Treatment of neonatal hyperbilirubinemia

Abstract

Objective: to review the recent medical literature on the treatment of neonatal jaundice, focusing on practical aspects that are relevant to pediatricians and neonatologists.Sources: an extensive review of the related literature was performed, also including the author's clinical experience in this field of investigation. Summary of the findings:jaundice is very common among infants during the first days of life. Several factors such as maternal and neonatal history have to be considered before implementing treatment. Significant advances have been made in the past few years concerning the treatment of jaundiced newborn infants. This review focuses on three forms of treatment of neonatal hyperbilirubinemia: phototherapy, exchange transfusion and the use of drugs to reduce serum bilirubin concentration.Conclusions: nowadays, the in-depth knowledge about the mechanism of action of phototherapy, the development of intensified phototherapy units and the use of drugs to reduce bilirubin formation, have contributed to significantly decrease the need for exchange transfusion.

Mist and water condensation inside incubators reduce the efficacy of phototherapy

“…There is a clear dose-response relation between irradiance and the effectiveness of phototherapy. Many factors alter the amount of light energy reaching the newborn's skin and consequently the irradiance delivered by a phototherapy device 9. In this study, although the irradiance delivered by the daylight fluorescent lamps phototherapy was no affected by the increasing humidification levels, the low reading suggests that they are not an effective device.…”

O neonato sob fototerapia na unidade de internação neonatal – conhecimento das mães

“…Para impedir aquecimento e queimaduras, a fonte luminosa não deve ser mantida próxima ao bebê. Recomenda-se que fototerapias equipadas com lâmpadas halógenas sejam posicionadas a 40-50 cm do neonato 23 . A temperatura deve ser verificada frequentemente para evitar o superaquecimento 24 .…”

Investigating the Efficacy and Safety of Silymarin in Management of Hyperbilirubinemia in Neonatal Jaundice

“…Efficacy of phototherapy needs a lot of precautions to justify the required minimal effective dose. Hence numerous newborns still submitted to subtherapeutic doses of phototherapy, which may lead to neurological sequelae that may not be detected in childhood [22,23]. Several pharmacological drugs are used to treat neonatal jaundice [12].…”