Premie BiliRecs (PBR) was created to provide clinical decision support for treatment of indirect hyperbilirubinemia in pre-term neonates from 27 weeks and 0 days through 34 weeks and 6 days post-menstrual age. Though there is a dearth of evidence on phototherapy and exchange transfusion thresholds for this age group, PBR serves to operationalize the expert recommendations published by Maisels et al. in 2012. Because phototherapy and exchange transfusion thresholds are lower at early postnatal age, the tool is intended for use in infants greater than 48 hours of age. Ultimately, expert clinical reasoning should guide management of indirect hyperbilirubinemia in preterm neonates of any postnatal age.
Peer-reviewed journal articles:
An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation
Maisels MJ, Watchko JF, Bhutani VK, and Stevenson DK
Journal of Perinatology June 2012
Jaundice and kernicterus in the moderately preterm infant
Wallenstein MW, Bhutani VK
Clinics in Perinatology December 2013
Clinical Practice Guideline: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
AAP Subcommittee on Hyperbilirubinemia
Pediatrics July 2004
The User acknowledges and agrees that this tool will be used only as a reference aid and that the information contained should not be used as a substitute for the exercise of professional diagnosis and treatment.
In view of the possibility of human error or changes in medical science, the User should confirm the information provided through independent sources. This tool is provided without warranties of any kind, expressed or implied, and Stanford University, Lucile Packard Children's Hospital/Stanford Children's Hospital, its staff, employees and faculty disclaim any liability, loss, damages, injury or liability whatsoever suffered as a result of the User's reliance on the information contained in this tool or its content.
By continuing to use this tool, the User indicated the acceptance of these terms.