Neonatal Phototherapy Calculator

Calculate phototherapy and exchange transfusion thresholds for neonates with precision and ease

Enter either GA weeks or weight above

Phototherapy

Calculated TSB Level

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Clinical Treatment Guidelines

Evidence-based neonatal jaundice management protocols

Phototherapy

Mechanism

Unconjugated bilirubin in skin is isomerized by visible light (420-460 nm) to water-soluble 'lumirubin', which is excreted in stools and urine.

Key Points

  • Uses blue visible light, NOT ultraviolet
  • Eyes must be properly covered
  • Monitor temperature regularly
  • Continue frequent breastfeeding
  • Monitor with blood tests, not clinical assessment

Monitoring

  • TSB levels daily or more frequently if severe
  • Check TSB 12-24 hours after stopping
  • Stop when TSB >50 μmol/L below threshold

Western Cape 2006 Guidelines

Risk factors: Use one line lower for sepsis, haemolysis, acidosis, asphyxia

Monitoring intervals:

  • 1-20 μmol/L below: repeat in 6 hours
  • 21-50 μmol/L below: repeat in 12-24 hours
  • >50 μmol/L below: repeat until falling

Exchange Transfusion

Indications

  • High risk of bilirubin encephalopathy
  • TSB >85 μmol/L above threshold
  • Signs of bilirubin encephalopathy
  • Rising TSB >17 μmol/L/hr despite intensive phototherapy

Procedure

  • Double volume exchange (160 ml/kg over 4 hours)
  • Via umbilical vein or arterial catheter
  • Only in specialized centers

Risks

  • Hypothermia, hypoglycaemia
  • Sepsis and transfusion reactions
  • Incompatibility reactions

General Management

Physiological jaundice: Most infants don't require treatment

Early feeding: Reduces enterohepatic circulation

Conjugated jaundice: Treat underlying condition (surgery for biliary atresia, antibiotics for infections)

Important Clinical Notice

This calculator provides threshold values based on established guidelines. Clinical judgment should always be applied. Consider individual risk factors, and consult pediatric specialists for complex cases. Monitor phototherapy response with serial blood tests, not clinical assessment.

Professional medical calculator for neonatal phototherapy threshold determination

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