Any one had new jaundice curves post it for me

Take a look at the curves you can download from NICE / UK.

http://guidance.nice.org.uk/CG98/treatmentthresholdgraph/xls/English

The direct URL (download) is: http://www.nice.org.uk/nicemedia/live/12986/48683/48683.xls

Thanks, but I want curves which depend on gestational age not weight

These curves should be what you're looking for, as you set gestational age and the graph's adjusted.

See the screen shot.

Thanks stefan

Dear Stefan

 

Are these curves not different from AAP curves in terms of the threshold they give for term babies for Exchange transfusion. I remember one baby within 24 hrs of life where we were contemplating exchange and on comparison we found that the NICE curves are more liberal for exchange transfusion at a younger age. My question is for term and > 35 week  babies should we not follow the AAP  ? And are these NICE curves based on some evidence and data or they are just presumptive charts based on certain specialists opinion.

 

Regards

Dr Satyen K Hemrajani 

@satyen75 - to be honest I don't know the AAP curves, but I suppose curves differ between countries, as interpretation of research and experience probably leads to slightly different conclusions regarding safe levels etc.

 

The work by NICE that resulted in their curves seems very thorough, and the full document is extensive (http://guidance.nice.org.uk/CG98).

Still, I personally believe their work was probably also influenced/biased by some degree of subjectivity/consensus/"tradition", as there is no gold standard for these curves.

It is basically a simple rule: gestation in weeks multiplied by 100 is the level for exchange and 100 minus this level is the treatment line for phototherapy This is applicable until 37 weeks .

Therefore 25 weeker 25* 100 = 250 is exchange and 150 will be phototherapy level

For the first 72 hours the levels are set at lower levels for early intervention with phototherapy and other measures ie 40 for phototherapy 80 for exchange @ cord blood levels or 0 hours.

38 weeks and over

the values @ 0 hour (birth) is 100 for phototherapy and 200 for exchange

After 72 hours phototherapy levels is 350 and exchange is 450

Sorry forgot to mention the above values which NICE use is bilirubin in micromol/L equivalent mg/L is the above values divided by 17 approximately

Dear Dr Satyen, 

 

Attached are NICE excel graphs for jaundice and NICE detailed guidelines.

NICE is National Institute of Health Care and Excellence.. see website....www.nice.org.uk

Every guidelines is rigorously reviewed and then only adopted , the process is explained in detail on website.

Studies from developed countries (Most from USA) have been used to derive them.

I am attaching brief guidelines for reference. 

Full guidleines are  nearly 500 pages , that explains the  reasons and references used for these graphs

As the file is too big (>7 MB)  to load , I will give a link to download it below :

 

http://guidance.nice.org.uk/CG98/Guidance/pdf/English

 

In UK, they are universally followed.

 

Regards,

 

Dr H Sharma

Neonatal Research Fellow

London, UK

 

Neonatal Jaundice Graphs.xls

NICE neonatal jaundice brief.pdf

ever tried bilitool.org, thats based on the aap guidance. We use both, NICE for less than 35/40 and for newborns less than 16 h and bilitool.org (starts with 16 h of life) for all the others. No concerns with either charts/guidelines so far.

These are the charts being used in South Africa

RP NN Jaundice assessment chart 2010 NT.ppt

https://www.dropbox.com/sh/w6fx27cqap625y1/LiNMm2hpkr

Guidelines from italian society of neonatology (ed. 2013)

Inviato dal mio iPad utilizzando Tapatalk