This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.
Bilirubin per NICE CG98 (United Kingdom)
Phototherapy and exchange thresholds according to the British guideline, also for preterm infants from 23 weeks
About this calculator
Phototherapy and exchange transfusion thresholds according to the British NICE guideline CG98 “Jaundice in newborn babies under 28 days” (2010, updated 2023), in µmol/L and mg/dL. From 38 weeks according to the table for the first 96 hours of life, from 23 to 37 weeks according to the formula gestational age × 10 − 100 (phototherapy) or × 10 (exchange). With advice on the next measurement, its own table and chart.
How the calculator works: From 38 weeks, a table applies with values every 6 hours from birth to 96 hours; after that the thresholds stay the same (phototherapy above 350, exchange transfusion above 450 µmol/L). Between the 6-hour values, the calculator connects with a straight line, like the NICE graphs. From 23 to 37 weeks, from 72 hours: phototherapy above gestational age × 10 − 100, exchange transfusion above gestational age × 10 (in µmol/L, gestational age in completed weeks). Before 72 hours, the threshold rises in a straight line from 40 µmol/L (phototherapy) or 80 µmol/L (exchange) at birth.
Unit: NICE uses µmol/L. 1 mg/dL = 17.1 µmol/L.
- The thresholds are a consensus of the NICE guideline group, not limits derived from studies.
- Assays from different manufacturers give different results; check the thresholds with your own laboratory.
- Do not subtract direct (conjugated) bilirubin from total bilirubin.
- The thresholds apply to newborns under 28 days in care following NICE (United Kingdom). Other recommendations apply in German-speaking countries.
Frequently asked questions
When does NICE recommend treatment?
When total bilirubin exceeds the threshold. A value exactly at the threshold is not enough. If the value is above the exchange threshold, NICE recommends an exchange transfusion unless the level falls below the threshold while it is being prepared.
How does NICE calculate for preterm infants?
From 23 to 37 weeks, from 72 hours of life: phototherapy above gestational age in weeks × 10 − 100, exchange transfusion above gestational age × 10 (µmol/L). Before that, the threshold rises in a straight line from 40 or 80 µmol/L at birth.
Why do the values differ from the AAP guideline?
NICE and the AAP set their thresholds independently. NICE uses consensus values in µmol/L without risk factors; the AAP 2022 uses curves by gestational age and neurotoxicity risk factors. The NICE thresholds apply to care in the United Kingdom.
Is direct bilirubin subtracted?
No. NICE states that conjugated bilirubin must not be subtracted from total bilirubin.