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The knowledge of Indonesian pediatric residents on hyperbilirubinemia management
Heliyon ( IF 3.4 ) Pub Date : 2021-04-06 , DOI: 10.1016/j.heliyon.2021.e06661
Mahendra T.A. Sampurna , Rinawati Rohsiswatmo , Aris Primadi , Setya Wandita , Eko Sulistijono , Arend F. Bos , Pieter J.J. Sauer , Christian V. Hulzebos , Peter H. Dijk

Hyperbilirubinemia in the newborn occurs more frequently in Indonesia. Therefore, it is important that pediatric residents in Indonesia acquire adequate knowledge of hyperbilirubinemia management. This study aims to determine the pediatric residents' knowledge on hyperbilirubinemia management, whether they follow recommended guidelines, and whether differences exist between five large Indonesian teaching hospitals. We handed out a 25-question questionnaire on hyperbilirubinemia management to pediatric residents at five teaching hospitals. A total of 250 questionnaires were filled in completely, ranging from 14 to 113 respondents per hospital. Approximately 76% of the respondents used the Kramer score to recognize neonatal jaundice. Twenty-four percent correctly plotted the total serum bilirubin levels (TSB) on the phototherapy (PT) nomograms provided by the American Academy of Pediatrics (AAP) and the National Institute for Health and Care Excellence (NICE) for full-term and nearly full-term infants. Regarding preterm infants <35 weeks' gestational age, 66% of the respondents plotted TSB levels on the AAP nomogram, although this nomogram doesn't apply to this category of infants. Seventy percent of residents knew when to perform an exchange transfusion whereas 27% used a fixed bilirubin cut-off value of 20 mg/dL. Besides PT, 25% reported using additional pharmaceutical treatments, included albumin, phenobarbitone, ursodeoxycholic acid and immunoglobulins, while 47% of the respondents used sunlight therapy, as alternative treatment. The limited knowledge of the pediatric residents could be one factor for the higher incidence of severe hyperbilirubinemia and its sequelae. The limited knowledge of the residents raises doubts about the knowledge of the supervisors and the training of the residents since pediatric residents receive training from their supervisors.



中文翻译:

印尼儿科居民对高胆红素血症的管理知识

印度尼西亚的新生儿高胆红素血症发生率更高。因此,印度尼西亚的儿科居民获得足够的高胆红素血症管理知识非常重要。这项研究旨在确定儿科居民对高胆红素血症的管理知识,他们是否遵循建议的指南以及印度尼西亚五家大型教学医院之间是否存在差异。我们向五家教学医院的儿科居民发放了25个问题的高胆红素血症管理问卷。总共填写了250份问卷,每家医院从14到113位受访者不等。大约76%的受访者使用Kramer评分来识别新生儿黄疸。在美国儿科学会(AAP)和美国国立卫生与医疗保健研究院(NICE)提供的光疗(PT)诺模图上,有24%的人正确地绘制了全部和几乎完全的血清总胆红素水平(TSB)。足月婴儿。对于胎龄小于35周的早产儿,尽管有此指数不适用于此类婴儿,但66%的受访者在AAP诺模图上标出了TSB水平。70%的居民知道何时进行换血,而27%的居民使用固定的20毫克/分升胆红素截止值。除了PT,还有25%的人报告使用其他药物治疗,包括白蛋白,苯巴比妥,熊去氧胆酸和免疫球蛋白,而47%的受访者使用阳光疗法作为替代疗法。儿科居民的知识有限可能是严重高胆红素血症及其后遗症发生率较高的因素之一。由于儿科住院医师接受其主管的培训,居民知识的匮乏使人们对主管的知识和居民的培训产生了怀疑。

更新日期:2021-04-08
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