Authors' objectives:

The objective of this study is to assess the safety, efficacy and effectiveness, and cost implications of management of neonatal hyperbilirubinemia.

Authors' recommendations: Based on the evidence obtained it is recommended for laboratory diagnosis, the laboratory should select the appropriate method based on needs and availability of technical resources. Quality control programmes and other measures need to be instituted to increase the accuracy of results. Transcutaneous bilirubinometry should be carried out on a selective basis. Periodic instrument calibration and generation of individualised correlation curves (institutional or regional) between transcutaneous bilirubinometer indices and serum bilirubin levels should be instituted. Local data on the reliability of transcutaneous bilirubinometry in a multi-ethnic population with varying intensities of skin pigmentation, as well as its cost effectiveness is needed. More data is also needed with respect to laboratory diagnosis like the indications for use of the non-invasive end tidal carbon monoxide excretion (ETCOc) technique and the best method of bilirubin determination for identifying the infant at risk for kernicterus. In the treatment of hyperbilirubinemia, phototherapy should be considered at serum bilirubin levels of 222-260 micro mol/l taking into account other clinical factors. White light phototherapy is recommended, using intensive or blue light phototherapy only if serum bilirubin levels are high and it does not respond to conventional phototherapy. In using exchange transfusions, serum bilirubin levels, bilirubin/albumin ratio and other clinical factors should be taken into consideration. All necessary precautions should be taken to limit morbidity and mortality. Drug treatment is not recommended at present, until more evidence on efficacy is available.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.moh.gov.my/

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment Unit

Contact Address: Health Technology Assessment Unit, Medical Development Division, Ministry of Health Malaysia, Level 21, PERKIM Building, Jalan Ipoh, 51200 Kuala Lumpur, Malaysia. Tel: 603 4045 7781, Fax: 603 4045 77 40

Copyright: Malaysian Health Technology Assessment Unit (MHTAU)