Hyperbilirubinemia in premature infants <35 weeks' gestation: A chronologic age format for graphing consensus-based recommendations.

BACKGROUND: At the request of the AAP, consensus-based recommendations for managing hyperbilirubinemia in infants < 35 weeks' postmenstrual age (PMA) were published in 2012. Subsequently, a PMA-based graphical format of these recommendations was popularized as Premie BiliRecs, providing decision support for infants ≥ 27 weeks' PMA and ≥ 48 h old. METHODS: Chronologic age-based guidelines based on gestational age (GA) at birth were derived from the consensus-based recommendations and modified with integration of the AAP hyperbilirubinemia guidelines and extension of decision support for a minimum of 14 days. These guidelines were implemented in an electronic medical record. RESULTS: The modified consensus guidelines provide support from birth for all infants < 35 weeks' GA and address limitations of the current graphical tools. An interactive tool illustrating these guidelines is available at https://bilirubin-guidelines.net . (Contact your institutional IT department if access to the website is blocked). CONCLUSIONS: These modified consensus guidelines expand decision support for infants < 35 weeks' GA with a format harmonized with the AAP graphs.