Phototherapy and exchange transfusion for neonatal hyperbilirubinaemia : Neonatal academic hospitals' consensus guidelines for South African hospitals and primary care facilities

• Published in: South African medical journal 2006-09, Vol.96 (9), p.819-824
• Main Authors: HORN, A. R, KIRSTEN, G. F, NAZO, M, MAWELA, B, KROON, S. M, HENNING, P. A, MOLLER, G, PIEPER, C, ADHIKARI, M, COOPER, P, HOEK, B, DELPORT, S
• Format: Article
• Language: English
• Subjects: Bilirubin - blood; Biological and medical sciences; Exchange Transfusion, Whole Blood - standards; General aspects; Hospitals, University; Humans; Hyperbilirubinemia, Neonatal - therapy; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - therapy; Medical sciences; Phototherapy - standards; Primary Health Care; South Africa
• ISSN: 0256-9574

The purpose of this document is to address the current lack of consensus regarding the management of hyperbilirubinaemia in neonates in South Africa. If left untreated, severe neonatal hyperbilirubinaemia may cause kernicterus and ultimately death and the severity of neonatal jaundice is often underestimated clinically. However, if phototherapy is instituted timely and at the correct intensity an exchange transfusion can usually be avoided. The literature describing intervention thresholds for phototherapy and exchange transfusion in both term and preterm infants is therefore reviewed and specific intervention thresholds that can be used throughout South Africa are proposed and presented graphically. A simplified version for use in a primary care setting is also presented. All academic heads of neonatology departments throughout South Africa were consulted in the process of drawing up this document and consensus was achieved.