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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

There are no good guidelines for preterm infants An unconjugated bilirubin level of 25 or less in TERM, ... one-third of all infants with untreated hemolytic diseases that have bilirubin levels >25 will develop Kernicterus Prognosis depends of severity of effects Wide spectrum of ...

http://www.nccpeds.com/powerpoints/Kernicterus.ppt

Date added: October 25, 2011 - Views: 52

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KERNICTERUS AS A “NEVER EVENT” FOR NEWBORNS IN USA

B.I.N.D. Center at Pennsylvania Hospital (Bilirubin Induced Neurologic Dysfunction) University of Pennsylvania, Philadelphia Pre-discharge bilirubin screening to prevent adverse outcomes of neonatal hyperbilirubinemia

http://www.fda.gov/OHRMS/DOCKETS/AC/03/slides/3965OPH1_01_Bhutani.ppt

Date added: November 1, 2011 - Views: 67

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Hyperbilirubinemia in the Newborn

There was a report of a 29 week infant whose peak bilirubin level was only 15.7 and yet developed classic kernicterus with spasticity, dystonia, ballismus, ... ALBUMIN A low albumin level could possibly be the reason behind kernicterus occurring in some infants at relatively low bilirubin levels.

http://inovapeds.org/library/powerpoints/General%20&%20Preventative/Hyperbilirubinemia.ppt

Date added: June 30, 2012 - Views: 29

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Hyperbilirubinemia - Stanford University

Outcomes among Newborns with Total Serum Bilirubin Levels of 25 mg per Deciliter or More Thomas B. Newman N Engl J Med 354;18 may 4, 2006. Kaiser data. Infants with bili >24. No cases of kernicterus and no ... No dif in neuro problems or deafness between severe hyperbili (>19) and no ...

http://peds.stanford.edu/Rotations/scvmc_picu_wards/documents/Hyperbilirubinemia.pptx

Date added: October 18, 2013 - Views: 11

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Neonatal Hyperbilirubinemia - Yale University

Has she had her TcB checked? Has she had blood bilirubin levels checked? Case #1 ... 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 ...

http://medstation.yale.edu/pedres/files/Resident%20Education/NICU%20lectures/Neonatal%20Hyperbilirubinemia.ppt

Date added: August 8, 2013 - Views: 32

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Neonatal Jaundice - ACT Medicare Local

Serum bilirubin level Conjugated fraction of bilirubin Liver function test (GGT, ALT, AST ... bilirubin is: neurotoxic at high levels lipophilic and can cross the blood-brain-barrier Long term clinical sequelae Bilirubin staining of affected areas Dysfunction and death of neurons Impairs ...

http://www.actml.com.au/Uploads/Documents/Events/Education%20Notes/Dr%20Zsuzsoka%20Kecskes%20-%20Neonatology%20-%20what%20not%20to%20miss%20in%20general%20practice%20baby%20checks%20hearthips.ppt

Date added: May 13, 2013 - Views: 19

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KERNICTERUS AS A “NEVER EVENT” FOR NEWBORNS IN USA

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 ...

http://www.ehcca.com/presentations/qualitycolloquium5/bhutani_1b.ppt

Date added: November 25, 2011 - Views: 34

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

Direct evidence indicates treatment lowers elevated bilirubin concentration levels, and lower bilirubin level is associated with less acute clinical manifestations. No evidence that treatment prevents kernicterus.

http://www.hrsa.gov/advisorycommittees/mchbadvisory/heritabledisorders/meetings/twentysix/hyperbilirubinemia.ppt

Date added: February 5, 2013 - Views: 21

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NEONATAL HYPERBILIRUBINEMIA - NCC Pediatrics Residency at ...

... feeding difficulties dystonia incoordination choreoathetosis sensorineural hearing loss painful muscle spasms KERNICTERUS Incidence of bilirubin levels>30 1/10,000 Over 120 cases ... There was a report of a 29 week infant whose peak bilirubin level was only 15.7 and yet ...

http://www.nccpeds.com/powerpoints/Hyperbili_Kravitz.ppt

Date added: October 25, 2011 - Views: 176

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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?

http://www.mef.unizg.hr/meddb/slike/pisac79/file3185p79.ppt

Date added: November 22, 2012 - Views: 47

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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 ...

http://blog.lib.umn.edu/rcrichlo/ebmcrichlow/Neonatal%20Hyperbilirubinemia2009%20modified%20for%20presention.ppt

Date added: October 8, 2011 - Views: 108

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BILIRUBIN: FRIEND OR FOE? - SFRBM

Elevated levels of plasma bilirubin were shown to affect the concentration of other plasma antioxidants, such as Vitamin E, ... Neonatal hyperbilirubinemia is defined as a total serum bilirubin level above 5 mg/dL.

http://www.sfrbm.org/frs/FrielBilirubin.ppt

Date added: March 5, 2012 - Views: 34

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Hyperbilirubinemia in Infants - Alverno College

... 2005, p. 11) “As bilirubin levels rise, the accuracy of visual assessment decreases ... to factors that alter the process of bilirubin metabolism It usually appears within 24 hours of life Associated with a bilirubin level increase of 0.5 mg/dL/ hour or 5mg/dL per day (10) Persists ...

http://faculty.alverno.edu/bowneps/MSN621/student%20tutorials/HyperbilirubinemiaMSN%20621.ppt

Date added: September 3, 2011 - Views: 113

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

Kernicterus occurs at lower levels of bilirubin in the presence of acidosis, hypoalbuminemia, prematurity and certain drugs (e.g., ... It should be considered if the total serum bilirubin level is approaching 20 mg/dL and continues to rise despite intense in-hospital phototherapy.

http://www.austincc.edu/mlt/clin2/clinical2_HDN.ppt

Date added: October 12, 2011 - Views: 128

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Neonatal Unconjugated Hyperbilirubinemia - University of Chicago

... then an exchange transfusion may be warranted at a lower bilirubin level Exchange Transfusion With a ... A visible manifestation in the skin and sclera of elevated bilirubin concentrations Adults are usually jaundiced when bilirubin levels exceed 2 mg/dL Neonates appear jaundiced ...

http://pediatrics.uchicago.edu/chiefs/documents/Hyperbilirubinemia.ppt

Date added: October 25, 2011 - Views: 126

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HYPERBILIRUBINEMIA - Emory University

Diagnosis Jaundice in a term newborn fewer than 24 hours old is always pathologic Based on rate of bilirubin level rise, risk of developing significant hyperbilirubinemia can be ... Phototherapy Tid-Bits If TSB levels approach or exceed the exchange transfusion line the sides of the ...

http://fpm.emory.edu/family/didactics_for_cascade/powerpint/Hyperbilirubinemia%20Pandya.ppt

Date added: May 2, 2013 - Views: 24

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Hyperbilirubinemia - Oregon Health & Science University

Hsia, et al. NEJM 1952;247:668-71 Mollison and Cutbush. Blood 1951:777-88 Serum Bilirubin Level and Kernicterus in 229 ... 96:730-733 6 patients 4-10 days of age Bilirubin levels 39-50 Jaundice of Prematurity Jaundice appears at a level of 6-8 No relationship between kernicterus at ...

http://www.ohsu.edu/xd/health/services/doernbecher/research-education/education/med-education/upload/Hyperbilirubinemia-3-2005.ppt

Date added: November 12, 2011 - Views: 48

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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 ...

http://biochem.uvm.edu/courses/files/212_spring_2005_heme%20degradation.ppt

Date added: October 25, 2011 - Views: 166

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Hyperbilirubinemia

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 mg/dL ... If the bilirubin level continues to increase > 18 mg/dL in a term infant with ...

http://xa.yimg.com/kq/groups/20561209/2048328448/name/Hyperbilirubinemia+nursery.ppt

Date added: May 16, 2013 - Views: 15

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

Kernicterus: The deposition of bilirubin in basal ganglia of the brain. Occurs typically in infants affected by the massive hemolysis of eryhthroblastosis fetalis. High levels of unconjugated bilirubin enable it to cross blood-brain barrier.

http://nky.wdfiles.com/local--files/pathology/Jaundice%20and%20liver%20function%20tests.ppt

Date added: February 18, 2013 - Views: 47

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Approach to the management of hyperbilirubinemia in term ...

... and with extremely high bilirubin levels Classification Benign Physiologic Breast Milk Breastfeeding Pathologic Many causes ... without f/u within 48 hrs Failure to check bilirubin level if onset in first 24 hours Failure to note risk factors Visual assessment underestimate ...

http://www.just.edu.jo/%7Emykhassawneh/lectures/appr_term.ppt

Date added: September 28, 2011 - Views: 91

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Neonatal Hyperbilirubinemia - Home | California Perinatal ...

... brain stem nuclei and cerebellum Causing neuronal necrosis Bilirubin levels at which kernicterus occurs vary depending on the presence of hemolytic disease and gestational age No “safe” levels of bilirubin have been identified Thought to be highly preventable in most cases Kernicterus ...

http://www.cpqcc.org/documents/1108/download

Date added: June 15, 2012 - Views: 107

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JAUNDICE Just Call Me Yellow - Emory University

... bilirubin in the fetus is not cleared by the placenta and may accumulate in fetal tissues Factors influencing bilirubin levels Racial and ethnic ... Treatment Discontinue breastfeeding for 24 hours Have mom pump and then resume breastfeeding Kernicterus Bilirubin induced neurological ...

http://www.pediatrics.emory.edu/divisions/neonatology/apnec/JAUNDICE.ppt

Date added: October 25, 2011 - Views: 47

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Neonatal Jaundice - Wikispaces

... repeat bilirubin level not indicated in healthy term infants useful in premature infants, hemolysis ... there is no such thing as an overdose of phototherapy” (Maisels2001) The saturation point (where higher irradiance levels don’t matter) ...

http://ccrmc.wikispaces.com/file/view/Neonataljaundice2010.ppt

Date added: May 2, 2013 - Views: 17

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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 ...

http://sbhpedsres.com/docsSBH%202012-2013/Presentations/Infant%20Jaundice%202012.ppt

Date added: May 23, 2013 - Views: 31

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Slide 1

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

http://www.umassmed.edu/PageFiles/46265/Hyperbilirubinemia%20Final.ppt

Date added: August 26, 2014 - Views: 1

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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.

http://www.uams.edu/ANGELS/perinatal_conference/Presentations/2005/Hyperbilirubinemia%20in%20the%20Newborn.ppt

Date added: March 22, 2012 - Views: 160

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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 ...

http://www.austincc.edu/mlt/chem/Liver_Alterations_2013_STUDENT.ppt

Date added: May 18, 2013 - Views: 12

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Bilirubin Metabolism - Gee

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

http://groupf2.yolasite.com/resources/Bilirubin%20Met%20%26%20Jaundice%20-%20GIT.pptx

Date added: August 11, 2014 - Views: 1

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

... in newborns Hemolysis: Destruction of red blood cells Kernicterus: Rare, severe, permanent brain damage from very high bilirubin levels ... 9/4/05 Cost: $4000 + $7/use Cost: $19,000 + $15 per use No bilirubin level sent. (-9%) Next day, bilirubin 34.6 mg/dl Outcome: Kernicterus ...

http://vmsstreamer1.fnal.gov/VMS_Site_03/Lectures/Colloquium/presentations/050907Newman.ppt

Date added: September 12, 2011 - Views: 67

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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.

http://niv-zmora.com/pediatrics/%F9%E9%F2%E5%F8%20%EE%F1%27%2014%20-%20%F6%E4%E1%FA%20%E1%E9%E9%EC%E5%E3%20-%20%EE%F6%E2%FA%20%F8%E9%F7%E4%2028.10.08.ppt

Date added: May 22, 2013 - Views: 12

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The Normal Newborn, Assessment, Care, Feeding

Increased Bilirubin Levels Jaundice in the 1st day is NOT normal Bilirubin level greater than 12 at any time needs further attention Maternal causes of increased bilirubin levels in the NB: epidural use, oxytocin induced labor, infection, ...

http://www.csub.edu/~jhaskin/normalnewborn(jh).ppt

Date added: October 2, 2011 - Views: 430

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Jaundice and the Newborn - Smoky Hill FMRP

Hyperbilirubinemia Indirect/Unconjugated Direct/Conjugated Considered elevated if direct portion is >20% of total bilirubin level Scope won’t be ... Decreased bilirubin clearance Deficiency of UGT UGT activity at 7 days of age is approx 1% of adult Reaches adult levels around 14 ...

http://www.smokyhillfmrp.org/assets/power-point-catalog/[Rupe-Abbey]Jaundice-in-the-Newborn.ppt

Date added: May 2, 2013 - Views: 33

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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: ...

http://www.pedstudent.com/wp-content/uploads/2010/01/hematology_101.ppt

Date added: October 19, 2011 - Views: 44

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The Liver & Tests of Hepatic Function - Amazon S3

When the baby’s unconjugated bilirubin levels reach >15 – 20 mg/dl, ... (KERNICTERUS) in newborns. PLASMA AMMONIA Source of ammonia: Breakdown of amino-acids obtained from dietary proteins in intestine Metabolized by liver ...

http://s3.amazonaws.com/engrade-myfiles/4085111772653484/6_Liver__Tests_of_Hepatic_Function.ppt

Date added: February 13, 2014 - Views: 15

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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 production of Bilirubin (Hemolytic) From hemolysis of RBC Lysis of RBC precursors ... Affinity to lipids (Kernicterus) ...

http://www.drsarma.in/files/medicine/Jaundice%20Hepatitis/Concepts%20of%20Jaundice%20by%20Dr%20Sarma.ppt

Date added: December 2, 2011 - Views: 95

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Neonatal Jaundice

Neonatal Jaundice (Hyperbilirubinemia) Definition: Hyperbilirubinemia refers to an excessive level of accumulated bilirubin in the blood and is ... jaundice occurs in 6 % of term babies Bilirubin metabolism Clinical assessment of jaundice Area of body Bilirubin levels ...

http://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4280169/jaundice-neonatal%20%20.ppt

Date added: November 12, 2011 - Views: 172

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HIGH RISK NEWBORN - Suffolk County Community College

Kernicterus: Indirect bilirubin of 20 > permanent brain damage; bilirubin encephalophathy. Signs: hi-pitched cry, seizures, hypotonia Interventions: Immediate exchange transfusion; followed by phototherapy & frequent bili levels. ... * * * * * * LEVELS OF NICU Level I Basic neonatal care; ...

http://www2.sunysuffolk.edu/kiralyc/nur248/HIGH%20RISK%20NEWBORN%20%2013%20student%20version.ppt

Date added: January 27, 2012 - Views: 118

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Neonatal Jaundice - Shantou University

Neonatal Jaundice Li weizhong Introduction Neonatal Jaundice is known as the visible clinical manifestation of dying skin and sclera yellow during the neonatal period, resulting from deposition of bilirubin in the neonatal bodies.

http://erke.med.stu.edu.cn/news/edit/UploadFile/200971313237492.ppt

Date added: October 26, 2011 - Views: 261

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Neonatal Jaundice - New Born Baby

Bilirubin metabolism Clinical assessment of jaundice Area of body Bilirubin levels mg/dl Face 4-8 Upper trunk 5-12 ... hourly Turn baby after each feed Temperature record 2 to 4 hourly Weight record- daily Monitor urine frequency Monitor bilirubin level Side effects of phototherapy ...

http://newbornwhocc.org/pdf/teaching-aids/pps/jaundice.pps

Date added: March 23, 2014 - Views: 6

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

... of bilirubin Hepatic immaturity results in altered hepatic uptake and conjugation of bilirubin Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the ... Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the blood/brain ...

http://www.pediatrics.emory.edu/divisions/neonatology/apnec/THE%20LATE%20PRETERM%20BABY%20APNEC.ppt

Date added: October 13, 2011 - Views: 65

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Anesthesia and Liver Disease

AST/ALT Bilirubin Alk Phos Albumin Ammonia Coags Aminotransferases Aspartate aminotransferase (AST=SGOT) Alanine aminotransferase (ALT=SGPT ... obstruction kernicterus Total Albumin Low levels Decreased production Liver disease, malnutrition, stress Increased loss Renal, gut Coagulation ...

http://www.anesthesiawiki.net/metrohealthanesthesia/MHAnes/presentations/liverDiseaseAndAnesthesia.ppt

Date added: February 3, 2012 - Views: 46

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Using this template

Do we ever rely on visual examination alone to estimate the bilirubin level in a baby with jaundice? Do we ever use icterometers? Do we currently use TCBs? If not, how many do we need to purchase? ... gestational age and bilirubin levels.

http://www.nice.org.uk/guidance/cg98/resources/cg98-neonatal-jaundice-slide-set2

Date added: August 9, 2014 - Views: 1

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Clube de Revista - Paulo Roberto Margotto

Definition of the clinical spectrum of kernicterus and bilirubin-induced neurologic dysfunction (BIND). J Perinatol 2005;25:54–9 ... et al. Intelligence at six years in relation to neonatal bilirubin levels: follow-up of the National Institute of Child Health and Human Development ...

http://www.paulomargotto.com.br/documentos/Relacao_Bilirubina-albumina.ppt

Date added: November 9, 2011 - Views: 21

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AFP Journal Review - Emory University

Measurement of transcutaneous bilirubin levels is much less accurate than that of total serum bilirubin levels. B. ... (Tetanus), c.1809 Kernicterus Bilirubin Metabolism Slide 7 Slide 8 Slide 9 Slide 10 Slide 11 Slide 12 Slide 13 Slide 14 Pathologic Jaundice Features Bored Yet??? ...

http://www.fpm.emory.edu/Family/didactics/powerpint/AFP_Journal_Review5-1-08%5B1%5D.ppt

Date added: May 22, 2012 - Views: 38

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Obstructive Jaundice - Wikispaces

Jaundice Dr. Gehan Mohamed Dr. Abdelaty Shawky * Learning objectives Understand mechanism of Bilirubin formation and how its increase can lead to jaundice.

http://mcst.wikispaces.com/file/view/jaundice.ppt

Date added: March 30, 2014 - Views: 11

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Respiratory Therapy Licensure Alabama - Web Page Maker : Make ...

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 ...

http://crcresources.com/files/07_hyperbilirubinemia.pptx

Date added: August 16, 2013 - Views: 3

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Neonatal jaundice education presentation - Queensland Health

Queensland Maternity and Neonatal Clinical Guidelines Program: Neonatal jaundice. Bilirubin encephalopathy. Risk factors: Preterm birth. Rapid rate of rise of serum bilirubin

http://www.health.qld.gov.au/qcg/documents/ed-jaundice.ppt

Date added: June 22, 2013 - Views: 17

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DISCUSSION

TSB became low at levels: 13+/-0.7mg/dl (term), 10.7+/-1.2mg/dl (preterm) No risk factors for reaching toxic levels of bilirubin Direct bilirubin level is increasing Note: check total bilirubin 12-24hours after phototherapy Side Effects of Phototherapy Increased insensible water loss ...

http://xa.yimg.com/kq/groups/26169278/1107558846/name/Hyperbilirubinemia+by+Maya.ppt

Date added: June 22, 2013 - Views: 3

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a part - Department of Surgery: Residency Pages

Jaundice Bilirubin Metabolism Pre-hepatic Hepatic Post-hepatic Bilirubin Metabolism: Pre-Hepatic Bilirubin is formed in reticuloendothelial system as breakdown product of hemaglobin.

http://education.surgery.ufl.edu/students/PowerPoint/Jaundice_Vlada.ppt

Date added: May 30, 2012 - Views: 63