Pediatric emergency medicine trisk 0898 0898
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (98.64 KB, 1 trang )
pathways.html ). (Copyright © 2014 by The Children’s Hospital of Philadelphia. All rights
reserved.)
Beyond the Neonatal Period
For patients beyond the neonatal period, the approach is primarily directed at
identification and treatment of the underlying cause. In some cases of severe
hyperbilirubinemia, such as those caused by Crigler–Najjar syndrome type II and
Lucey–Driscoll syndrome, phototherapy or phenobarbital may be indicated. If a
patient appears acutely ill, the physician should proceed with the appropriate
evaluation and treatment for sepsis. Among well-appearing patients, the presence
or absence of anemia determines the likely diagnostic possibilities and
appropriate studies. When unconjugated hyperbilirubinemia occurs without
anemia, abnormal liver function tests will differentiate hepatic disease from
inherited disorders of bilirubin metabolism. Anemic children should be evaluated
for an underlying hemolytic process.
Suggested Readings and Key References
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia.
Management of hyperbilirubinemia in the newborn infant 35 or more weeks of
gestation. Pediatrics 2004;114(1):297–316.
Johnson L, Bhutani VK. The clinical syndrome of bilirubin-induced neurologic
dysfunction. Semin Perinatol 2011;35:101–113.
Lai NM, Ahmad Kamar A, Choo YM, et al. Fluid supplementation for neonatal
unconjugated hyperbilirubinaemia. Cochrane Database Syst Rev
2017;8:CD011891.
Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med
2008;358(9):920–928.
Wolff M, Schinasi DA, Lavelle J, et al. Management of neonates with
hyperbilirubinemia: improving timeliness of care using a clinical pathway.
Pediatrics 2012;130(6):e1688–e1694.
