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

Objective: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).study design: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.results: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%).conclusions:routine measurement of db in neonates admitted to nicu may be helpful in identifying potentially treatable causes of cholestasis.