PDF(Pubmed)
Abstract：
UNASSIGNED: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia.
UNASSIGNED: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline.
UNASSIGNED: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal.
UNASSIGNED: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.
UNASSIGNED: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline.
UNASSIGNED: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal.
UNASSIGNED: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.
摘要：
■新生儿高胆红素血症是新生儿住院患者最常见的疾病之一。印度尼西亚面临着一个重大挑战，其中存在关于这种状况管理的不同准则。本研究旨在比较现有的预防指南，诊断,治疗和监测，以便为印度尼西亚新的高胆红素血症指南提供最佳建议。
■通过早期关于新生儿高胆红素血症指南依从性的调查，我们确定印度尼西亚正在使用三个主要准则。这些是由印度尼西亚儿科协会（IPS）开发的，卫生部（MoH），世界卫生组织（WHO）。在这项研究中,我们比较了预防等因素，监测,识别方法，新生儿黄疸发生的危险因素,增加脑损伤的危险因素，和现有指南中的干预治疗阈值，以确定新指南的最佳建议。
■卫生部和WHO指南仅允许基于视觉检查（VE）筛查和治疗高胆红素血症。与卫生部和世卫组织的指导方针相比，风险评估在IPS指南中进行了全面讨论。MoH指南建议对黄疸婴儿进行进一步检查，以确保母亲有足够的乳汁，而无需测量胆红素水平。MoH指南建议当婴儿在鞋底和手掌上看起来呈黄色时转介婴儿。WHO和IPS指南建议将VE与经皮或血清胆红素的客观测量相结合。WHO指南中开始光疗的阈值低于IPS指南，而两个指南中的交换输血阈值相当相等。
■卫生部的指导方针已经过时。MoH和IPS指南在治疗高胆红素血症的方法上引起了差异。一个新的,需要统一的指导方针。
■通过早期关于新生儿高胆红素血症指南依从性的调查，我们确定印度尼西亚正在使用三个主要准则。这些是由印度尼西亚儿科协会（IPS）开发的，卫生部（MoH），世界卫生组织（WHO）。在这项研究中,我们比较了预防等因素，监测,识别方法，新生儿黄疸发生的危险因素,增加脑损伤的危险因素，和现有指南中的干预治疗阈值，以确定新指南的最佳建议。
■卫生部和WHO指南仅允许基于视觉检查（VE）筛查和治疗高胆红素血症。与卫生部和世卫组织的指导方针相比，风险评估在IPS指南中进行了全面讨论。MoH指南建议对黄疸婴儿进行进一步检查，以确保母亲有足够的乳汁，而无需测量胆红素水平。MoH指南建议当婴儿在鞋底和手掌上看起来呈黄色时转介婴儿。WHO和IPS指南建议将VE与经皮或血清胆红素的客观测量相结合。WHO指南中开始光疗的阈值低于IPS指南，而两个指南中的交换输血阈值相当相等。
■卫生部的指导方针已经过时。MoH和IPS指南在治疗高胆红素血症的方法上引起了差异。一个新的,需要统一的指导方针。
