Normal distribution of pre-discharge total serum bilirubin in a culturally diverse cohort of healthy term newborn infants

2010 ◽  
Vol 3 (3) ◽  
pp. 223-227
Author(s):  
Gillian Birchwood ◽  
Rajeev Mehta ◽  
Anna Petrova
Keyword(s):  
Normal Distribution ◽  
Culturally Diverse ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Term Newborn

SERUM ALBUMIN RESERVE PSP DYE BINDING CAPACITY IN INFANTS WITH KERNICTERUS

PEDIATRICS ◽  
1967 ◽  
Vol 39 (6) ◽  
pp. 876-883
Author(s):  
J. F. Lucey ◽  
T. Valaes ◽  
S. A. Doxiadis
Keyword(s):  
Serum Concentration ◽  
Serum Albumin ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Clinically Normal ◽  
Dye Binding

Observations have been reported on the serum albumin PSP reserve dye binding capacity in a group of 93 newborn infants with total serum bilirubin concentrations ranging between 20 to 52 mg/100 ml. Eleven of these infants had a clinically established diagnosis of kernicterus at the time of these measurements. The PSP reserve dye binding capacity in these neurologically damaged infants was not different from that found in clinically normal infants with the same degree of jaundice. We, therefore, do not believe that this test is sufficiently sensitive to serve as a useful adjunct in assaying the risk of neurologic damage at a particular serum concentration of bilirubin.

scholarly journals Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

2015 ◽  
Vol 9 ◽  
pp. CMPed.S24909 ◽  
Author(s):  
Mahmoud A. F. Kaabneh ◽  
Ghassan S. A. Salama ◽  
Ayoub G. A. Shakkoury ◽  
Ibrahim M. H. Al-Abdallah ◽  
Afrah Alshamari ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Blood Exchange ◽  
Blood Exchange Transfusion ◽  
Group 2 ◽  
Group 1

Objective The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD) and its impact on blood exchange transfusion rates. Patients and Method This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were divided randomly into two groups: (1) the phenobarbital plus phototherapy group ( n = 103), and (2) the phototherapy-only group ( n = 97). Infants in group 1 received an oral dose of 2.5 mg/kg phenobarbital every 12 hours for 3 days in addition to phototherapy. The total serum bilirubin was observed. Results Of the total 200 included newborn infants, 186 infants completed the study: 97 infants were included in group 1 and 89 infants in group 2. The difference between the mean total serum bilirubin levels at 24, 48, and 72 hours after starting the trial was clinically and statistically significant at P < 0.05. The differences between the two groups were also statistically significant at P < 0.05. Of the total 186 who completed the study, only 22 underwent blood exchange transfusion [7 from group 1, and 15 from group 2 ( P = 0.0478)]. Conclusion In a limited-resources setting, phenobarbital in combination with phototherapy may be helpful to newborn infants with IHD, as it results in a faster decline in total serum bilirubin, thus decreasing the need for blood exchange transfusion than phototherapy alone.

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

Two Different UGT1A1 Mutations causing Crigler–Najjar Syndrome types I and II in an Iranian Family

2015 ◽  
Vol 24 (4) ◽  
pp. 523-526 ◽  
Author(s):  
Yoshihiro Maruo ◽  
Mahdiyeh Behnam ◽  
Shinichi Ikushiro ◽  
Sayuri Nakahara ◽  
Narges Nouri ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Compound Heterozygous ◽  
Type I ◽  
Syndrome Type ◽  
Type Ii ◽  
Wild Type ◽  
Iranian Family ◽  
Udp Glucuronosyltransferase

Background: Crigler–Najjar syndrome type I (CN-1) and type II (CN-2) are rare hereditary unconjugated hyperbilirubinemia disorders. However, there have been no reports regarding the co-existence of CN-1 and CN-2 in one family. We experienced a case of an Iranian family that included members with either CN-1 or CN-2. Genetic analysis revealed a mutation in the bilirubin UDP-glucuronosyltransferase (UGT1A1) gene that resulted in residual enzymatic activity.Case report: The female proband developed severe hyperbilirubinemia [total serum bilirubin concentration (TB) = 34.8 mg/dL] with bilirubin encephalopathy (kernicterus) and died after liver transplantation. Her family history included a cousin with kernicterus (TB = 30.0 mg/dL) diagnosed as CN-1. Her great grandfather (TB unknown) and uncle (TB = 23.0 mg/dL) developed jaundice, but without any treatment, they remained healthy as CN-2. Results: The affected cousin was homozygous for a novel frameshift mutation (c.381insGG, p.C127WfsX23). The affected uncle was compound heterozygous for p.C127WfsX23 and p.V225G linked with A(TA)7TAA. p.V225G-UGT1A1 reduced glucuronidation activity to 60% of wild-type. Thus, linkage of A(TA)7TAA and p.V225G might reduce UGT1A1 activity to 18%–36 % of the wild-type. Conclusion: Genetic and in vitro expression analyses are useful for accurate genetic counseling for a family with a history of both CN-1 and CN-2. Abbreviations: CN-1: Crigler–Najjar syndrome type I; CN-2: Crigler–Najjar syndrome type II; GS: Gilbert syndrome; UGT1A1: bilirubin UDP-glucuronosyltransferase; WT: Wild type; TB: total serum bilirubin.

scholarly journals Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

2017 ◽  
Vol 57 (1) ◽  
pp. 8 ◽  
Author(s):  
Andra Kurnianto ◽  
Herman Bermawi ◽  
Afifa Darmawanti ◽  
Erial Bahar
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Subcutaneous Tissue ◽  
Correlation Coefficients ◽  
Total Serum Bilirubin ◽  
Blood Sampling ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometry

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

Practice Parameter: Management of Hyperbilirubinemia in the Healthy Term Newborn

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 558-565
Author(s):  
◽  
Keyword(s):  
Serum Bilirubin ◽  
Elevated Serum ◽  
The United States ◽  
Total Serum ◽  
Brain Cells ◽  
Albumin Concentration ◽  
Specific Level ◽  
Term Newborn ◽  
Term Newborns ◽  
The Brain

Each year approximately 60% of the 4 million newborns in the United States become clinically jaundiced. Many receive various forms of evaluation and treatment. Few issues in neonatal medicine have generated such long-standing controversy as the possible adverse consequences of neonatal jaundice and when to begin treatment. Questions regarding potentially detrimental neurologic effects from elevated serum bilirubin levels prompt continuing concern and debate, particularly with regard to the management of the otherwise healthy term newborn without risk factors for hemolysis. Although most data are based on infants with birth weights ≥2500 g, "term" is hereafter defined as 37 completed weeks of gestation. Under certain circumstances, bilirubin may be toxic to the central nervous system and may cause neurologic impairment even in healthy term newborns. Most studies, however, have failed to substantiate significant associations between a specific level of total serum bilirubin (TSB) during nonhemolytic hyperbilirubinemia in term newborns and subsequent IQ or serious neurologic abnormality (including hearing impairment). Other studies have detected subtle differences in outcomes associated with TSB levels, particularly when used in conjunction with albumin binding tests and/or duration of exposure. In almost all published studies, the TSB concentration has been used as a predictor variable for outcome determinations. Factors influencing bilirubin toxicity to the brain cells of newborn infants are complex and incompletely understood; they include those that affect the serum albumin concentration and those that affect the binding of bilirubin to albumin, the penetration of bilirubin into the brain, and the vulnerability of brain cells to the toxic effects of bilirubin.

scholarly journals Development of Jaundice Detection Approaches in Neonates

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Priti Bhagat V ◽  
◽  
Dr Mukesh Raghuwanshi M ◽  
Dr. Kavita Singh ◽  
Dr Sachin Damke ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Serum Bilirubin ◽  
Visual Assessment ◽  
Assessment Methods ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Gold Standard Method ◽  
Life Detection ◽  
Precision And Accuracy ◽  
Transcutaneous Bilirubinometer

Jaundice is one of the most common diseases that have a significant impact in the first few days of newborn life. Detection and regular monitoring of bilirubin, which is responsible for Jaundice, is an essential phase during the hyperbilirubinemia. In the literature, various clinical assessment methods of Jaundice are available. It motivates us to present a review of these clinical assessment methods in practice, along with their advantages and limitations. In this paper, we have discussed three widely used methods, such as visual assessment, total serum bilirubin and transcutaneous bilirubinometer. From the comparative analysis of these methods, it is concluded that the visual assessment is very subjective in nature, whereas, the total serum bilirubin method is still a gold standard method. The detailed analysis of the methods depicts that the correlation between this two total serum bilirubin and transcutaneous bilirubinometer has enormous potential for improvement resulting in the enhancement in precision and accuracy of bilirubin measurement.

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