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Hyperbilirubinemia in premature infants <35 weeks' gestation: A chronologic age format for graphing consensus-based
Robert L Stavis1, Jack D Guida2,3
1, Bryn Mawr, PA, 19010, USA. robstavis@gmail.com.
Background:
At the request of the AAP, consensus-based recommendations for managing hyperbilirubinemia in infants < 35 weeks' postmenstrual age (PMA) were published in 2012. Subsequently, a PMA-based graphical format of these recommendations was popularized as Premie BiliRecs, providing decision support for infants ≥ 27 weeks' PMA and ≥ 48 h old.
Methods:
Chronologic age-based guidelines based on gestational age (GA) at birth were derived from the consensus-based recommendations and modified with integration of the AAP hyperbilirubinemia guidelines and extension of decision support for a minimum of 14 days. These guidelines were implemented in an electronic medical record.
Results:
The modified consensus guidelines provide support from birth for all infants < 35 weeks' GA and address limitations of the current graphical tools. An interactive tool illustrating these guidelines is available at https://bilirubin-guidelines.net . (Contact your institutional IT department if access to the website is blocked).
Conclusions:
These modified consensus guidelines expand decision support for infants < 35 weeks' GA with a format harmonized with the AAP graphs.
