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Understanding severe hyperbilirubinemia and preventing kernicterus: adjuncts in the interpretation of neonatal serum bilirubin.
Clin Chim Acta. 2005 Jun; 356(1-2):9-21.CC

Abstract

The serum total bilirubin concentration at any point in time represents the amount of bilirubin being produced minus that being excreted. Hyperbilirubinemia develops when bilirubin production exceeds the body's capacity to excrete it, primarily by conjugation. When extreme, hyperbilirubinemia may lead to the development of free bilirubin, that form of bilirubin which may cross the blood-brain barrier and enter and damage the basal nuclei of the brain. This rare, though devastating complication, may result in irreversible bilirubin induced brain damage termed kernicterus. In this paper, adjuncts to the interpretation of the serum total bilirubin are discussed, with the purpose of singling out those few neonates in real danger of bilirubin encephalopathy. Interpretation of the serum total bilirubin should be performed in conjunction with factors unique to the particular infant being evaluated. Understanding the mechanisms and dangers of severe neonatal hyperbilirubinemia should facilitate recognition of an emergency situation and optimize the speed with which bilirubin testing is performed and blood for exchange transfusion prepared. Hyperbilirubinemia is a condition of major importance and a source of concern to all involved in the management of the newborn. Its prevention and management should be based on the recently revised American Academy of Pediatric guidelines, with special attention paid to neonates manifesting risk factors for kernicterus. Close cooperation between the clinical laboratory and the medical team managing the newborn is an essential component in the management of a hyperbilirubinemic baby.

Authors+Show Affiliations

Department of Neonatology, Shaare Zedek Medical Center, P.O. Box 3235, Jerusalem 91031, Israel. kaplan@cc.huji.ac.ilNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15936300

Citation

Kaplan, Michael, and Cathy Hammerman. "Understanding Severe Hyperbilirubinemia and Preventing Kernicterus: Adjuncts in the Interpretation of Neonatal Serum Bilirubin." Clinica Chimica Acta; International Journal of Clinical Chemistry, vol. 356, no. 1-2, 2005, pp. 9-21.
Kaplan M, Hammerman C. Understanding severe hyperbilirubinemia and preventing kernicterus: adjuncts in the interpretation of neonatal serum bilirubin. Clin Chim Acta. 2005;356(1-2):9-21.
Kaplan, M., & Hammerman, C. (2005). Understanding severe hyperbilirubinemia and preventing kernicterus: adjuncts in the interpretation of neonatal serum bilirubin. Clinica Chimica Acta; International Journal of Clinical Chemistry, 356(1-2), 9-21.
Kaplan M, Hammerman C. Understanding Severe Hyperbilirubinemia and Preventing Kernicterus: Adjuncts in the Interpretation of Neonatal Serum Bilirubin. Clin Chim Acta. 2005;356(1-2):9-21. PubMed PMID: 15936300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding severe hyperbilirubinemia and preventing kernicterus: adjuncts in the interpretation of neonatal serum bilirubin. AU - Kaplan,Michael, AU - Hammerman,Cathy, Y1 - 2005/03/19/ PY - 2004/10/29/received PY - 2005/01/11/revised PY - 2005/01/13/accepted PY - 2005/6/7/pubmed PY - 2005/8/27/medline PY - 2005/6/7/entrez SP - 9 EP - 21 JF - Clinica chimica acta; international journal of clinical chemistry JO - Clin Chim Acta VL - 356 IS - 1-2 N2 - The serum total bilirubin concentration at any point in time represents the amount of bilirubin being produced minus that being excreted. Hyperbilirubinemia develops when bilirubin production exceeds the body's capacity to excrete it, primarily by conjugation. When extreme, hyperbilirubinemia may lead to the development of free bilirubin, that form of bilirubin which may cross the blood-brain barrier and enter and damage the basal nuclei of the brain. This rare, though devastating complication, may result in irreversible bilirubin induced brain damage termed kernicterus. In this paper, adjuncts to the interpretation of the serum total bilirubin are discussed, with the purpose of singling out those few neonates in real danger of bilirubin encephalopathy. Interpretation of the serum total bilirubin should be performed in conjunction with factors unique to the particular infant being evaluated. Understanding the mechanisms and dangers of severe neonatal hyperbilirubinemia should facilitate recognition of an emergency situation and optimize the speed with which bilirubin testing is performed and blood for exchange transfusion prepared. Hyperbilirubinemia is a condition of major importance and a source of concern to all involved in the management of the newborn. Its prevention and management should be based on the recently revised American Academy of Pediatric guidelines, with special attention paid to neonates manifesting risk factors for kernicterus. Close cooperation between the clinical laboratory and the medical team managing the newborn is an essential component in the management of a hyperbilirubinemic baby. SN - 0009-8981 UR - https://wwww.unboundmedicine.com/medline/citation/15936300/Understanding_severe_hyperbilirubinemia_and_preventing_kernicterus:_adjuncts_in_the_interpretation_of_neonatal_serum_bilirubin_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-8981(05)00052-5 DB - PRIME DP - Unbound Medicine ER -