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Novel treatment strategy for J apanese newborns with high serum unbound bilirubin
Author(s) -
Yokota Tomoyuki,
Morioka Ichiro,
Kodera Takayuki,
Morisawa Takeshi,
Sato Itsuko,
Kawano Seiji,
Koda Tsubasa,
Matsuo Kiyomi,
Fujioka Kazumichi,
Morikawa Satoru,
Miwa Akihiro,
Shibata Akio,
Yokoyama Naoki,
Yonetani Masahiko,
Yamada Hideto,
Nakamura Hajime,
Iijima Kazumoto
Publication year - 2013
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03726.x
Subject(s) - medicine , bilirubin , albumin , neurotoxicity , serum bilirubin , gastroenterology , serum albumin , pediatrics , toxicity
Background Serum unbound bilirubin ( UB ) is a measure of bilirubin not bound to albumin, and has been reported to be better than total bilirubin level at identifying infants at risk of developing bilirubin‐induced neurotoxicity, including auditory abnormalities. A detailed treatment strategy for newborns with high serum UB has not been established. The aim of this study was to assess auditory outcomes in newborns with serum UB ≥1.00 μg/d L who were treated according to a novel treatment protocol. Methods A prospective clinical study was conducted in newborns weighing >1500 g with serum UB ≥1.00 μg/d L who were admitted to K obe U niversity H ospital and K akogawa M unicipal H ospital, J apan from 2006 to 2011. Enrolled newborns were treated as follows: (i) if serum UB was 1.00–1.50 μg/d L , phototherapy and infusion were given with or without albumin or immunoglobulin therapy; and (ii) if serum UB was >1.50 μg/d L , exchange transfusion was performed immediately. Auditory brainstem responses were evaluated at the time of discharge. Results A total of 89 Japanese newborns with UB ≥1.00 μg/d L were enrolled at a median age of 4 days. Of these, 85 had UB 1.00–1.50 μg/d L and four had UB >1.50 μg/d L . After being treated according to the protocol, no newborns were diagnosed with auditory brainstem response abnormalities. Conclusions The present treatment protocol for Japanese newborns with serum UB ≥1.00 μg/d L may be useful for the prevention of bilirubin‐induced auditory abnormalities.