Pediatr Ann. 2024 Jun;53(6):e208-e216. doi: 10.3928/19382359-20240407-02. Epub 2024 Jun 1.
Neonatal hyperbilirubinemia is one of the most common conditions managed by pediatricians. Although many infants are affected, most will experience complete resolution without complication. Acute bilirubin encephalopathy and kernicterus are rare yet debilitating sequelae of severe hyperbilirubinemia that can be avoided through careful monitoring and treatment with phototherapy. Appropriate management of neonatal hyperbilirubinemia must balance the risks of these severe conditions with the effects of overtreatment. Released in 2022, the American Academy of Pediatrics revised the clinical practice guideline for the management of hyperbilirubinemia, which aims to provide that balance through updates to the previous guideline. This article will provide the reader with (1) an evidence-based harm and benefit analysis of the guideline, (2) an overview of key changes and clarifications made in the new guideline, and (3) a practical summary of guideline updates. .
新生儿高胆红素血症是儿科医生最常处理的病症之一。尽管许多婴儿受其影响,但大多数情况下,胆红素水平会完全恢复正常,不会出现并发症。急性胆红素脑病和核黄疸是严重高胆红素血症的罕见但严重的后遗症,如果能通过仔细监测和光疗治疗,这些后遗症是可以避免的。新生儿高胆红素血症的恰当管理必须在这些严重情况的风险与过度治疗的影响之间取得平衡。美国儿科学会于 2022 年发布了修订后的高胆红素血症管理临床实践指南,该指南旨在通过更新之前的指南来实现这种平衡。本文将为读者提供:(1)对该指南的循证危害和获益分析;(2)新指南中所作的主要更改和澄清概述;以及(3)指南更新的实用总结。