Outcomes of BMA Medical College and Vajira Hospital Clinical Practice Guideline for Management of Hyperbilirubinemia in the Newborn Infants ≥ 35 Weeks Gestation

Abstract

Outcomes of BMA Medical College and Vajira Hospital Clinical Practice Guideline for Management of Hyperbilirubinemia in the Newborn Infants ≥ 35 Weeks Gestation

Siwiluck Kanchanabat MD

Payon Boonyarittipong MD

Department of Pediatrics, BMA Medical College and Vajira Hospital

Objective: To evaluate the outcomes of Bangkok Metropolitan Administration Medical College and Vajira Hospital clinical practice guideline for management of hyperbilirubinemia in the newborn infants ≥ 35 weeks of gestation.

Study design: Retrospective cohort study.

Subjects: The total of 150 healthy newborn infants ≥ 35 weeks of gestation with hyperbilirubinemia treated by phototherapy were included in this study. Seventy five newborn infants were treated "before" and 75 "after" the use of the clinical practice guideline.

Methods: Data from medical records of the enrolled subjects were recorded and analyzed.

Main outcome measures: Length of hospital stay, total blood exchange transfusion rate, re-phototherapy rate, readmission rate for hyperbilirubinemia and medical cost.

Results: Management according to the clinical practice guideline significantly reduced the duration of phototherapy 10.1 hours (p-value < 0.001) and reduced length of hospital stay 19.2 hours (p-value < 0.001). There were no difference in medical cost, re-phototherapy rate and readmission rate for hyperbilirubinemia. No infant received total blood exchange transfusion.

Conclusion: The BMA Medical College and Vajira Hospital clinical practice guideline for management of hyperbilirubinemia in the newborn infants ≥ 35 weeks gestation reduced duration of phototherapy and length of hospital stay.

Vajira Med J 2009 ; 53 : 233-241