RT Book, Section
A1 Gomella, Tricia Lacy
A1 Eyal, Fabien G.
A1 Bany-Mohammed, Fayez
SR Print(0)
ID 1168357694
T1 Hyperbilirubinemia: Unconjugated
T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781259644818
LK accesspediatrics.mhmedical.com/content.aspx?aid=1168357694
RD 2024/04/24
AB When  the  rate  of  bilirubin  production  exceeds  the  rate  of  elimination,  the  end  result  is  a  rise  in  the  total  serum  bilirubin  (TSB),  a  clinical  condition  called  hyperbilirubinemia.  The  accumulation  of  bilirubin  manifests  as  yellow  discoloration  of  the  skin,  sclera,  and  mucosa  called  jaundice.  Neonates  with  severe  hyperbilirubinemia  (defined  as  a  TSB  >25  mg/dL  in  late  preterm  and  term  infants)  are  at  risk  for  bilirubin-induced  neurologic  dysfunction  (BIND),  which  occurs  when  bilirubin  crosses  the  blood–brain  barrier  and  binds  to  targeted  brain  tissues.  Hyperbilirubinemia  presents  as  either  unconjugated  hyperbilirubinemia  or  conjugated  hyperbilirubinemia.  The  2  forms  involve  different  causes  and  complications.  In  contrast  to  unconjugated  hyperbilirubinemia,  which  can  be  transient  and  physiologic  in  the  newborn  period,  conjugated  hyperbilirubinemia  is  always  pathologic  and  requires  thorough  investigation.  See  Chapter  98  for  a  discussion  of  conjugated  hyperbilirubinemia  (direct)  and  Chapters  62  and  63  for  rapid  “on-call”  assessment  and  management  of  the  2  conditions.