FOR THE past several years exchange transfusion has been generally accepted as the best preventive measure available against the hazard of kernicterus in hyperbilirubinemia in the newborn. During this period the Committee on Fetus and Newborn has repeatedly discussed the advisability of making a recommendation concerning the concentration of bilirubin in the serum above which an exchange transfusion would be indicated in the immediate neonatal period of life.
The Committee to date has not felt that sufficient evidence existed to justify a specific recommendation of this sort, because the ultimate clinical decision rests on the relative risks of kernicterus and serious complications of death associated with the exchange transfusion procedure. While knowledge and experience are accumulating which improve the effectiveness of, and confidence in, exchange transfusion, the Committee recognized that several areas existed where greater application could be made of existing knowledge with obvious benefit.
In 1961 the Committee attempted to stimulate Academy State Chapters to initiate or conduct educational programs on the subject of neonatal jaundice at the state and local level. At the same time, the Committee established a Subcommittee under the chairmanship of Dr. David Hsia to work with other interested groups and experts to draw up recommendations on a uniform bilirubin standard. Surveys using unknown standard bilirubin solution had emphasized what was widely suspected, that laboratories determining bilirubin were using standards prepared in several different ways, and different analytic methods, which resulted in a considerable range of answers on any single specimen.
- Copyright © 1963 by the American Academy of Pediatrics