Utility of measuring direct bilirubin at first 72 h of age in neonates admitted to the neonatal intensive care unit

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To assess the utility of measuring direct bilirubin (DB) during the first 72 h of life in infants admitted to the neonatal intensive care unit (NICU).


Infants born between May 2006 and June 2013, and admitted to the NICU were included. Abnormal DB was defined as: DB level≥1 mg dl-1 with a corresponding TB of ≤5 mg dl-1 or DB level >20% of the corresponding TB>5 mg dl-1.


The DB levels were measured in 3715 infants during the first 72 h of life. Sixty-three infants (1.7%) had abnormal DB. In a number of infants with potentially treatable diseases (biliary atresia and choledochal cyst), the only abnormal finding was a mildly elevated DB (1 to 2 mg dl-1) during the first 3 days of life. In 22 infants (35%), the cause for high DB was unknown (16%) or not investigated (19%).


Routine measurement of DB in neonates admitted to NICU may be helpful in identifying potentially treatable causes of cholestasis.

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