Unbound Bilirubin Levels in Phototherapy-treated Preterm Infants Receiving Soy-based Lipid Emulsion.

Publication Date

2020

Journal Title

Pediatr Int

Abstract

BACKGROUND:Phototherapy is an effective treatment neonatal jaundice. Treatment indication uses total serum bilirubin (TSB), although unbound bilirubin (Bf) more accurately predicts handicap risk. The goals of this investigation were to examine the response of Bf and TSB to phototherapy in preterm infants, and we hypothesized that 1) TSB and Bf respond differently 2) the relationship between TSB and Bf is altered and 3) unexpected Bf elevations are found. METHODS:Preterm infants below 2 kg at birth and receiving Intralipid (IL) were enrolled measurements of TSB and Bf were obtained. TSB was measured by the diazo method and Bf with a fluorescent Bf sensor BL22P1B11-Rh. RESULTS:Initial TSB and Bf levels (41.4±6.9 hours) were 8.0±9.0 mg/dl and 16.9±12.4 nM (p11 nM in 64, >17 nM in 18, and >22 nM in 7 infants. CONCLUSIONS:Bf land TSB responded differently. While TSB and Bf correlated well before phototherapy, they did not during phototherapy. TSB showed a trend toward a reduction with treatment, Bf did not. While TSB ROR information is not helpful, ROR Bf data can be utilized to anticipate treatment. Potentially high Bf levels existed before and after phototherapy and the mean Bf level at phototherapy termination remained elevated in a significant proportion of infants.

Volume Number

62

Issue Number

12

Pages

1357-1363

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

General Pediatrics

PMID

32535983

DOI

10.1111/ped.14346

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