Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Rome.
Ital J Pediatr. 2012 Feb 1;38:6. doi: 10.1186/1824-7288-38-6.
Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB) nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before discharge.
A percentile-based hour-specific nomogram for TSB values was performed using TSB data of 1708 healthy full term neonates. The nomogram's predictive ability was then prospectively assessed in five different first level neonatal units, using a single TSB value determined before discharge.
The 75 th percentile of hour specific TSB nomogram allows to predict newborn babies without significant hyperbilirubinemia only after the first 72 hours of life. In the first 48 hours of life the observation of false negative results did not permit a safe discharge from the hospital.
The hour-specific TSB nomogram is able to predict all neonates without risk of non physiologic hyperbilirubinemia only after 48 to 72 hours of life. The combination of TSB determination and risk factors for hyperbilirubinemia could facilitate a safe discharge from the hospital and a targeted intervention and follow-up.
由于当前的社会和经济需求，健康的晚期早产儿和足月儿的早期出院已成为常见做法。一些早产儿在早期出院后出现了严重的黄疸，甚至核黄疸。本研究旨在制定基于百分位的小时特异性总血清胆红素（TSB）列线图，并评估其在出院前预测随后非生理性严重高胆红素血症风险的能力。
使用 1708 例健康足月儿的 TSB 数据，制定基于百分位的小时特异性 TSB 列线图。然后，在五个不同的一级新生儿病房中前瞻性评估列线图的预测能力，使用出院前单次 TSB 值。
75 百分位的小时特异性 TSB 列线图仅在生命的前 72 小时内可预测无显著高胆红素血症的新生儿。在生命的前 48 小时，观察到假阴性结果，不允许安全出院。
只有在 48 至 72 小时的生命后，小时特异性 TSB 列线图才能预测所有无非生理性高胆红素血症风险的新生儿。TSB 测定与高胆红素血症危险因素的结合可以促进安全出院以及有针对性的干预和随访。
