Literature

Curbside Consults Podcast


By Clement Lee, MD, MSc

Published January 18, 2023

In this episode of Curbside Consults, we examine the 2022 revision of the clinical practice guideline on the management of hyperbilirubinemia in the newborn infant by the American Academy of Pediatrics (AAP). We are joined by two authors of the revised guideline: Dr. Alex R. Kemper, the Division Chief of Primary Care Pediatrics at Nationwide Children’s Hospital and Professor of Pediatrics at The Ohio State University College of Medicine; and Dr. Thomas Newman, Professor Emeritus of Epidemiology & Biostatistics and Pediatrics at UCSF.

00:05 – Intro
01:11 – AAP Clinical Practice Guideline process
03:31 – Isoimmune hemolytic disease
05:27 – Risk factors for hyperbilirubinemia
06:31 – Risk factors for neurotoxicity
09:34 – Transcutaneous versus serum bilirubin
12:41 – New curves and thresholds for phototherapy
18:35 – Logistics of phototherapy
20:31 – Routine bloodwork before phototherapy
22:44 – Bilirubin monitoring on therapy
24:30 – Stopping phototherapy
27:12 – Follow-up after discharge
29:00 – Escalation of care
31:45 – Concluding remarks: transitions of care
32:35 – Concluding remarks: G6PD deficiency
33:55 – Outro

Articles discussed in this episode:

1. Kemper AR et al. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics 2022.
2. Wickremasinghe AC et al. Neonatal Phototherapy and Infantile Cancer.  Pediatrics 2016.
3. Newman TB et al. Childhood Seizures After Phototherapy. Pediatrics 2018.
4. Chang PW et al. A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy. Pediatrics 2017.
5. Healthychildren.org. Jaundice in Newborns. American Academy of Pediatrics 2022.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

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Alex R. Kemper, MD, MPH, MS, is Division Chief of Primary Care Pediatrics at Nationwide Children’s Hospital and Professor of Pediatrics at The Ohio State University College of Medicine.
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Thomas Newman, MD, MPH, is Professor Emeritus of Epidemiology & Biostatistics and Pediatrics at UCSF.
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Clement Lee, MD, MSc, was a 2021–2022 NEJM Editorial Fellow and is a 2022-2023 Senior Editorial Fellow. He is currently an internal medicine hospitalist at Newton-Wellesley Hospital and a pediatric hospitalist at Boston Children's Hospital. He completed his internal medicine-pediatrics residency at Penn-CHOP.
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