Importance of managing jaundice in pretern infants

Jaundice is a very frequent problem in preterm neonates and upto 80% of them develop Neonatal jaundice In most cases neonatal jaundice can be managed with Phototherapy alone but a few neonates may require exchange transfusion in addition to phototherapy.
Exchange transfusion for jaundice carries an inherent risk of mortality and morbidity in addition to the usual risks associated with blood transfusions. Effective use of Phototherapy in the management of Neonatal Jaundice can drastically decrease the need for exchange transfusion
Optimal management of Jaundice includes risk stratification and timely identification of those needing therapeutic intervention( Phototherapy) Effective use of Phototherapy means initiating Phototherapy as per standard guidelines and using the right dose and duration of Phototherapy.
It is also important to ensure that these infants are adequately monitored when under phototherapy. Exchange transfusions must be done only when indicated as per standard guidelines. And all preterm infants with jaundice needing treatment with phototherapy or exchange transfusion must be followed up after discharge for hearing and neurodevelopmental assessments.
  • Introduction...
  • 1. Learning object...
  • 2. Effects of exch...
  • 3. Managing jaundi...
  • 4. Why optimal man...
 

Introduction

DR. GEETA GATHWALA
MD, DM (Neonatology)

Professor and Head
Department of Pediatrics
PGI, Rohtak

1. Learning objectives

â–º Upto 80% preterm neonates have jaundice



â–º Many of these neonates can be managed by phototherapy
    alone



â–º Few neonates may require exchange transfusion in
    addition to phototherapy

2. Effects of exchange transfusion

â–º Exchange transfusion for jaundice carries significant risk of
    mortality and morbidity in addition to the usual risks of
    blood transfusions



â–º Effective use of phototherapy in the management of neonatal
    jaundice can drastically decrease the need for exchange
    transfusion

3. Managing jaundice optimally

â–º Risk stratification


â–º Timely identification


â–º Effective use of phototherapy
      ♦ Initiation as per guidelines
      ♦ Dose and duration
      ♦ Monitoring


â–º Judicious use of exchange transfusion


â–º Post discharge follow up

4. Why optimal management?

â–º Adequate and timely treatment of jaundice is important


â–º It helps prevent
      ♦ acute neurological injury 
      ♦ long term neurological damage


â–º Effective usage of phototherapy can prevent exchange
    transfusion and its associated risks