Neonatal Jaundice (AAP 2022 & Preterm)

1. Infant Parameters

Gestational Age AAP 2022 (≥35w)

Postnatal Age Hours (1–168h)

Total Serum Bilirubin (TSB)

Neurotoxicity Risk Factors None (Standard)

Isoimmune hemolytic disease (+DAT/Coombs), G6PD deficiency, or other hemolytic condition Serum Albumin < 3.0 g/dL Clinical sepsis or hemodynamic instability in past 24h Perinatal asphyxia (10-min Apgar ≤5 or cord pH ≤7.00)

2. Clinical Decision & Visual Nomogram

Delta: —

⚡ Phototherapy Indicated

Phototherapy Threshold

13.5 mg/dL

(231 µmol/L)

Exchange Transfusion Threshold

20.0 mg/dL

(342 µmol/L)

📈 Real-Time Hour-Specific Threshold Plot (≥40w)

— Phototherapy --- Escalation (-2 mg/dL) — Exchange Transfusion ● Patient TSB

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AAP 2022 Key Clinical Recommendations:

Escalation of Care Window: When TSB is within 2.0 mg/dL (34 µmol/L) of the exchange transfusion threshold, initiate emergency intensive phototherapy (multiple LED banks with max irradiance), IV hydration, and prepare blood bank for urgent double-volume exchange transfusion.
Discontinuing Phototherapy: Phototherapy can be safely discontinued when TSB has decreased by ≥ 2.0 mg/dL below the phototherapy threshold at initiation. Rebound TSB is recommended within 12–24 hours for hemolytic conditions or infants receiving phototherapy before 48 hours of life.

Neonatal Hyperbilirubinemia (AAP 2022 & Preterm Guidelines)

1. Infant Parameters

2. Clinical Decision & Visual Nomogram