Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
Department of Pediatrics, Boston Medical Center, Boston, MA, USA.
J Perinatol. 2023 Nov;43(11):1357-1362. doi: 10.1038/s41372-023-01650-3. Epub 2023 Mar 23.
We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed full-term ABOi DAT negative newborns on the low risk phototherapy nomogram, rather than medium risk, as previously done.
A chart review was performed for ABOi newborns born ≥36 weeks gestation between January 2020 and October 2021. Primary outcome measures were rates of phototherapy across pre- and post-intervention groups and among DAT negative newborns.
There was an increased proportion of newborns assigned to the low risk curve after the intervention. There were no significant differences in phototherapy rates among the intervention groups, although there was a non-significant decrease in phototherapy rates among DAT negative newborns after the intervention. There were no increases in adverse outcomes.
Providers adhered to the guidelines after implementation of the HCP. ABOi DAT negative newborns can be viewed as low risk for hyperbilirubinemia requiring phototherapy.
我们分析了实施高胆红素血症临床路径（HCP）后的光疗率，该路径将足月 ABOiDAT 阴性新生儿置于低风险光疗列线图上，而不是像以前那样置于中风险。
对 2020 年 1 月至 2021 年 10 月期间出生胎龄≥36 周的 ABOi 新生儿进行了图表回顾。主要结局指标是干预前后的光疗率以及 DAT 阴性新生儿的光疗率。
干预后，更多的新生儿被分配到低风险曲线。干预组之间的光疗率没有显著差异，尽管干预后 DAT 阴性新生儿的光疗率有非显著下降。没有不良结局的增加。
提供者在实施 HCP 后遵守了指南。ABOiDAT 阴性新生儿可视为需要光疗的高胆红素血症低风险。
