bilirubin and/or the duration
of hyperbilirubinemia responsible for causing kernicterus injury
in newborn infants is not known (Dennery 2004). Low concentrations
of bilirubin may have some antioxidant benefits, suggesting
that bilirubin should not be completely eliminated. Studies
from developed countries estimate the incidence of kernicterus
to range from about 0.4 to 2 per 100,000 (Sgro 2006; Manning
2007; Burke 2009). However, studies from developing countries
suggest that the incidence may be much higher (Nair 2003; Owa
2009).
The acute phase signs of kernicterus are poor feeding, lethargy,
high-pitched cry, hypertonia or hypotonia, opisthotonos and
seizures. The chronic manifestations include athetoid cerebral
palsy, motor delay, gaze palsy, dental dysplasia, mental retardation
and sensorineural hearing loss (AAP 2004). Current treatments
for hyperbilirubinemia include phototherapy and exchange transfusion
(usually reserved for severe cases of hyperbilirubinemia)
(NICE 2010).
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Cochrane Database of Systematic Reviews | ||||
Publisher: | John Wiley & Sons Ltd. | ||||
ISSN: | 1469-493X | ||||
Official Date: | 11 April 2014 | ||||
Dates: |
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Number: | 4 | ||||
Page Range: | pp. 1-7 | ||||
DOI: | 10.1002/14651858.CD011060 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) |
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