This is an unprecedented time. It is the dedication of healthcare workers that will lead us through this crisis. Thank you for everything you do.

      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Hour-specific Risk for Neonatal Hyperbilirubinemia

    Predicts risk of hyperbilirubinemia in neonates.
    Favorite

    INSTRUCTIONS

    • Use in otherwise healthy neonates ≥35 weeks gestational age (GA) at the time of discharge. Do not use in neonates with positive direct Coombs test, or in those requiring phototherapy before 60 hours of age. Do not use to determine need for exchange transfusion.
    • The recommendations listed here for starting phototherapy are based on AAP guidelines. Always use clinical judgment, in addition to considering evidence-based clinical guidelines, in making treatment decisions. 

    When to Use
    Pearls/Pitfalls
    Why Use

    • Neonates ≥35 weeks GA at the time of discharge.

    • Do not use in neonates with positive direct Coombs test, or in those requiring phototherapy before 60 hours of age.

    • The recommendations listed here for starting phototherapy are based on AAP guidelines. Always use clinical judgment, in addition to considering evidence-based clinical guidelines, in making treatment decisions.
    • Do not use to determine need for exchange transfusion.

    • Predicts risk of subsequent severe hyperbilirubinemia in neonates ≥35 weeks GA at the time of discharge.

    • Only total serum bilirubin should be used (i.e., not direct or indirect).

    hours
    mg/dL
    ≥38
    35 to <38

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    • The risk calculator is one of two clinical options recommended by the AAP for risk assessment (either clinical risk factors alone or in combination with the risk calculator).

    • Most important clinical risk factors to consider include: breastfeeding, GA <38 weeks, significant jaundice in a sibling (defined as requiring phototherapy), and jaundice noted before discharge (Newman 2000).

    Management

    • An infant whose predischarge total serum bilirubin is in the low risk zone is at very low risk for developing severe hyperbilirubinemia.

    • Appropriate follow up after discharge must be ensured regardless of method of risk assessment used.

    Infant discharged

    Should be seen by age

    Before 24 hrs

    72 hrs

    Between 24 and 48 hrs

    96 hrs

    Between 48 and 72 hrs

    120 hrs

    From AAP guidelines.

    Critical Actions

    Clinical judgment should guide follow up. Neonates at higher risk and with clinical risk factors may be followed earlier.

    About the Creator
    Dr. Vinod K. Bhutani
    Are you Dr. Vinod K. Bhutani?