Premie BiliRecsLucile Packard Children's Hospital at Stanford LPCH

Stanford BiliTool

A tool for treatment of indirect hyperbilirubinemia in newborns

BiliRecs is designed to help clinicians appropriately prescribe phototherapy or exchange transfusion for infants >=35 weeks post-menstrual age.

Required values include either the patient's age in hours at time of blood sampling or date and time of birth and date and time of blood sampling, as well as the total bilirubin in either US (mg/dl) or SI (µmol/L) units.

Recommendations are based on Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation by AAP Subcommittee on Hyperbilirubinemia (Pediatrics 2004)

Total Serum Bilirubin Trend
Phototherapy Threshold
Transfusion Threshold
Clinical Assesment
Treatment Recommendation
  • Predischarge TSB or TcB level in the high-risk zone
  • Jaundice observed in the first 24h
  • Blood group incompatibility with positive direct antiglobulin test, other known hemolytic disease, elevated ETCO
  • Previous sibling received phototherapy
  • Cephalohematoma or significant bruising
  • Exclusive breastfeeding, particularly if nursing is not going well and weight loss
  • East Asian race
  • Isoimmune Hemolytic Disease
  • G6PD deficiency
  • Asphyxia
  • Significant lethargy
  • Temperature instability
  • Sepsis
  • Acidosis
  • Albumin < 3.0 g/dL