Guidelines for the use of phototherapy and exchange transfusion in low birthweight infants based on birth weight57
| Birth weight (g) | Total bilirubin level (mg/dl (μmol/l)*) | |
|---|---|---|
| Phototherapy† | Exchange transfusion‡ | |
| Note that these guidelines reflect ranges used in neonatal intensive care units. They cannot take into account all possible situations. Lower bilirubin concentrations should be used for infants who are sick—for example, presence of sepsis, acidosis, hypoalbuminaemia—or have haemolytic disease. | ||
| *Consider initiating treatment at these levels. Range allows discretion based on clinical conditions or other circumstances. Note that bilirubin levels refer to total serum bilirubin concentrations. Direct reacting or conjugated bilirubin levels should not be subtracted from the total. | ||
| †Used at these levels and in therapeutic doses, phototherapy should, with few exceptions, eliminate the need for exchange transfusions. | ||
| ‡Levels for exchange transfusion assume that bilirubin continues to rise or remains at these levels despite intensive phototherapy. | ||
| ⩽1500 | 5–8 (85–140) | 13–16 (220–275) |
| 1500–1999 | 8–12 (140–200) | 16–18 (275–300) |
| 2000–2499 | 11–14 (190–240) | 18–20 (300–340) |