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Percorsi Assistenziali Neonatologici Anno 2008
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I livelli bilirubinemici sopra riportati sono da considerarsi utili per programmare
il primo intervento di exsanguinotrasfusione. Per gli interventi successivi al
primo, ove necessari, si può essere meno interventisti considerando oltre che il
livello di bilirubinemia anche altri fattori condizionanti quali:
a. livello di bilirubinemia pre-exsanguinotrasfusione
b. rebound bilirubinemico post-exsanguinotrasfusione
c. presenza di emolisi
d. tollerabilità dell'intervento
e. stato generale del neonato al momento della decisione.
1. Smitherman H, Stark AR, Bhutani VK. Early recognition of neonatal hyperbilirubinemia and its emergent management. Semin
Fetal Neonatal Med 2006; 11:214-224.
2. Romagnoli C, De Luca D, Zuppa AA, Parenti D, Latella C. Could early serum bilirubin measurement be useful in predicting
non physiologic hyperbilirubinemia? Ital J Pediatr 2005;31:52-60.
3. American Academy of Pediatrics. Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn
infant 35 or more weeks of gestation. Pediatrics 2004; 114:297-316.
4. Murray NA, Roberts IA, Haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed 2007;92;83-88
5. Maisels MJ, Watchko JF. Treatment of jaundice in low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2003; 88:F459–
F463
6. Which phototherapy system is most effective in lowering serum bilirubin in very preterm infants? Romagnoli C, Zecca E,
Papacci P, Vento G, Girlando P, Latella C. Fetal Diagn Ther 2006;21:204-209.
7. Ip S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S, Maisels J, Lau J, and the Subcommittee on Hyperbilirubinemia. An
Evidence-Based Review of Important Issues Concerning Neonatal Hyperbilirubinemia. Pediatrics 2004;114: e130–e153. URL:
http://www.pediatrics.org/cgi/content/full/114/1/e130.
8. Chou SC, Palmer H, Ezhuthachan S, Newman C, Pradell-boyd B, Maisels MJ, Testa MA. Management of hyperbilirubinemia in
newborns: measuring performance by using a benchmarking model. Pediatrics 2003;112:1264-1273.
9. Wenneberg RP, Ahlfors CE, Bhutani VK, Johnson LH, Shapiro SM. Toward understanding kernicterus: a challenge to improbe
the management of jaundiced newborns. Pediatrics 2006;117:474-485.
10. Newman TB, Liljestrand P, Jeremy RJ, Ferreiro DM, Wu YW, Hydes ES, Escobar GJ, for the jaundice and infant feeding study
team. Outcomes among newborns with total serum bilirubin levels of 25 mg per decilitre or more. N Engl J Med
2006;354:1889-1900.
11. Jackson JG. Adverse Events Associated With Exchange Transfusion in Healthy and Ill Newborns. Pediatrics1997;99(5).
http://www.pediatrics.org/cgi/content/full/99/5/e7;
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