The Clinical Approach to the Jaundiced Newborn Epidemiology of Neonatal Hyperbilirubinemia An important first step in the diagnosis and manaWgement of any jaundiced newborn is an understanding of the factors…
Clinical Sequelae of Hyperbilirubinemia Although there is no doubt about the relationship between elevated TSB levels and brain damage, the ability of a single peak bilirubin level to predict long-term…
Clinical Features of Bilirubin Encephalopathy Terminology Although originally a pathologic diagnosis characterized by bilirubin staining of the brainstem nuclei and cerebellum, the term kernicterus has come to be used interchangeably…
Bilirubin Toxicity Kernicterus Pathology The first description of kernicterus (or brain jaundice) in newborns was provided by Hervieux in 1847 (1) and in 1875, Orth (36) observed bilirubin pigment at…
Physiologic Jaundice Because at some point during the first week of life almost every newborn has a total serum bilirubin (TSB) level that exceeds 1 mg/dL (17 μmol/L, the upper…
Physiologic Mechanisms of Neonatal Jaundice At any time in the infant’s first few days after birth, the serum bilirubin level reflects a combination of the effects of bilirubin production, conjugation,…
Fetal Bilirubin Metabolism Bilirubin can be detected in normal amniotic fluid after about 12 weeks of gestation, but it disappears by 36 to 37 weeks’ gestation. The ability of human…
Neonatal Bilirubin Metabolism Bilirubin Production The normal destruction of circulating erythrocytes accounts for about 75% of the daily bilirubin production in the newborn. Senescent erythrocytes are removed and destroyed in…
Preoperative and Postoperative Care of the Infant with Critical Congenital Heart Disease John M. Costello Wayne H. Franklin INTRODUCTION The contemporary strategy of early, complete repair for congenital heart defects…
Formation, Structure, and Properties of Bilirubin Detailed reviews of the chemistry and metabolism of bilirubin are found elsewhere (3,4,5,6,7). Bilirubin is the end product of the catabolism of iron protoporphyrin…
