Abstract
Fourty two cases of kernicterus were reported by sixteen national hospitals during 1966-1968, and the types of hyperbilirubinemia that coused subsequent kernicterus were discussed. 86.4% of the hyperbilirubinemia in full term infants were caused by ABO- or Rh- incompatibility, while most (66.7%) of that in premature infants were idiopathic.
According to my experiences added to the opinions of many authors, the serum total bilirubin value as the indication of exchange transfusion in full term infants may be employed as 25-27mg%.
The phototherapy is a relatively harmless and effective procedure to drop the serum bilirubin level, next to the exchange transfusion. But it must not be used to the case with slight degree of jaundice for the purpose of prophylaxis against hyperbilirubinemia. The bilirubin level as the indication to begin a phototherapy may be about 20-22 mg% in the cases of full term infant during 4-7 days of age. But in the case that the jaundice appeared early and increased rapidly within 3 days of age, the phototherapy must be immediately performed even in the lower bilirubin level. But it can not be almighty in such cases, so we must be ready to switch to give immediate exchange transfusion if necessary
