Neonatal hyperbilirubinemia bilirubin encephalopathy: investigations into the diagnosis, epidemiology, pathogenesis, management and treatment of the jaundiced newborn
Date
2009-05-22T11:24:13Z
Authors
Maisels, Michael Jeffrey
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Abstract
Jaundice is probably the most common newborn infant problem dealt with on a daily
basis by the family practitioner and paediatrician. Jaundice occurs when the liver
cannot clear a sufficient amount of bilirubin from the plasma. When the problem is
excessive bilirubin formation or limited uptake or conjugation, unconjugated (i.e.,
indirect reacting) bilirubin appears in the blood and indirect hyperbilirubinemia is the
predominant form of jaundice found in the newborn infant. In the vast majority of
newborns, hyperbilirubinemia is transient and benign but, in rare cases, the serum
bilirubin rises to a level that is toxic to the central nervous system. Understanding the
pathogenesis and epidemiology of neonatal hyperbilirubinemia; recognizing, the
problems involved in appropriate surveillance and monitoring of the jaundiced infant and
the factors contributing to bilirubin encephalopathy; and implementing treatment of the
jaundiced neonate in a timely fashion, are issues that have engaged clinicians and
researchers for some 6 decades. This work will summarize my contributions to the field
of neonatal hyperbilirubinemia and it includes papers published between 1971 and
2007. The description of this work will not follow its chronological sequence, but will be
divided into the categories of diagnosis, epidemiology, pathogenesis, management,
treatment, and bilirubin encephalopathy.
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Keywords
jaundice, newborn infant, pathogenesis, epidemiology, diagnosis, treatment