BOSCO’S EXTENDED TSB TABLE

TSB LEVELS FOR PHOTOTHERAPY AND EXCHANGE TRANSFUSION IN BABIES ≥35WEEKS GESTATION, adapted from AAP Guidelines

LOW RISK MEDIUM RISK HIGH RISK

> 38 weeks & well > 38 weeks with risk factors, 35-37 weeks + 35-37 weeks + 6 days with risk factors
6 days & well
HOURS Conventional Exchange Conventional Exchange Conventional Exchange
OF LIFE Phototherapy Transfusion Phototherapy Transfusion Phototherapy Transfusion
TSB mg/dL (µmol/L) TSB mg/dL TSB mg/dL (µmol/L) TSB mg/dL TSB mg/dL TSB mg/dL
(µmol/L) (µmol/L) (µmol/L) (µmol/L)
6 5 (80) 17 (290) 4 (60) 14 (240) 2 (30) 13 (220)
7 83.33 293.333 63.33 243.33 33.33 223.33
8 86.67 296.667 66.67 246.67 36.67 226.67
9 90 300 70 250 40 230
10 93.33 303.333 73.33 253.33 43.33 233.33
11 96.67 306.667 76.67 256.67 46.67 236.67
12 6 (100) 18 (310) 5 (80) 15 (260) 3 (50) 14 (240)
13 104.5 311.25 83.33 262.583 53 241.417
14 109 312.5 86.67 265.167 56 242.83
15 113.5 313.75 90 267.75 59 244.25
16 118 315 93.33 270.33 62 245.67
17 122.5 316.25 96.67 272.917 65 247.083
18 127 317.5 100 275.5 68 248.5
19 131.5 318.75 103.33 278.083 71 249.917
20 136 320 106.67 280.67 74 251.33
21 140.5 321.25 110 283.25 77 252.75
22 145 322.5 113.33 285.83 80 254.167
23 149.5 323.75 116.67 288.417 83 255.583
24 9 (154) 19 (325) 7 (120) 17 (291) 5 (86) 15 (257)
25 156.125 327.125 122.125 292.417 88.125 258.417
26 158.25 329.25 124.25 293.83 90.25 259.83
27 160.375 331.375 126.375 295.25 92.375 261.25
28 162.5 333.5 128.5 296.67 94.5 262.67
29 164.625 335.625 130.625 298.083 96.625 264.083
30 166.75 337.75 132.75 299.5 98.75 265.5
31 168.875 339.875 134.875 300.917 100.875 266.917
32 171 342 137 302.33 103 268.33
33 173.125 344.125 139.125 303.75 105.125 269.75
34 175.25 346.25 141.25 305.167 107.25 271.167
35 177.375 348.375 143.375 306.583 109.375 272.583
36 179.5 350.5 145.5 308 111.5 274
37 181.625 352.625 147.625 309.417 113.625 275.417
38 183.75 354.75 149.75 310.83 115.75 276.83
39 185.875 356.875 151.875 312.25 117.875 278.25
40 188 359 154 313.67 120 279.67
41 190.125 361.125 156.125 315.083 122.125 281.083
42 192.25 363.25 158.25 316.5 124.25 282.5
43 194.375 365.375 160.375 317.917 126.375 283.917
44 196.5 367.5 162.5 319.33 128.5 285.33
45 198.625 369.625 164.625 320.75 130.625 286.75
46 200.75 371.75 166.75 322.167 132.75 288.167
47 202.875 373.875 168.875 323.583 134.875 289.583
48 12 (205) 22 (376) 10 (171) 19 (325) 8 (137) 17 (291)
49 207.167 377.417 172.417 326.417 138.417 292.0417
50 209.33 378.333 173.83 327.83 139.83 293.083
51 211.5 380.25 175.25 329.25 141.25 294.125
52 213.667 381.667 176.67 330.67 142.67 295.167
53 215.833 383.083 178.083 332.083 144.083 296.2083
54 218 384.5 179.5 333.5 145.5 297.25

*Values are rounded off to the nearest significant decimal point

**Values have been crosschecked 3 times, you are encouraged to recalculate if value unsure/suspicious
BOSCO’S EXTENDED TSB TABLE
TSB LEVELS FOR PHOTOTHERAPY AND EXCHANGE TRANSFUSION IN BABIES ≥35WEEKS GESTATION, adapted from AAP Guidelines

55 220.167 385.917 180.917 334.917 146.917 298.2917

56 222.33 387.333 182.33 336.33 148.33 299.33
57 224.5 388.75 183.75 337.75 149.75 300.375
58 226.667 390.167 185.167 339.167 151.167 301.417
59 228.833 391.583 186.583 340.583 152.583 302.4583
60 231 393 188 342 154 303.5
61 233.167 394.417 189.417 343.417 155.417 304.5417
62 235.333 395.833 190.83 344.83 156.83 305.583
63 237.5 397.25 192.25 346.25 158.25 306.625
64 239.667 398.667 193.67 347.67 159.67 307.67
65 241.833 400.083 195.083 349.083 161.083 308.7083
66 244 401.5 196.5 350.5 162.5 309.75
67 246.167 402.917 197.917 351.917 163.917 310.7917
68 248.333 404.333 199.33 353.33 165.33 311.83
69 250.5 405.75 200.75 354.75 166.75 312.875
70 252.667 407.167 202.167 356.167 168.167 313.917
71 254.833 408.583 203.583 357.83 169.583 314.9583
72 15 (257) 24 (410) 12 (205) 21 (359) 10 (171) 18.5 (316)
73 258.417 410.75 206.417 360.083 171.7083 316.375
74 259.833 411.5 207.83 361.167 172.417 316.75
75 261.25 412.25 209.25 362.25 173.125 317.125
76 262.667 413 210.67 363.33 173.83 317.5
77 264.083 413.75 212.083 364.417 175.5417 317.875
78 265.5 414.5 213.5 365.5 175.25 318.25
79 266.917 415.25 214.917 366.583 175.9583 318.625
80 268.333 416 216.33 367.67 176.67 319
81 269.75 416.75 217.75 368.75 177.375 319.375
82 271.167 417.5 219.167 369.83 178.083 319.75
83 272.583 418.25 220.583 370.917 178.7917 320.125
84 274 419 222 372 179.5 320.5
85 275.417 419.75 223.417 373.083 180.2083 320.875
86 276.833 420.5 224.83 374.167 180.917 321.25
87 278.25 421.25 226.25 375.25 181.625 321.625
88 279.667 422 227.67 376.33 182.33 322
89 281.083 422.75 229.083 377.417 183.0417 322.375
90 282.5 423.5 230.5 378.5 183.75 322.75
91 283.917 424.25 231.917 379.583 184.4583 323.125
92 285.333 425 233.33 380.67 185.167 323.5
93 286.75 425.75 234.75 381.75 185.875 323.875
94 288.167 426.5 236.167 382.83 186.583 324.25
95 289.583 427.25 237.583 383.917 187.2917 324.625
96 17 (291) 25 (428) 14 (239) 22.5 (385) 11 (188) 19 (325)
>96 18 (308) 25 (428) 15 (257) 22.5 (385) 12 (205) 19 (325)
*Start intensive phototherapy at TSB of 3mg/dL (51µmol/L) above the level for conventional phototherapy or
when TSB increasing at >0.5mg/dL (8.5µmol/L) per hour.
*Risk factors are isoimmune haemolytic disease, G6PD deficiency, asphyxia and sepsis.
The AAP exchange transfusion guidelines for babies ≥35weeks gestation recommend:
*ET if baby shows signs of ABE or if TSB ≥5mg/dL (85µmol/L) above the ET levels.
*ET if TSB rises to ET levels despite intensive phototherapy in hospitalized babies.
*For readmitted babies without signs of ABE, if the TSB is above the ET levels, repeat TSB every 2-3hours and
consider ET if it is not expected to drop below ET levels after 6hours of intensive phototherapy.

CREDITS: DR. THEVASREE, DR. AMELIA JANE, DR. RINA, DR. KHIRREN, MY FAMILY & LOVED ONES (APRIL 2019)

*Values are rounded off to the nearest significant decimal point

**Values have been crosschecked 3 times, you are encouraged to recalculate if value unsure/suspicious