Exchange transfusion criterion in newborn jaundice is which of the following?

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The key idea is recognizing when hyperbilirubinemia is severe enough to threaten the brain and requires rapid reduction of bilirubin. Exchange transfusion is considered when a newborn falls in the high-risk Bhutani zone and there is a markedly elevated bilirubin level. The Bhutani nomogram helps identify infants at highest risk for bilirubin-induced neurotoxicity by age in hours; those in the high-risk zone with very high bilirubin are the cases where exchanging the baby’s blood can quickly remove bilirubin and any circulating antibodies, thereby preventing kernicterus. Phototherapy is used for less severe cases, and is not sufficient when the risk is very high or bilirubin is markedly elevated. Low bilirubin levels do not prompt exchange transfusion, and saying it’s rarely indicated overlooks situations with severe hyperbilirubinemia in high-risk infants.