MEDICAL MANAGEMENT

IDEAL MEDICAL MANAGEMENT FOR HYPERBILIRUBINEMIA

Initiation of Early Feeding Bilirubin is removed from the body by being incorporated into feces. Therefore, the sooner bowel elimination begins, the sooner bilirubin removal begins. this. Early feeding (either breastmilk or formula, therefore, stimulates bowel peristalsis and accomplishes

Phototherapy An infants liver processes little bilirubin in utero because the mothers circulation does this for an infant. With birth, exposure to light, apparently triggers the liver to assume this function. Additional life supplied by phototherapy appears to speed the conversion potential of the liver. In phototherapy, an infant is continuously exposed to specialized light such as quartz halogen, cool white daylight or special blue fluorescent life. The lights are placed 12 to 30 inches above the newborns bassinet or incubator.

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Exchange Transfusion Intensive phototheraphy in conjunction with hydration and close monitoring of serum bilirubin levels is the preferred method bilirubin of treatment of neonatal to rise, jaundice. Despite these measures, if levels continue exchange transfusion may be necessary. The therapy may be used for any condition that leads to hyperbilirubinemia or polycythemia. When used as therapy for blood incompatibility, it removes approximately 85% of sensitized red cells. It reduces the serum concentration of indirect bilirubin often prevents heart failure in infants. Because indirect bilirubin levels rise at relatively preitable levels, standards performing exchange transfusion depend on the indirect bilirubin concentration, a transfusion is used when this levels exceed: 5 mg/100 ml at birth 10 mg/100 ml at age of 8 hours 12 mg/100 ml at age of 16 hours 15 mg/100 ml at 24 hours

In also may be used if the serum bilirubin level is rising more than 0.5 mg/hour in infants with Rh incompatibility or 1.0 mg/hour in infants with ABO incompatibility.

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ACTUAL MEDICAL MANAGEMENT DONE TO THE PATIENT:

A. Phototherapy Phototherapy for every 8 hours was ordered by the physician to reduce jaundice and decrease bilirubin level of the neonate. Temperature and intake and output were monitored every 4 hours. Passage of meconium or greenish stool was checked. Signs of priapism is assessed. Changed the position of the baby atleast every two hours or as needed.

B. Laboratory Tests a. Complete Blood Count b. Serum Bilirubin Test

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