Osaku Nelson Ossamu, Lopes Heitor Silvério
Hospital Universitário Universidade Estadual do Oeste do Paraná - UNIOESTE, R. da Bandeira, 668, 85812-270, Cascavel, Brazil.
J Clin Monit Comput. 2006 Jun;20(3):159-64. doi: 10.1007/s10877-006-9016-1. Epub 2006 Jun 10.
Jaundice of the newborn is a common problem as a consequence of the rapid increment of blood bilirubin in the first days of live. In most cases, it is considered a physiological transient situation, but unmanaged hyperbilirubinemia can lead to death or serious injuries for the survivors. For decades, phototherapy has been used as the main method for prevention and treatment of hyperbilirubinaemia of the newborn. This work aims at finding a predictive model for the decrement of blood bilirubin for patients submitted to conventional phototherapy. Data from the phototherapy of 90 term newborns were collected and used in a multiple regression method. A rigorous statistical analysis was done in order to guarantee a correct and valid model. The obtained model was able to explain 78% of the variation of the dependent variable. We show that it is possible to predict the total serum bilirubin of the patient under conventional phototherapy by knowing its birth weight, bilirubin level at the beginning of treatment and the radiant energy density (dose). Besides, it is possible to infer the time necessary for a given decrement of bilirubin, under approximately constant irradiance. Statistical analysis of the obtained model shows that it is valid for several ranges of birth weight, initial bilirubin level, and radiant energy density. It is expected that the proposed model can be useful in the clinical management of hyperbilirubinemia of the newborn.
新生儿黄疸是一种常见问题，这是由于出生后最初几天血液胆红素迅速增加所致。在大多数情况下，它被认为是一种生理性的短暂情况，但未得到管理的高胆红素血症可能导致死亡或给幸存者带来严重伤害。几十年来，光疗一直被用作预防和治疗新生儿高胆红素血症的主要方法。这项工作旨在为接受传统光疗的患者找到一种预测血液胆红素降低的模型。收集了90名足月儿光疗的数据，并将其用于多元回归方法。进行了严格的统计分析以确保模型的正确性和有效性。所获得的模型能够解释78%的因变量变化。我们表明，通过了解患者的出生体重、治疗开始时的胆红素水平和辐射能量密度（剂量），可以预测接受传统光疗患者的总血清胆红素。此外，在近似恒定辐照下，可以推断出胆红素降低给定值所需的时间。对所获得模型的统计分析表明，它在几个出生体重、初始胆红素水平和辐射能量密度范围内都是有效的。预计所提出的模型可用于新生儿高胆红素血症的临床管理。
