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Hyperbilirubinemia
Rebecca Heckaman
Jackson College
HYPERBILIRUBINEMIA 2
Hyperbilirubinemia
Bilirubin is a reddish-yellow, water insoluble pigment, that is formed by the breakdown of heme
(Bilirubin). The liver is what filters bilirubin from the bloodstream. It is then released into the
intestinal tract. In a newborn the immature liver often struggles to remove bilirubin as quick as
needed, from there the excess bilirubin stays in the blood, and can enter tissues, and other fluids
(Diseases and Conditions). Excess bilirubin being in the infant’s tissues can show as jaundice of
There are several signs and symptoms that should be looked for to detect
hyperbilirubinemia. The most notable sign is an infant’s body or whites of the eyes appearing
yellow or jaundice, especially if it lasts longer than 3 weeks. Bilirubin levels become elevated in
the blood of almost all infants in the first few days after birth, while jaundice takes place in more
than half of them (Porter & Dennis). For most of the infants, jaundice and elevation represents a
normal and routine physiological phenomenon and as such does not cause any specific problem.
Some other signs are infants seeming listless or sick of hyperbilirubinemia (Hyperbilirubinemia
and Jaundice). Some or all signs and symptoms may be present when an infant has
Bilirubin in low levels is not usually a concern. When test show large amounts of
bilirubin circulating tissues in the brain it may cause seizures or brain damage because it is toxic
to brain tissue. Acute bilirubin encephalopathy may occur if severe jaundice is present and
bilirubin passes into the brain. Receiving treatment quickly may prevent permanent damage. If
permanent damage does occur, it results in the condition called kernicterus (Hyperbilirubinemia
HYPERBILIRUBINEMIA 3
and Jaundice). It is important to see the signs of hyperbilirubinemia in the infant early and seek
Like treatments for all diseases the overall health of the infant, the extent of the
hyperbilirubinemia, and the expectation for the outcome all factor into the decision of how it
should be treated. The treatment options for hyperbilirubinemia include phototherapy, fiber optic
hyperbilirubinemia and managing the infection can cure it. Phototherapy is used because
bilirubin absorbs light; bilirubin levels usually decrease when the infant is exposed to special
blue spectrum lights. It may take several hours to begin working and it is used throughout the
day and night. The baby’s eyes must be protected and the temperature needs to be monitored
during phototherapy. Blood levels of bilirubin are checked throughout treatment to monitor if it
is working. Another form of phototherapy is a fiber optic blanket placed under the infant. Fiber
optic blankets may be used alone or in combination with regular phototherapy (Porter & Dennis).
help with dehydration and weight loss. Another treatment is exchange fusion. This is the use of a
blood transfusion. This process involves repeatedly withdrawing small amounts of blood,
diluting the bilirubin and maternal antibodies, and then transferring blood back into the infant.
Exchange fusion is usually only used when other treatments do not work (Diseases and
Conditions Infant Jaundice). The early recognition and treatment of hyperbilirubinemia are the
References
webster.com/dictionary/bilirubin
Diseases and Conditions Infant Jaundice. (n.d.) Retrieved September 18, 2016, from
http://www.mayoclinic.org/diseases-conditions/infant-jaundice/basics/causes/con-
20019637
http://www.stanfordchildrens.org/en/topic/default?id=hyperbilirubinemia-and-jaundice-
90-PO2375
Porter, Meredith L., CPT, MC, USA, and Beth L. Dennis, MAJ, MC, USA, Dewitt Army
http://www.aafp.org/afp/2002/0215/p599.html