nashwa Posted March 23, 2014 Share Posted March 23, 2014 Any one had new jaundice curves post it for me Link to comment Share on other sites More sharing options...
Stefan Johansson Posted March 23, 2014 Share Posted March 23, 2014 Take a look at the curves you can download from NICE / UK.http://guidance.nice.org.uk/CG98/treatmentthresholdgraph/xls/EnglishThe direct URL (download) is: http://www.nice.org.uk/nicemedia/live/12986/48683/48683.xls Link to comment Share on other sites More sharing options...
nashwa Posted March 24, 2014 Author Share Posted March 24, 2014 Thanks, but I want curves which depend on gestational age not weight Link to comment Share on other sites More sharing options...
Stefan Johansson Posted March 24, 2014 Share Posted March 24, 2014 These curves should be what you're looking for, as you set gestational age and the graph's adjusted. See the screen shot. Link to comment Share on other sites More sharing options...
selvanr4 Posted March 26, 2014 Share Posted March 26, 2014 Thanks stefan Link to comment Share on other sites More sharing options...
satyen75 Posted March 26, 2014 Share Posted March 26, 2014 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 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted March 26, 2014 Share Posted March 26, 2014 @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. Link to comment Share on other sites More sharing options...
Guest khader Posted March 26, 2014 Share Posted March 26, 2014 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 Link to comment Share on other sites More sharing options...
Guest khader Posted March 26, 2014 Share Posted March 26, 2014 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 Link to comment Share on other sites More sharing options...
Guest drharry Posted March 27, 2014 Share Posted March 27, 2014 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.xlsNICE neonatal jaundice brief.pdf Link to comment Share on other sites More sharing options...
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