TY - JOUR
T1 - A review of existing neonatal hyperbilirubinemia guidelines in Indonesia
AU - Sampurna, Mahendra Tri Arif
AU - Liem, Kian Djien
AU - Pratama, Danny Chandra
AU - Oktaviana, Novita
AU - Putra, Achmad Januar Er
AU - Zakiyah, Rahmi
AU - Visuddho, Visuddho
AU - Etika, Risa
AU - Handayani, Kartika Dharma
AU - Utomo, Martono Tri
AU - Angelica, Dina
AU - Ayuningtyas, Wurry
AU - Hendrarto, Toto Wisnu
AU - Rohsiswatmo, Rinawati
AU - Wandita, Setya
AU - Kaban, Risma Karina
AU - Ahmad, Jordy Maulana
N1 - Funding Information:
This project was supported by a research grant from the Universitas Airlangga in 2020, HK No. 329/UN3.14/LT/2020.
Publisher Copyright:
Copyright: © 2022 Sampurna MTA et al.
PY - 2022
Y1 - 2022
N2 - Background: 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. Methods: 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. Results: 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. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.
AB - Background: 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. Methods: 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. Results: 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. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.
KW - LMIC
KW - icterus
KW - neonates
KW - recommendations
UR - http://www.scopus.com/inward/record.url?scp=85152937384&partnerID=8YFLogxK
U2 - 10.12688/f1000research.110550.1
DO - 10.12688/f1000research.110550.1
M3 - Article
AN - SCOPUS:85152937384
SN - 2046-1402
VL - 11
JO - F1000Research
JF - F1000Research
M1 - 1534
ER -