Document Detail

Early isomerization of bilirubin in phototherapy of neonatal jaundice.
MedLine Citation:
PMID:  20308939     Owner:  NLM     Status:  MEDLINE    
Neonatal jaundice is usually treated with phototherapy that converts bilirubin to more polar stereoisomers. These should theoretically be less able to cross the blood-brain barrier. The rates of photoisomer formation and concentrations accumulating in the circulation may have a bearing on the risk of kernicterus. The purpose of this study was to determine the rate of appearance of the major 4Z, 15E photoisomer of bilirubin during the early stages of phototherapy. Twenty jaundiced neonates were treated with phototherapy, and blood samples were drawn before and at approximately 15, 30, 60, and 120 min (10 infants) or at approximately 15, 60, 120, and 240 min (10 infants) after beginning phototherapy. Blood samples were analyzed for total serum bilirubin (TSB) and the 4Z, 15E photoisomer of bilirubin. Significant (p<0.0001) formation of the 4Z, 15E photoisomer was detectable within 15 min. The change in TSB from time 0 was insignificant at 120 min but reached significance at 240 min (p<0.001). The 4Z, 15E bilirubin constituted up to 20-25% of TSB at 2 h and may not have peaked by 4 h. Further studies are needed to determine whether this early shift in balance between bilirubin isomers with different polarities may impact the risk of bilirubin encephalopathy even before TSB starts to fall.
Khalaf Mreihil; Antony F McDonagh; Britt Nakstad; Thor Willy Ruud Hansen
Related Documents :
14602689 - Jaundice in low birthweight infants: pathobiology and outcome.
9536929 - Does total antioxidant status relate to outcome in very preterm infants?
16306189 - Evaluation of a model for brain bilirubin uptake in jaundiced newborns.
2471139 - Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age:...
20463489 - Assessing jaundice in infants of 35-week gestation and greater.
7390029 - The behavior of jaundiced infants undergoing phototherapy.
7415539 - Colonic stricture following necrotizing enterocolitis.
8312339 - Growth and neurodevelopmental outcome of infants undergoing heart transplantation.
12969869 - Inflammatory and microbiologic markers in induced sputum after intravenous antibiotics ...
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  67     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  656-9     Citation Subset:  IM    
Neonatal Intensive Care Unit, Children's and Youth Clinic, Akershus University Hospital, N-1478 Nordbyhagen, Norway.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Bilirubin / blood*
Biological Markers / blood
Gestational Age
Infant, Newborn
Intensive Care Units, Neonatal
Jaundice, Neonatal / blood,  therapy*
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 635-65-4/Bilirubin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  A Dual-Platform Proteomics Study of Plasma Biomarkers in Pediatric Patients Undergoing Cardiopulmona...
Next Document:  Noninvasive Respiratory Support of Juvenile Rabbits by High Amplitude Bubble Continuous Positive Air...