Document Detail

The influence of skin temperature and skin perfusion on the cephalocaudal progression of jaundice in newborns.
MedLine Citation:
PMID:  19751377     Owner:  NLM     Status:  In-Process    
AIM: Despite being widely recognized, the cephalocaudal progression of jaundice in newborns (Kramer's Rule) has never been satisfactorily explained. The aim of this study was to test the hypothesis that the cephalocaudal progression of jaundice in newborns is related to regional differences in skin temperature and skin perfusion. METHODS: A convenience sample of 50 infants was included in the study. On each infant, a transcutaneous bilirubin, skin temperature and capillary refill time measurement was made at five sites; the forehead, sternum, lower abdomen, mid thigh and sole. The relationship between the three variables was studied by analysis of variance. RESULTS: The transcutaneous bilirubin measurements upheld Kramer's observation, being significantly higher at the head and chest than at the thigh and sole (P < 0.001). A similar pattern was found for both skin temperature and capillary refill, both significantly different at the head compared to the sole (P < 0.001). CONCLUSION: The results of the study support the hypothesis that the cephalocaudal progression of jaundice in newborns is a consequence of diminished capillary blood flow in distal parts of the body. It is hypothesized that newborn infants preferentially perfuse their head and proximal parts of their body in the first few days of life, leading to higher temperatures and increased bilirubin deposition at these sites.
Natalie Purcell; Philip J Beeby
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Publication Detail:
Type:  Journal Article     Date:  2009-09-14
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  45     ISSN:  1440-1754     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  582-6     Citation Subset:  IM    
Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
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