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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

Kernicterus Developmental Pediatrics Louis Meng, PL2 November 12th 2002 History Earliest work on jaundice from Baumes-1785, and Hervieux-1847 Kernicterus was first described by Johannes Orth, 1875 He postulated that jaundice might have hematologic origins He noted that the brain in jaundiced ...

Date added: October 25, 2011 - Views: 49


Title: KERNICTERUS AS A “NEVER EVENT” FOR NEWBORNS IN USA Author: Vinod K. Bhutani Last modified by: FDA.CDER Created Date: 4/20/2002 2:12:25 AM

Date added: November 1, 2011 - Views: 63

Hyperbilirubinemia in the Newborn

Hyperbilirubinemia in the ... so starting phototherapy should decrease the risk of kernicterus by turning 20-25% of bilirubin into a form unable to ... ALBUMIN A low albumin level could possibly be the reason behind kernicterus occurring in some infants at relatively low bilirubin levels.

Date added: June 30, 2012 - Views: 28

Hyperbilirubinemia - Stanford University

Objectives. Understand pathway where bilirubin comes from. Physiologic vs Pathologic Hyperbilirubinemia. Understand the risk for Kernicterus . Understand why we care about hyperbilirubinemia

Date added: October 18, 2013 - Views: 11

Neonatal Bilirubin Levels and Developmental Outcome - URLEND

Neonatal Bilirubin Levels and Developmental Outcome Dennis Odell Rachel Duchoslav Erin Clark Rena Vanzo Lisa Samson-Fang Background High bilirubin levels in neonates are known to be associated with kernicterus Multiple additional risk factors with high bilirubin levels increase risk of ...

Date added: November 19, 2011 - Views: 13


CONJUGATED VS UNCONJUNCATED HYPERBILI Conjugated hyperbilirubinemia is always ... feeding difficulties dystonia incoordination choreoathetosis sensorineural hearing loss painful muscle spasms KERNICTERUS Incidence of bilirubin levels>30 1/10,000 Over 120 cases kernicterus ...

Date added: October 25, 2011 - Views: 175

Neonatal Hyperbilirubinemia - Yale University

... risk due to further reduced activity of liver conjugating enzymes Pre-term infants can develop encephalopathy or kernicterus at lower total bilirubin levels Indirect Hyperbilirubinemia: Elevated levels of bilirubin due to imbalance in production, transport, uptake, ...

Date added: August 8, 2013 - Views: 26

Hyperbilirubinemia in Infants - Alverno College

... irreversible complication of hyperbilirubinemia If bilirubin levels become markedly elevated, ... converted it can be deposited into the skin which causes the yellowing of the skin or into the brain which can lead to kernicterus (1) Conjugated Bilirubin Conjugated ...

Date added: September 3, 2011 - Views: 108

Neonatal Unconjugated Hyperbilirubinemia - University of Chicago

... A visible manifestation in the skin and sclera of elevated bilirubin concentrations Adults are usually jaundiced when bilirubin levels exceed 2 ... WE WORRY ABOUT HYPERBILIRUBINEMIA? Sequelae Bilirubin may penetrate the brain ... with kernicterus die Acute Bilirubin ...

Date added: October 25, 2011 - Views: 119

Hyperbilirubinemia - Oregon Health & Science University

Hyperbilirubinemia Case 1 5 day old former term male infant born to a 23 y.o. G1P0->1 woman. Is exclusively breastfeeding. Has total bilirubin of 25, direct is 0.7.

Date added: November 12, 2011 - Views: 46


Elevated levels of plasma bilirubin were shown to affect the concentration of other plasma antioxidants, such as Vitamin E, ... However “unconjugated” bilirubin can induce a loss of neurons and atrophy of involved fiber systems (called Kernicterus).

Date added: March 5, 2012 - Views: 32

Recommending a Strategy - Official Web site of the U.S ...

... and fever – not considered ABE in this report.] Chronic Bilirubin Encephalopathy (Kernicterus) Persistent and permanent ... of ABE may resolve with treatment Direct evidence that earlier treatment with phototherapy effectively lowers serum bilirubin levels and diminishes the ...

Date added: February 5, 2013 - Views: 19


Newborn Jaundice and the Prevention of Kernicterus A Six-Sigma Approach Vinod K. Bhutani, MD, FAAP ... PICK) Characterize the problem: adverse outcome with high bilirubin levels (CDC, AAP, JCAHO, AHRQ) Optimal solution: pre-discharge screening and targeted follow-up in the first week (AAP ...

Date added: November 25, 2011 - Views: 29

Jaundice - UNIZG

Jaundice Prepared and presented by Luka Marinculić Mentor: A. Žmegač Horvat Jaundice – is it a disease? Yellowish staining of the skin and sclerae High levels of bilirubin in blood What causes jaundice?

Date added: November 22, 2012 - Views: 47

Neonatal Jaundice - ACT Medicare Local

The absorbance spectrum of bilirubin bound to ... FBC and film Blood group Maternal blood group Direct coombs test Investigations for prolonged jaundice Kernicterus Also called bilirubin encephalopathy ... bilirubin is: neurotoxic at high levels lipophilic and can cross the ...

Date added: May 13, 2013 - Views: 17

heme degradation - Department of Biochemistry : University of ...

Heme Degradation & Hyperbilirubinemias Beth A. Bouchard BIOC 212: Biochemistry of Human Disease Spring 2005 Purposes: 1. Scavenge iron 2. Prevent major iron losses 3.

Date added: October 25, 2011 - Views: 163

Hemolytic Disease of the Newborn, Current Methods of ...

Hemolytic Disease of the Newborn, ... (due to hyperinsulinemnia from islet cell hyperplasia) Kernicterus Kernicterus (bilirubin encephalopathy) results from high levels of ... Kernicterus occurs at lower levels of bilirubin in the presence of acidosis, hypoalbuminemia, prematurity and ...

Date added: October 12, 2011 - Views: 124


Phototherapy is not indicated for conjugated hyperbilirubinemia. ... With increasing bilirubin levels, jaundice seems to advance in a head-to-foot direction, appearing at the umbilicus at about 15 ... It provides definitive treatment of neonatal hyperbilirubinemia and prevention of kernicterus.

Date added: May 16, 2013 - Views: 13

Infant Jaundice - SBH Peds Res

... but home phototherapy should not be used in any infant with risk factors. * Kernicterus Develops during the first year after birth ... (start at 1% of the adult levels) Conjugated bilirubin is more water soluble than unconjugated bilirubin and is excreted in bile Bilirubin ...

Date added: May 23, 2013 - Views: 29

Neonatal Hyperbilirubinemia - Home | California Perinatal ...

... brain stem nuclei and cerebellum Causing neuronal necrosis Bilirubin levels at which kernicterus occurs vary depending on the ... by the American Academy of Pediatrics to develop the recommended nomogram for identifying infants at risk for excessive hyperbilirubinemia, bilirubin levels by ...

Date added: June 15, 2012 - Views: 104

PowerPoint Presentation

... Due to immaturity of the enzymes involved in bilirubin conjugation High levels of unconjugated bilirubin are toxic to ... due to its hydrophobicity it can cross the blood-brain barrier and cause a type of mental retardation known as kernicterus If bilirubin levels are judged to be ...

Date added: October 29, 2011 - Views: 38

Approach to the management of hyperbilirubinemia in term ...

American Academy of Pediatrics, Subcommittee on Neonatal Hyperbilirubinemia. Neonatal jaundice and kernicterus ... and with extremely high bilirubin levels Classification Benign Physiologic Breast Milk Breastfeeding Pathologic Many causes Physiologic Jaundice Features Elevated ...

Date added: September 28, 2011 - Views: 90

Jaundice and liver function tests - Welcome to nky.wikidot ...

Jaundice and liver function tests KVB ... Kernicterus: The deposition of bilirubin in basal ganglia of the brain. ... High levels of unconjugated bilirubin enable it to cross blood-brain barrier. Deposition of bilirubin causes brain injury.

Date added: February 18, 2013 - Views: 47


HYPERBILIRUBINEMIA IN TERM NEONATES Tanya ... the initial bilirubin level is meets defined critical levels based on the ... Damage & scarring of basal ganglia & brain stem Kernicterus (Cont’d) Unconjugated bilirubin > albumin binding capacity Unconjugated bilirubin = Fat Soluble Enters ...

Date added: May 2, 2013 - Views: 22

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez Alterations in Liver Function * Jaundice/Icterus Yellow discoloration of the skin, eyes and mucous membranes Due to the presence of bilirubin Onset seen at bilirubin levels > 3.0 mg/dL Kernicterus Yellow staining of the meninges of the brain due ...

Date added: May 18, 2013 - Views: 12

Neonatal Jaundice - Wikispaces

Neonatal Jaundice: Indirect Hyperbilirubinemia “Triple”Phototherapy: Halogen, Blanket Halogen Photometer Reading “Double” halogen lights Only able to generate 10 microwatts/cm2/nm Very low “dose” of phototherapy Fiberoptic Phototherapy Light from tungsten-halogen bulb through ...

Date added: May 2, 2013 - Views: 16

The Normal Newborn, Assessment, Care, Feeding - CSU Bakersfield

The Normal Newborn: Assessment, Care, Feeding Presented by, ... Immune System Temperature Regulation Cold Stress Kidneys and Urination Hepatic Function Increased Bilirubin Levels Kernicterus Neurologic Weight Loss Infants at Risk Nursing Diagnosis: ...

Date added: October 2, 2011 - Views: 421

JAUNDICE Just Call Me Yellow - Emory University

... Treatment Discontinue breastfeeding for 24 hours Have mom pump and then resume breastfeeding Kernicterus Bilirubin induced ... Bilirubin Metabolism Bilirubin Metabolism Bilirubin Binding Before Birth Before Birth Factors influencing bilirubin levels Enterohepatic ...

Date added: October 25, 2011 - Views: 47

Jaundice and the Newborn - Smoky Hill FMRP

Complications Chronic bilirubin encephalopathy (kernicterus) ... Decreased bilirubin clearance Deficiency of UGT UGT activity at 7 days of age is approx 1% of adult Reaches adult levels around ... etc Polycythemia Infants of diabetic mothers Pathologic jaundice--causes Disorders of bilirubin ...[Rupe-Abbey]Jaundice-in-the-Newborn.ppt

Date added: May 2, 2013 - Views: 30

Bilirubin Metabolism - Gee

Bilirubin Metabolism in the Liver. Uptake of Bilirubin by hepatocytes: Bilirubin dissociates from its carrier albumin & enters hepatocytes. Conjugation

Date added: August 11, 2014 - Views: 1

Neonatal Hyperbilirubinemia - University of Minnesota

Neonatal Hyperbilirubinemia Jaundice Yellowish discoloration of skin +/- sclera of newborns due to bilirubin Affects nearly all newborns Peak: 48-120 hours, typically 5-6 mg/dL, usually does not exceed 17-18 mg/dL Pathologic: TSB exceeds age (in hours) specific 95th percentile according to ...

Date added: October 8, 2011 - Views: 102

The Liver & Tests of Hepatic Function - Amazon S3

When the baby’s unconjugated bilirubin levels reach >15 ... Bilirubin that deposits in brain tissue may cause irreversible brain damage “kernicterus”. ... Summary of Lab Tests of Liver Function Total protein, albumin, bilirubin, ALT, AST, GGT, ALP AFP, ammonia, iron Urine bilirubin ...

Date added: February 13, 2014 - Views: 15

Slide 1

Neonatal hyperbilirubinemia JFK pediatric core curriculum MGH Center for Global Health Pediatric Global Health Leadership Fellowship Credits: Brett Nelson, MD, MPH

Date added: August 26, 2014 - Views: 1

Neonatal Hyperbilirubinemia: An Update - University of ...

Neonatal Hyperbilirubinemia: An Update Bryan Burke, MD Arkansas Children’s Hospital University of Arkansas for Medical Sciences Definitions Hyperbilirubinemia: An unusually large amount of bilirubin in the blood resulting in jaundice.

Date added: March 22, 2012 - Views: 155

Neonatal Jaundice

Neonatal Jaundice By Dr. Nahed Al-Nagger Neonatal Jaundice Learning Objectives: Define hyperbilirubinemia. Differentiate between physiological and pathological jaundice.

Date added: November 12, 2011 - Views: 169

Neonatal Hyperbilirubinemia

... Abnormality in ABR Hypotony: reverses with bilirubin levels Very rarely kernicterus Low birth weight infants: Damage most probably due to accompanying factors than to high bilirubin. Breast Feeding Jaundice Bilirubin after 4 days of age.

Date added: May 22, 2013 - Views: 10

Jaundice Noted in the First 24 Hours After Birth in a Large HMO

Overview Introduction Jaundice in newborns and kernicterus Infant safety seats on airplanes Stories vs Statistics; ... permanent brain damage from very high bilirubin levels Jaundice --Background 2 Phototherapy: Shining light on the babies skin -- helps lower bilirubin levels Exchange ...

Date added: September 12, 2011 - Views: 64

Obstructive Jaundice - Wikispaces

This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid. ... Most dangerous complication is brain-damage due to deposition of bilirubin,a condition known as kernicterus leading to significant lifelong disability. * 2.

Date added: March 30, 2014 - Views: 8

Neonatal Jaundice - New Born Baby

Neonatal Jaundice Visible form ... Bilirubin metabolism Clinical assessment of jaundice Area of body Bilirubin levels mg/dl Face 4-8 Upper trunk 5-12 Lower trunk & thighs 8 ... Decide whether jaundice is physiological or pathological Look for evidence of kernicterus* in deeply ...

Date added: March 23, 2014 - Views: 6

HIGH RISK NEWBORN - Suffolk County Community College

HIGH RISK NEWBORN Lecture 13 ... Single, double, triple phototherapy. Kernicterus: Indirect bilirubin of 20 > permanent brain damage; bilirubin encephalophathy. Signs: hi-pitched cry, seizures, hypotonia ... 2nd-3rd day. R/T low albumin (decreased binding sites for bilirubin). ^ levels of RBC’s.

Date added: January 27, 2012 - Views: 116

Alterations in Hematologic Function - Pediatric Nursing

Kernicterus: bilirubin encephalopathy Jaundice Yellowing of the skin ... or floppiness Photo Therapy Fiberoptic Blanket Multidisciplinary Interventions Monitor bilirubin levels Assess activity level – muscle tone – infant reflexes Encourage po intake: ...

Date added: October 19, 2011 - Views: 42

Adrenal Incidentaloma NIH State-of-the-art conference ...

... Association of neonatal hyperbilirubinemia with neurodevelopmental outcomes What is the relationship between peak bilirubin levels and/or ... bibliography of relevant review articles for potential additional studies Supplemental search for case reports of kernicterus was also ...

Date added: August 29, 2011 - Views: 16


In late-preterm and full-term infants to reduce excessive bilirubin levels and avoid development of kernicterus Phototherapy ends when ... Windpower design template Hyperbilirubinemia Jaundice Bilirubin Hyperbilirubinemia in Neonates Pathophysiology Kernicterus Kramer’s ...

Date added: June 22, 2013 - Views: 3

Respiratory Therapy Licensure Alabama

Unconjugated (indirect) bilirubin >13 mg/dl. Indirect levels rise by more than 5 mg/dl in a 24 hour period. Direct bilirubin >1.5 mg/dl. ... Most serious complication is kernicterus (bilirubin pigment deposited in brain tissue) leading to neuronal injury. Treatment. Treat cause. Phototherapy ...

Date added: August 16, 2013 - Views: 3

Jaundice – Its Differential Diagnosis - Drsarma

... Classification Normal Serum Bilirubin (SB) is 0.3 to 1.0 mg% Jaundice is increased levels of SB > 1.0 mg% Over ... Affinity to lipids (Kernicterus) ... Schematic Slide 14 Slide 15 Bilirubin in the Intestine Bilirubin handling in Kidney An Approach to Jaundice Bilirubin testing ...

Date added: December 2, 2011 - Views: 90

Anesthesia and Liver Disease

Anesthesia and Liver Disease ... (fat soluble vitamins) Bilirubin exrection heme – RES – Bilirubin in blood (unconjugated) ... congenital defects of conjugation Conjugated Hepatocellular dysfunction, obstruction kernicterus Total Albumin Low levels Decreased production Liver disease ...

Date added: February 3, 2012 - Views: 42

AFP Journal Review - Emory University

AFP Journal Review May 1, ... Measurement of transcutaneous bilirubin levels is much less accurate than that of total serum bilirubin ... * In the 1980s and 1990s, there was a resurgence of kernicterus in the United States and abroad, which has been attributed in part to early hospital ...

Date added: May 22, 2012 - Views: 36


... Due to immaturity of the liver enzymes High levels of unconjugated bilirubin are toxic to the newborn ... due to its fat solubility it can cross the blood-brain barrier and cause a type of mental retardation known as kernicterus If bilirubin levels are judged to be too high, ...

Date added: February 23, 2012 - Views: 59

a part - Department of Surgery: Residency Pages

Kernicterus in newborns Bilirubin Metabolism: ... (LKM) antibodies (for autoimmune hepatitis) Serum levels of iron, transferrin, and ferritin (for hemochromatosis) Serum levels of ceruloplasmin (for Wilson's disease) Measurement of alpha-1 antitrypsin activity ...

Date added: May 30, 2012 - Views: 62

THE “NEAR TERM” NEWBORN: Not Ready for “Term Time”

THE “LATE PRETERM ... uptake and conjugation of bilirubin Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the blood/brain ... of bilirubin Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the blood/brain barrier ...

Date added: October 13, 2011 - Views: 63