BiliTool™

Patient Summary
Age at sampling:		48 hours
Total Bilirubin:		15.2 mg/dL
Bilirubin trend:		0.03 mg/dL/hour (14.4 mg/dL → 15.2 mg/dL over 24 hours) Bilirubin rate of increase is within normal limits (< 0.2 mg/dL/hour after 24 hrs).
Gestational Age (GA):		39 weeks
Neurotoxicity Risk Factors:		No

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Hyperbilirubinemia management summary (1,2) for a newborn at 39 weeks gestation with a total bilirubin of 15.2 mg/dL collected at 48 hours of age with no known neurotoxicity risk factors. Bilirubin rate of increase of 0.03 mg/dL/hour (14.4 mg/dL → 15.2 mg/dL over 24 hours) is within normal limits (< 0.2 mg/dL/hour after 24 hrs).

Treatment thresholds:
The baby is *at or above* the threshold for reflex testing with total serum bilirubin (TSB) if using transcutaneous bilirubin (TcB) (13.7 mg/dL); *below* the phototherapy threshold (16.6 mg/dL); *below* the escalation of care threshold (22 mg/dL) and *below* the exchange transfusion threshold (24 mg/dL).

Postdischarge Follow Up:
For the baby 1.4 mg/dL below the phototherapy threshold (delta-TSB) at 48 hours of age  (during birth hospitalization with no prior phototherapy):
 Measure TSB in 4 to 24 hours. Options: (1) Delay discharge and consider phototherapy. (2) Discharge with home phototherapy if all considerations in the guideline are met.  (3) Discharge without phototherapy but with close follow-up.

1. Recommendations derived from 'Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation' [Pediatrics. 2022 Sep 1;150(3)] by the American Academy of Pediatrics (AAP).
2. Generated by BiliTool (https://bilitool.org) 2024 Apr 27 17:14:14 UTC. BiliTool serves only as a reference aid. It is not intended to be (nor should it be used as) a substitute for the exercise of professional judgment.
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Recommendations
	Recommendation	Threshold
If using TcB, confirm with TSB?	Yes	13.7 mg/dL
Phototherapy?	No	16.6 mg/dL
Escalation of Care? (learn more)	No	22 mg/dL
Exchange Transfusion?	No	24 mg/dL

Postdischarge Follow Up
For the baby 1.4 mg/dL below the phototherapy threshold (Δ-TSB) at 48 hours of age (during birth hospitalization with no prior phototherapy): Measure TSB in 4 to 24 hours. Options: (1) Delay discharge and consider phototherapy. (2) Discharge with home phototherapy if all considerations in the guideline are met. (3) Discharge without phototherapy but with close follow-up.