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Treatment of neonatal jaundice
Summarized from Masiels MJ, McDonagh AF. Phototherapy for neonatal jaundice. New Eng J Med 2008; 358: 920-28.
Transient increase in serum bilirubin concentration is a normal physiological feature of the neonatal period and this rise is sufficient to cause visible jaundice in around 60 % of newborns. For most the condition is harmless and resolves spontaneously with no long-term effects.
However for those neonates with particularly high serum bilirubin intervention is necessary to prevent kernicterus a condition, characterized by deposition of bilirubin in the brain, that can lead to devastating permanent neurological deficit. Phototherapy, the standard treatment for lowering serum bilirubin in the neonate, is the subject of a recently published review.
The review begins with an account of the pathophysiology of neonatal jaundice and an explanation of how phototherapy increases the rate of bilirubin elimination. There follows evidence of effectiveness. Other topics include dosage guidelines, adverse effects and contraindications. The review cites 65 references.
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