Neonatal Bili Wheel

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About Neonatal Bili Wheel

Use this wheel to guide therapy for neonates with hyperbilirubinemia. There are 6 circles for providers to categorize neonates of a certain gestational age in the treatment of hyperbilirubinemia including those infants who have hemolytic disease of the newborn such as RH disease, ABO or other blood group incompatibility with coombs positive status, presence of sepsis, hypoxemia, acidosis, or low albumin level of ≤ 2.5mg/dL. Bili Wheel Circles 1. Orange Circle: Select the gestational age of the infant and determine the healthy/sick status as defined above. 2. Yellow Semi-Circle: Select the weight in kilograms for the infant that corresponds to the Orange Circle selection. 3. Light Green Circle: This is the infant's age in hours from birth, at which their serum bili was drawn. 4. Dark Green Circle: This is the bili level range based on the infant's gestational age, and age in days. 5. Teal Circle: This is the phototherapy zone for corresponding bili levels in the yellow circle. Please remember these are not absolute values for phototherapy. Recommendations based on personal experience, guidelines, and references. 6. Blue (outermost) Circle: Serum bili level at which exchange transfusion may be considered. Please note that exchange levels serum bilirubin for 500 grams to 1500 grams (both healthy and sick infants) infants are "variable" and be considered on individual basis. Note:Bill levels are measured in mg/dL. Abbreviations: W = gestational weeks, G = grams, kg = kilograms, Bili = bilirubin in mg/dL, P = phototherapy, ET = exchange transfusion