Journal ArticleDOI
The Neurological Sequelae of Neonatal Hyperbilirubinemia: Definitions, Diagnosis and Treatment of the Kernicterus Spectrum Disorders (KSDs).
TLDR
Adopting a systematic nomenclature for the spectrum of clinical consequences of hyperbilirubinemia will help unify the field and promote more effective research in both prevention and treatment of KSDs.Abstract:
Background Despite its lengthy history, the study of jaundice, hyperbilirubinemia and kernicterus suffers from a lack of clarity and consistency in the key terms used to describe both the clinical and pathophysiological nature of these conditions. For example, the term Bilirubin-induced Neurological Dysfunction (BIND) has been used to refer to all neurological sequelae caused by exposure to high levels of bilirubin, to only mild neurological sequelae, or to scoring systems that quantitate the progressive stages of Acute Bilirubin Encephalopathy (ABE). Objective We seek to clarify and simplify terminology by introducing, defining, and proposing new terms and diagnostic criteria for kernicterus. Methods We propose a systematic nomenclature based on pathophysiological and clinical criteria, presenting a logical argument for each term. Acknowledging observations that kernicterus is symptomatically broad and diverse, we propose the use of the overarching term Kernicterus Spectrum Disorders (KSDs) to encompass all the neurological sequelae of bilirubin neurotoxicity including Acute Bilirubin Neurotoxicity (ABE). We further suggest subclassification of KSDs based on the principal disabling features of kernicterus (motor, auditory). Finally, we suggest the term subtle KSD to designate a child with a history of significant bilirubin neurotoxicity with mild or subtle developmental delays. Results and conclusion We conclude with a brief description of the limited treatments currently available for KSD, thereby underscoring the importance of further research. We believe that adopting a systematic nomenclature for the spectrum of clinical consequences of hyperbilirubinemia will help unify the field and promote more effective research in both prevention and treatment of KSDs.read more
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Journal ArticleDOI
Mechanism of bilirubin elimination in urine: insights and prospects for neonatal jaundice.
Mercy Thomas,Winita Hardikar,Winita Hardikar,Ronda F. Greaves,Ronda F. Greaves,David G. Tingay,Tze Ping Loh,Vera Ignjatovic,Fiona Newall,Fiona Newall,Anushi E Rajapaksa,Anushi E Rajapaksa +11 more
TL;DR: In this article, the authors discuss the clinical relevance of targeting the altered renal excretory pathway, as bilirubin in urine may hold diagnostic importance in screening for neonatal jaundice.
Journal ArticleDOI
Current phototherapy practice on Java, Indonesia
Mahendra Tri Arif Sampurna,Kinanti Ayu Ratnasari,Darto Saharso,Arend F. Bos,Pieter J. J. Sauer,Peter H. Dijk,Christian V. Hulzebos +6 more
TL;DR: In half of the hospitals that the levels of irradiance are too low and, in some cases, too high, it is recommended that manufacturers provide radiometers so hospitals can optimize the performance of their phototherapy devices.
Journal ArticleDOI
Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit
Berthe A M van der Geest,Ageeth N. Rosman,Klasien A. Bergman,Bert J. Smit,Peter H. Dijk,Jasper V Been,Christian V. Hulzebos +6 more
TL;DR: Characteristics of neonates with severe neonatal hyperbilirubinaemia (SNH) are described to gain more insight in improvable factors that may have contributed to the development of SNH and implementation of universal bilirubin screening and better documentation of the risk of hyper Bilirubineemia may enhance early recognition of potentially dangerous neonatal jaundice.
Journal ArticleDOI
A New Hour-Specific Serum Bilirubin Nomogram for Neonates ≥35 Weeks of Gestation
TL;DR: In this article, a statistically rigorous, hour-specific bilirubin nomogram for newborns based on a very large data set was developed and used prospectively as a replacement for the 1999 Bhutani nomogram.
Journal ArticleDOI
High levels of pathological jaundice in the first 24 hours and neonatal hyperbilirubinaemia in an epidemiological cohort study on the Thailand-Myanmar border.
Laurence Thielemans,Laurence Thielemans,Pimnara Peerawaranun,Mavuto Mukaka,Mavuto Mukaka,Moo Kho Paw,Jacher Wiladphaingern,Jordi Landier,Jordi Landier,Germana Bancone,Germana Bancone,Stephane Proux,Henrike Elsinga,Margreet Trip-Hoving,Borimas Hanboonkunupakarn,Tha Ler Htoo,Thaw Shee Wah,Candy Beau,François Nosten,François Nosten,Rose McGready,Rose McGready,Verena I. Carrara,Verena I. Carrara,Verena I. Carrara +24 more
TL;DR: In this article, the authors evaluated risk factors for developing hyperbilirubinaemia using Cox proportional hazard mixed model and found that one-quarter (26.3%) of the cases occurred within 24 hours.