Fundamentals of Phototherapy for Neonatal Jaundice

Stokowski, Laura A.

doi:10.1097/anc.0b013e31822ee62c

Cited by 69 publications

(69 citation statements)

References 37 publications

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“…Positioning the PT device as close to the infant as possible increases irradiance levels and consequently the efficacy of PT (figure 4). 6 However, if a specific light source produces too much heat, as could happen with halogen lamp–based devices, close positioning of the lamp to the infant may increase the risk of heat burn 2 17. Therefore, it is very important to follow the safety instructions of the manufacturer.…”

Section: Discussionmentioning

confidence: 99%

High variability and low irradiance of phototherapy devices in Dutch NICUs

Imhoff

Hulzebos

Heide

et al. 2012

Arch Dis Child Fetal Neonatal Ed

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PT devices in the Dutch NICUs show considerable variability with often too low irradiance levels. These results indicate that suboptimal PT is frequently applied and may even be ineffective towards reducing total serum bilirubin levels. These results underline the need for greater awareness among all healthcare workers towards the requirements for effective PT including measurements of irradiance and distance.

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Section: Discussionmentioning

confidence: 99%

High variability and low irradiance of phototherapy devices in Dutch NICUs

Imhoff

Hulzebos

Heide

et al. 2012

Arch Dis Child Fetal Neonatal Ed

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“…Excessive hyperbilirubinemia in human neonates may cause permanent dysfunction of the auditory system, as assessed with BAEPs (Rice et al, 2011). Phototherapy has been a widely and successfully used therapy to reduce the levels of UCB by transforming UCB in the skin into water-soluble isomers that are cleared without the need of liver conjugation (Stokowski, 2011). Guidelines for the management of hyperbilirubinemia in newborn infants and recommendations to use phototherapy were published by the American Academy of Pediatrics (2004) and Bhutani (2011), respectively.…”

Section: Bind: In Search Of Potential Neurotherapeuticsmentioning

confidence: 99%

The Evolving Landscape of Neurotoxicity by Unconjugated Bilirubin: Role of Glial Cells and Inflammation

Brites¹

2012

Front. Pharmacol.

116

103

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Unconjugated hyperbilirubinemia is a common condition in the first week of postnatal life. Although generally harmless, some neonates may develop very high levels of unconjugated bilirubin (UCB), which may surpass the protective mechanisms of the brain in preventing UCB accumulation. In this case, both short-term and long-term neurodevelopmental disabilities, such as acute and chronic UCB encephalopathy, known as kernicterus, or more subtle alterations defined as bilirubin-induced neurological dysfunction (BIND) may be produced. There is a tremendous variability in babies’ vulnerability toward UCB for reasons not yet explained, but preterm birth, sepsis, hypoxia, and hemolytic disease are comprised as risk factors. Therefore, UCB levels and neurological abnormalities are not strictly correlated. Even nowadays, the mechanisms of UCB neurotoxicity are still unclear, as are specific biomarkers, and little is known about lasting sequelae attributable to hyperbilirubinemia. On autopsy, UCB was shown to be within neurons, neuronal processes, and microglia, and to produce loss of neurons, demyelination, and gliosis. In isolated cell cultures, UCB was shown to impair neuronal arborization and to induce the release of pro-inflammatory cytokines from microglia and astrocytes. However, cell dependent sensitivity to UCB toxicity and the role of each nerve cell type remains not fully understood. This review provides a comprehensive insight into cell susceptibilities and molecular targets of UCB in neurons, astrocytes, and oligodendrocytes, and on phenotypic and functional responses of microglia to UCB. Interplay among glia elements and cross-talk with neurons, with a special emphasis in the UCB-induced immunostimulation, and the role of sepsis in BIND pathogenesis are highlighted. New and interesting data on the anti-inflammatory and antioxidant activities of different pharmacological agents are also presented, as novel and promising additional therapeutic approaches to BIND.

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“…In turn, biliverdin is reduced to bilirubin, the yellowish bile pigment. Free unconjugated bilirubin is lipid‐soluble and potentially toxic, thus for excretion it has to be transported to the liver where it is conjugated to glucuronic acid, therefor it binds reversibly to albumin . Conjugated bilirubin is excreted with the bile and is converted to urobilinogen in the large intestine by bacterial proteases, part of it is excreted with the feces.…”

Section: Discussionmentioning

confidence: 99%

Metabolic signature associated with parameters of the complete blood count in apparently healthy individuals

Masuch

Budde

Kastenmüller

et al. 2019

J Cellular Molecular Medi

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Metabolomics studies now approach large sample sizes and the health characterization of the study population often include complete blood count (CBC) results. Upon careful interpretation the CBC aids diagnosis and provides insight into the health status of the patient within a clinical setting. Uncovering metabolic signatures associated with parameters of the CBC in apparently healthy individuals may facilitate interpretation of metabolomics studies in general and related to diseases. For this purpose 879 subjects from the population‐based Study of Health in Pomerania (SHIP)‐TREND were included. Using metabolomics data resulting from mass‐spectrometry based measurements in plasma samples associations of specific CBC parameters with metabolites were determined by linear regression models. In total, 118 metabolites significantly associated with at least one of the CBC parameters. Strongest associations were observed with metabolites of heme degradation and energy production/consumption. Inverse association seen with mean corpuscular volume and mean corpuscular haemoglobin comprised metabolites potentially related to kidney function. The presently identified metabolic signatures are likely derived from the general function and formation/elimination of blood cells. The wealth of associated metabolites strongly argues to consider CBC in the interpretation of metabolomics studies, in particular if mutual effects on those parameters by the disease of interest are known.

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Fundamentals of Phototherapy for Neonatal Jaundice

Cited by 69 publications

References 37 publications

High variability and low irradiance of phototherapy devices in Dutch NICUs

High variability and low irradiance of phototherapy devices in Dutch NICUs

The Evolving Landscape of Neurotoxicity by Unconjugated Bilirubin: Role of Glial Cells and Inflammation

Metabolic signature associated with parameters of the complete blood count in apparently healthy individuals

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