Abstract
BackgroundKernicterus or bilirubin encephalopathy is a preventable cause of handicap, still occurs in our country. The aim of the current study was to assess the role of bilirubin/albumin ratio in improving the morbidity of the cases with unconjugated hyperbilirubinemia and to estimate of the cutoff value for B/A ratio for prevention and early management of bilirubin-induced neurological dysfunction.ResultsThe mean gestational age was 37.1 ± 2.11 weeks; the mean age of onset of jaundice was 2.36 ± 1.04 days; the mean level of total bilirubin was 26.14 ± 7.36 mg/dl. At chosen cutoff value of bilirubin albumin ratio (B/A) 6.68, sensitivity was 82% while specificity was 64% and accuracy was 95%.ConclusionBilirubin encephalopathy still occurs in significant number in our country though it is a preventable cause of handicapping. TSB is a sensitive but not a specific indicator of ABE, B/A ratio is more specific indicator of the neurologic outcome and should be utilized in the decision of early intervention.
Highlights
Kernicterus or bilirubin encephalopathy is a preventable cause of handicap, still occurs in our country
99.9% of unconjugated bilirubin in the circulation is bound to albumin, a relatively small fraction remains unbound and it can go into the brain across an intact blood-brain barrier
Retrospective data have favored an additional role for high bilirubin albumin ratio (B/A) ratios as risk factors for bilirubin-induced neurotoxicity and only limited data exist regarding B/A ratios in the management and neurodevelopmental outcome of preterm infants with unconjugated hyperbilirubinemia [24]. This prospective cohort study was performed over a period of 6 months from January 2016 to June 2016 on neonates admitted to the NICU department, at Abuelrish Pediatric Hospital with severe hyperbilirubinemia reached critical level of phototherapy or exchange transfusion according to the American Academy of Pediatrics guidelines
Summary
Kernicterus or bilirubin encephalopathy is a preventable cause of handicap, still occurs in our country. The aim of the current study was to assess the role of bilirubin/albumin ratio in improving the morbidity of the cases with unconjugated hyperbilirubinemia and to estimate of the cutoff value for B/A ratio for prevention and early management of bilirubin-induced neurological dysfunction. Neonatal jaundice if inappropriately managed may result in significant bilirubin-induced mortality and disability [20, 21]. Jaundice due to either indirect (unconjugated) or direct (conjugated) bilirubin within the first 24 h of life should be taken seriously. Identification and proper management are needed to prevent the serious neurological complications associated with it [3, 27]. 99.9% of unconjugated bilirubin in the circulation is bound to albumin, a relatively small fraction (only less than 0.1%) remains unbound (free bilirubin) and it can go into the brain across an intact blood-brain barrier. According to the experimental studies, the concentration of free bilirubin is believed to dictate the biologic effect on jaundiced newborns, including its neurotoxicity [11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
