Table 7

Summary of recommendations for approaches to treatment of neonatal hyperbilirubinemia

NICEMaHTASQCGISNAAPTPANPAINSSAPSSNCPSChPS
Phototherapy
Conventional irradiance (µW/cm²/nm)NA>1525–30NANA8–10NANA8–12NANA8–10
Intensive irradiance (µW/cm²/nm)NA>30>30>35>3030–65>20>30>30NA>30>30
Distance between light and baby (cm)NA<30–5010–15NAAbout 1035–4020About 1010NA10NA
Intensive phototherapy threshold for fullterm babies>96 hours (µmol/L)
Well350359359343359359359359359350359359
With risk factorsNA308308NA308291308308308300257308
Home phototherapyNANA+NA+NANA+NANANANA
Sunlight exposureNANANANANANANA
Complications+NA+NA++NA+NANA++
Exchange transfusion
Exchange transfusion threshold for fullterm babies>96 hours (µmol/L)
Well450428428428428428450428428430428428
With risk factorsNA393393NA376393NA376376370325376
Detail observation during exchange transfusionNA+NA+NANANANANANANA+
Maintain intensive phototherapy after exchange transfusion++++NA+NANANANA++
Measure TSB after exchange transfusionWithin 2 hours4–6 hoursWithin 2 hoursWithin 2 hoursNAWithin 2 hoursNANANANANAWithin 4 hours
Complications++++++NA+NANA+NA
Pharmacotherapy
Intravenous immunoglobulin++++NA++NA++
Human albuminNANANANANANANANA+
ClofibrateNANANANANANANANANA
Tin-mesoporphyrinNANANANANANANANA+NA
  • AAP, American Academy of Pediatrics Subcommittee on Hyperbilirubinemia (America); ChPS, Chinese Pediatric Society, Chinese Medical Association (China); CPS, Canadian Pediatric Society, Fetus and Newborn Committee (Canada); INS, Israel Neonatal Society (Israel); ISN, Italian Society of Neonatology (Italy); MaHTAS, Malaysia Health Technology Assessment Section (Malaysia); NA, not available; NICE, National Institute for Health and Care Excellence (the UK); NPA, Norwegian Pediatric Association (Norway); QCG, Queensland Clinical Guidelines (Australia); SAP, Spanish Association of Pediatrics (Spain); SSN, Swiss Society of Neonatology (Swiss); TPA, Turkish Pediatric Association (Turkey); TSB, total serum bilirubin.