Phototherapy Nomogram used as Risk Zone Nomogram and Exchange

Nomogram

WHEN USED AS RISK ZONE (RZ) NOMOGRAM

• The dashed line is the 95th percentile of the RZ nomogram.
• The solid line is the 75th percentile of the RZ nomogram.
• A line drawn by subtracting 2 from the solid line is the 40th percentile of the RZ nomogram.

TO USE AS EXCHANGE NOMOGRAM

• Add 8 to the corresponding lines (solid, dashed or dotted) if age is < 24 hours.
• Add 7 to the corresponding lines (solid, dashed or dotted) if age is 24-48 hours.
• Add 6 to the corresponding lines (solid, dashed or dotted) if age is 48-72 hours.
• Add 5 to the corresponding lines (solid, dashed or dotted) if age is 72-96 hours.
• Add 4 to the corresponding lines (solid, dashed or dotted) if age is > 96 hours.

DESCRIPTION
There are three nomograms that one refers to when managing babies with jaundice— risk zone nomogram,
phototherapy nomogram and exchange nomogram. It would be helpful if all three nomograms can be combined
into one nomogram to save time referring to each nomogram. But since a composite nomogram does not exist yet,
we can use some rules and apply them to just one nomogram, the phototherapy nomogram, and use it to substitute
for the other two nomograms. One must remember that these nomograms are just visual aids and are not
substitute for one’s clinical judgement.

When Phototherapy (PT) nomogram is used as Risk Zone (RZ) nomogram:

• The dashed line of the PT nomogram corresponds to the 95th percentile of the RZ nomogram.
• The solid line of the PT nomogram corresponds to the 75th percentile of the RZ nomogram.
• A line drawn by subtracting 2 from the solid line of the PT nomogram corresponds to the 40th percentile of the
RZ nomogram.

To use Phototherapy nomogram as Exchange nomogram:

• Add 8 to the corresponding lines (solid, dashed or dotted) if age is < 24 hours.
• Add 7 to the corresponding lines (solid, dashed or dotted) if age is 24-48 hours.
• Add 6 to the corresponding lines (solid, dashed or dotted) if age is 48-72 hours.
• Add 5 to the corresponding lines (solid, dashed or dotted) if age is 72-96 hours.
• Add 4 to the corresponding lines (solid, dashed or dotted) if age is > 96 hours.