RT Book, Section
A1 Peterson, Johann
A1 Berquist, William
A2 Stevenson, David K.
A2 Cohen, Ronald S.
A2 Sunshine, Philip
SR Print(0)
ID 1109794750
T1 Conjugated Hyperbilirubinemia
T2 Neonatology: Clinical Practice and Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071763769
LK accesspediatrics.mhmedical.com/content.aspx?aid=1109794750
RD 2024/04/19
AB Historical  estimates  place  the  incidence  of  cholestasis  among  all  neonates  at  1  in  2500  live  births.1  A  recent  retrospective  data  review  found  that  among  all  infants  cared  for  in  a  large  hospital  system  in  the  United  States  who  had  at  least  1  measured  conjugated  bilirubin  level,  3  in  1000  had  a  peak  conjugated  (direct)  bilirubin  greater  than  2.0  mg/dL2;  however,  in  the  majority  of  these  patients  a  specific  hepatobiliary  disorder  was  not  identified,  and  the  peak  bilirubin  was  relatively  low  (  1.0  mg/dL  when  total  bilirubin  is  5  mg  or  less  or  direct  bilirubin  >  20%  of  total  bilirubin  when  the  total  bilirubin  is  above  5  mg/dL)  was  identified  in  2%  of  all  NICU  patients.3  Risk  factors  that  are  common  in  this  population  include  prematurity,  low  birth  weight,  sepsis,  shock,  surgery,  and  parenteral  nutrition.4  Thus,  although  cholestatic  liver  disease  is  rare  in  general  outpatient  pediatrics,  the  neonatologist  must  be  familiar  with  the  initial  triage  and  diagnostic  evaluation,  as  well  as  supportive  care,  of  the  cholestatic  infant.