Management of Neonatal Hyperbilirubinemia. Evidence Report/Technology Assessment No. 65

摘要

This evidence report presents a comprehensive literature review of the effect of bilirubin on neurodevelopmental outcomes. It also examines the efficacy of phototherapy and the role of various effect modifiers-such as sepsis and hemolysis-on neurodevelopment. Specifically, the report addresses the five questions (1) what is the relationship between peak bilirubin levels and/or duration of hyperbilirubinemia and neurodevelopmental outcome; (2) what is the evidence for effect modification of the results in Question 1, by gestational age, hemolysis, serum albumin, and other factors; (3) what are the quantitative estimates of efficacy of treatment at reducing peak bilirubin levels such as the number needed to treat at 20 mg/dl to keep total serum bilirubin from rising; (4) what is the efficacy of various strategies for predicting hyperbilirubinemia, including hour-specific bilirubin percentiles; and (5) what is the accuracy of transcutaneous bilirubin measurements.