[Treatment of incterus in newborn infants. Norwegian guidelines in international perspective].
Jaundice is common in neonates and often requires diagnostic and therapeutic intervention. Recently a case has been made for less aggressive intervention when jaundice occurs in healthy term infants. This issue is also being discussed by Norwegian pediatricians. The present paper compares the most commonly used guidelines in Norwegian pediatrics with the results of a recent international survey of therapeutic practices in cases of neonatal jaundice. The survey documented wide variation in the approach to this common problem. Norwegian intervention limits for premature/SGA infants are generally at or above the 90th centile for the international sample, and must be said to be fairly unaggressive. The Norwegian intervention limits for term infants are generally between the median and the 75th centile. Thus they are on the less aggressive side of the international sample. Though it is likely that many term infants can tolerate quite high serum bilirubin levels without significant risk of brain damage, arguments for further elevation of the intervention limits are problematic as long as we do not have the tools to identify individuals, possibly very few, with lower tolerance.
Hansen
T W
TW
Children's Hospital of Pittsburgh, PA 15213-2583, USA.
D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007567:Jaundice, Neonatal / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D009664:Norway; D010789:Phototherapy; D017410:Practice Guidelines as Topic