What is the Highest Bilirubin you've ever seen?

[dawngloves]

Just curious. :wink2:

[jeepgirl, LPN, NP]

We got called to Peds for a 2 day old whos bili was 24 or something. The kid was dehydrated like no other and was a home birth. After a million lab draws and one IV gone bad, the parents said they would rather their baby die then to get poked again so the Peds let them take her home. I nearly threw up after being told that.

i think there are legal avenues healthcare providers can take if they feel the need. i'm suprised the peds let her do that - always amazes me.

[spartangal1989]

normal bili levels are dependant on age (in terms of hours/days), gestational age, and institutional values. I know this isn't really the answer that you want to hear, but in general a full term healthy baby should be less than 10 at 24 hours of age. If it is 10 or higher, you usually need phototherapy and further investigation

[SteveNNP, MSN, NP]

I'm also a big fan of nurses understanding and recognizing ABO incompatibility. Not every resident is going to pick up on it, and we find out later when the kid turns into a pumpkin and has no cord stump for an exchange transfusion.

[judi little]

My father is currently in hospital with bilirubin level over 400. Does anyone know how high it can go

[darynash]

i think there are legal avenues healthcare providers can take if they feel the need. i'm suprised the peds let her do that - always amazes me.

There is, it is called "chain of command." If you don't feel the order of the physician is appropriate, go up the ladder per your hospital policy. As nurses, we are the patient's advocate and it sounded like this baby needed one.

[dawnclnc]

40 yes I said 40!!!!!!!!!!

[littlepeach]

We had a 28 on a baby only 24 hours old. She had some weird endocrine disorder and it was still in the low 20's when we sent her home 3 weeks later. I think she's two now and on dialysis.

[sjc80]

How about the lowest? I had a baby who had a 0. On repeat she had a 1.

I don't even know what that means and I can't find any info about low neonatal bilirubin! Though there is info about low bili and coronary artery disease....... But I don't think that's a problem with a 3 day old!

[rn/writer, RN]

I've had a number of kids register less than 1, all the way down to zero. I've always taken this to mean that their livers were up to the task of processing the discarded red blood cell byproducts. Never heard of any pathology associated with low bilirubin level in a newborn.

[Elvish, BSN, DNP, RN, NP]

Yep, me either. I've had several bilis come back 0, or less than 1. Nobody gets their knickers in a wad.

[barbnicu]

Same here, upper 20's, exchange transfusion; you know the drill. Did have an infant who just could not get the bili down, it stayed in the teens. Went home on Actigal. Another one who had that deep bronze color, found out she had CMV. But it was too late when we got all the tests back. Sad day.

[ScammRNC]

27 is the highest I have seen with a couple of exchange transfusions to bring it down.