scholarly journals Efektifitas Fototerapi Pada Bayi Baru Lahir dengan Hiperbilirubinemia Berdasarkan Jenis Lampu dan Panjang Gelombang Fototerapi

2021 ◽  
Vol 27 (2) ◽  
pp. 129-135
Author(s):  
Calvin Augurius ◽  
Suryadi Susanto ◽  
Yorisye Septiana
Keyword(s):  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Boolean Operator

Hiperbilirubinemia adalah terjadinya peningkatan kadar bilirubin dalam darah, baik oleh faktor fisiologis maupun non fisiologis yang secara klinis menimbulkan gejala yang disebut ikterus (kuning). Pada neonatus, kadar serum bilirubin indirek yang tinggi dapat menyebabkan kerusakan otak yang parah dan tidak dapat disembuhkan. Fototerapi dan transfusi tukar adalah dua strategi terapeutik utama untuk mencegah kerusakan otak akibat bilirubin pada neonatus. Bilirubin, yang merupakan target fototerapi ini menyerap sinar secara maksimal pada rentang spektrum biru (460-490 nm). Namun, literatur lain mengatakan spektrum panjang gelombang yang berbeda, yaitu pirus (497 nm) juga sama efektifnya dalam menurunkan kadar bilirubin. Eligibilitas dari metode penelitian ini berdasarkan Participant, Intervention, Comparison, and Outcomes (PICO) dan penggunaan Boolean Operator. Berdasarkan seleksi studi dan penilaian kualitas, didapatkan 9 artikel yang dapat dianalisa. Pada bagian pembahasan didapatkan fototerapi lampu hijau dengan panjang gelombang (500nm) memiliki efektifitas yang sama dengan fototerapi gelombang biru dalam penurunan total serum bilirubin, sehingga dapat digunakan sebagai fototerapi alternatif. Fototerapi LED tidak lebih unggul dalam efektifitas penurunan total serum bilirubin jika dibandingkan dengan fototerapi konvensional. Hal ini dikarenakan iradiasi dalam keadaan normal fototerapi LED lebih tinggi dibandingkan dengan fototerapi konvensional sehinnga meningkatkan efektifitas dari fototerapi LED.

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.

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.

scholarly journals Possible Ibuprofen-Induced Kernicterus in a Near-Term Infant with Moderate Hyperbilirubinemia.

2006 ◽  
Vol 11 (4) ◽  
pp. 245-250
Author(s):  
Peter Gal ◽  
J Laurence Ransom ◽  
Sherri A Davis
Keyword(s):  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Primary Pulmonary Hypertension ◽  
Term Infant ◽  
Auditory Neuropathy ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Albumin Binding ◽  
Unbound Bilirubin ◽  
Near Term

A 36-week gestation newborn was admitted to the neonatal intensive care unit for treatment of primary pulmonary hypertension and possible sepsis. The infant developed hyperbilirubinemia on day 4 of life and peaked on day 5 at a total serum bilirubin of 19 mg/dL. Phototherapy was started on day 4 and continued for 5 days. On day 8 of life, ibuprofen was started for fever; a concurrent total serum bilirubin was 15.7 mg/dL. The subsequent hospital course was uneventful, and discharge occurred on day 22 of life. Because the patient failed a hearing screen at discharge, he was referred for a diagnostic audiology workup. He subsequently failed formal audiometric testing on two occasions one week apart, and was given a diagnosis of auditory dys-synchrony and/or auditory neuropathy, consistent with kernicterus. At 5½ months of age, he was reported to be hypotonic and to have frequent arching movements. Since the total serum bilirubin did not exceed 19 mg/dL, concern was raised that ibuprofen may have caused displacement of bilirubin from its albumin binding site, resulting in kernicterus due to excessive unbound bilirubin concentrations. Ibuprofen should be administered with caution in preterm infants at risk for kernicterus.

scholarly journals Detrimental Effect of Atazanavir Plasma Concentrations on Total Serum Bilirubin Levels in the Presence of UGT1A1 Polymorphisms

2011 ◽  
Vol 56 (3) ◽  
pp. e96-e97 ◽  
Author(s):  
Paola Cicconi ◽  
Teresa Bini ◽  
Alessandra Barassi ◽  
Maddalena Casana ◽  
Olivia Turri ◽  
...  
Keyword(s):  
Detrimental Effect ◽  
Serum Bilirubin ◽  
Plasma Concentrations ◽  
Total Serum Bilirubin ◽  
Total Serum

scholarly journals Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

2011 ◽  
Vol 51 (5) ◽  
pp. 256 ◽  
Author(s):  
Ari Kurniasih ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Pertin Sianturi
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Low Cost ◽  
Total Serum Bilirubin ◽  
Spectral Irradiance ◽  
Total Serum ◽  
Control Group ◽  
Study Group ◽  
Term Newborns ◽  
The Mean

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

Azorubin in Aqueous and Methanolic Solutions

1956 ◽  
Vol 2 (3) ◽  
pp. 160-165
Author(s):  
Howard S Friedman
Keyword(s):  
Serum Bilirubin ◽  
Test Solution ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Final Test

Abstract A study of the spectrophotometric characteristics of azorubin in varying proportions of methanol and water has been presented. The absorbence of azorubin in water was found to vary from 73 to 90 per cent of that in methanol, over a concentration range of 0.001 to 0.025 mg. per 2 ml. of test solution. The absorbence of azorubin was found to be linear over the same range of concentration, and over the range from 0.1 to 10 mg. per 100 ml. of serum, using a final test dilution of 1 to 8. The strong probability of the artefactual nature of "direct" and "total" serum bilirubin values has been demonstrated.

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