South African Medical Journal

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Phototherapy and exchange transfusion for neonatal hyperbilirubinaemia

AR Horn, GF Kirsten, SM Kroon, PA Henning, G Moller, C Pieper, M Adhikari, P Cooper, B Hoek, S Delport, M Nazo, B Mawela


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  timeously 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.

AJOL African Journals Online