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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

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Kernicterus - NCC Pediatrics Residency at Walter Reed-Bethesda

Kernicterus Developmental Pediatrics Louis Meng, PL2 November 12th 2002 History Earliest work on jaundice from Baumes-1785, and Hervieux-1847 Kernicterus was first described by Johannes Orth, 1875 He postulated that jaundice might have hematologic origins He noted that the brain in jaundiced ...

Date added: October 25, 2011 - Views: 48


* “Moderate” is defined by bilirubin levels >17.5 mg/dl (40) (17) (15) (8) Total (n = ) 0.25 - 0.4 0.3 - 0.5 0.3 - 0.6 ... regarding the toxic potential of bilirubin The Under-reporting of Occurrence of Kernicterus Slide 17 Incidence of Kernicterus Related to Total Serum Bilirubin ...

Date added: November 1, 2011 - Views: 60

Hyperbilirubinemia in the Newborn

Hyperbilirubinemia in the Newborn Objectives Understand the physiology of hyperbilirubinemia Be able to define kernicterus Know the associated risk factors for jaundice Be able to appropriately assess the risk of harm from jaundice Be familiar with current therapies Epidemiology 50-70% of ...

Date added: June 30, 2012 - Views: 28

Neonatal Hyperbilirubinemia - Yale University

Has she had her TcB checked? Has she had blood bilirubin levels checked? Case #1 ... risk due to further reduced activity of liver conjugating enzymes Pre-term infants can develop encephalopathy or kernicterus at lower total bilirubin levels Indirect Hyperbilirubinemia: Elevated ...

Date added: August 8, 2013 - Views: 26

Hyperbilirubinemia - Stanford University

Objectives. Understand pathway where bilirubin comes from. Physiologic vs Pathologic Hyperbilirubinemia. Understand the risk for Kernicterus . Understand why we care about hyperbilirubinemia

Date added: October 18, 2013 - Views: 11

Neonatal Bilirubin Levels and Developmental Outcome - URLEND

Neonatal Bilirubin Levels and Developmental Outcome Dennis Odell Rachel Duchoslav Erin Clark Rena Vanzo Lisa Samson-Fang Background High bilirubin levels in neonates are known to be associated with kernicterus Multiple additional risk factors with high bilirubin levels increase risk of ...

Date added: November 19, 2011 - Views: 11

Recommending a Strategy - Official Web site of the U.S ...

... and fever – not considered ABE in this report.] Chronic Bilirubin Encephalopathy (Kernicterus) Persistent and permanent ... of ABE may resolve with treatment Direct evidence that earlier treatment with phototherapy effectively lowers serum bilirubin levels and diminishes the ...

Date added: February 5, 2013 - Views: 15

Neonatal Jaundice - ACT Medicare Local

The absorbance spectrum of bilirubin bound to ... FBC and film Blood group Maternal blood group Direct coombs test Investigations for prolonged jaundice Kernicterus Also called bilirubin encephalopathy ... bilirubin is: neurotoxic at high levels lipophilic and can cross the ...

Date added: May 13, 2013 - Views: 16


Elevated levels of plasma bilirubin were shown to affect the concentration of other plasma antioxidants, such as Vitamin E, ... However “unconjugated” bilirubin can induce a loss of neurons and atrophy of involved fiber systems (called Kernicterus).

Date added: March 5, 2012 - Views: 28

Hyperbilirubinemia in Infants - Alverno College

... “As bilirubin levels rise, the accuracy of visual assessment decreases” (Juretschke, 2005, p. 11) ... converted it can be deposited into the skin which causes the yellowing of the skin or into the brain which can lead to kernicterus (1) Conjugated Bilirubin Conjugated ...

Date added: September 3, 2011 - Views: 100


... feeding difficulties dystonia incoordination choreoathetosis sensorineural hearing loss painful muscle spasms KERNICTERUS Incidence of bilirubin levels>30 1/10,000 Over ... June 2001 in MICC Curriculum. Maisels MJ and E Kring, Transcutaneous bilirubin levels in the first 96 hours in ...

Date added: October 25, 2011 - Views: 171

Jaundice -

Jaundice Prepared and presented by Luka Marinculić Mentor: A. Žmegač Horvat Jaundice – is it a disease? Yellowish staining of the skin and sclerae High levels of bilirubin in blood What causes jaundice?

Date added: November 22, 2012 - Views: 44

Neonatal Unconjugated Hyperbilirubinemia - University of Chicago

... A visible manifestation in the skin and sclera of elevated bilirubin concentrations Adults are usually jaundiced when bilirubin levels exceed 2 mg/dL ... and cerebellum which is followed by gliosis 50%of patients with kernicterus die Acute Bilirubin Encephalopathy Phase 1 - poor ...

Date added: October 25, 2011 - Views: 110


Newborn Jaundice and the Prevention of Kernicterus A Six-Sigma Approach Vinod K. Bhutani, MD, FAAP ... PICK) Characterize the problem: adverse outcome with high bilirubin levels (CDC, AAP, JCAHO, AHRQ) Optimal solution: pre-discharge screening and targeted follow-up in the first week (AAP ...

Date added: November 25, 2011 - Views: 29


Bilirubin levels can rise up to 18 mg/dL by 3 to 4 days of life ... liver and kidney without glucuronidation provides definitive treatment of neonatal hyperbilirubinemia and prevention of kernicterus Phototherapy is an option when unconjugated bilirubin is > 12 mg/dL ...

Date added: May 16, 2013 - Views: 11

FirstClass Login - University of Washington

Server: UW Family Medicine : User ID: Password:

Date added: November 23, 2012 - Views: 43

Hyperbilirubinemia - Oregon Health & Science University

Hsia, et al. NEJM 1952;247:668-71 Mollison and Cutbush. Blood 1951:777-88 Serum Bilirubin Level and Kernicterus in 229 Infants with ... 96:730-733 6 patients 4-10 days of age Bilirubin levels 39-50 Jaundice of Prematurity Jaundice appears at a level of 6-8 No relationship between ...

Date added: November 12, 2011 - Views: 45


... bilirubin level remains elevated after intensive phototherapy If the initial bilirubin level is meets defined critical levels ... consequences of unconjugated bilirubin deposition in brain Damage & scarring of basal ganglia & brain stem Kernicterus (Cont’d) Unconjugated bilirubin ...

Date added: May 2, 2013 - Views: 19

Jaundice and liver function tests - Welcome to nky.wikidot ...

Jaundice and liver function tests KVB Normal Liver: The liver is the largest internal organ,measuring on an average 1500 g. The liver has a dual blood supply: 2/3rd by the portal circulation & 1/3rd of blood arriving from the hepatic artery.

Date added: February 18, 2013 - Views: 47

Neonatal Hyperbilirubinemia - CPQCC

... brain stem nuclei and cerebellum Causing neuronal necrosis Bilirubin levels at which kernicterus occurs vary depending on the presence of hemolytic disease and gestational age No “safe” levels of bilirubin have been identified Thought to be highly preventable in most cases Kernicterus ...

Date added: June 15, 2012 - Views: 97

PowerPoint Presentation

... Due to immaturity of the enzymes involved in bilirubin conjugation High levels of unconjugated bilirubin are toxic to ... due to its hydrophobicity it can cross the blood-brain barrier and cause a type of mental retardation known as kernicterus If bilirubin levels are judged to be ...

Date added: October 25, 2011 - Views: 162

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez Alterations in Liver Function * Jaundice/Icterus Yellow discoloration of the skin, eyes and mucous membranes Due to the presence of bilirubin Onset seen at bilirubin levels > 3.0 mg/dL Kernicterus Yellow staining of the meninges of the brain due ...

Date added: May 18, 2013 - Views: 12

Hemolytic Disease of the Newborn, Current Methods of ...

Kernicterus occurs at lower levels of bilirubin in the presence of acidosis, hypoalbuminemia, prematurity and certain ... (due to hyperinsulinemnia from islet cell hyperplasia) Kernicterus Kernicterus (bilirubin encephalopathy) results from high levels of indirect bilirubin (>20 mg/dL in a term ...

Date added: October 12, 2011 - Views: 120

Neonatal Jaundice - Wikispaces

Neonatal Jaundice: Indirect Hyperbilirubinemia “Triple”Phototherapy: Halogen, Blanket Halogen Photometer Reading “Double” halogen lights Only able to generate 10 microwatts/cm2/nm Very low “dose” of phototherapy Fiberoptic Phototherapy Light from tungsten-halogen bulb through ...

Date added: May 2, 2013 - Views: 16

Infant Jaundice - SBH Peds Res

* Kernicterus Develops during the first year after ... sclerae and mucous membranes due to an elevated serum bilirubin Jaundice usually becomes apparent at a total serum bilirubin ... (start at 1% of the adult levels) Conjugated bilirubin is more water soluble than unconjugated bilirubin ...

Date added: May 23, 2013 - Views: 23

Approach to the management of hyperbilirubinemia in term ...

... and with extremely high bilirubin levels Classification Benign Physiologic Breast Milk Breastfeeding ... after intensive phototherapy attempted Complications Toxicity to Basal Ganglia and brainstem nuclei 2 terms Acute bilirubin encephalopathy Kernicterus Multiple phases Risk of ...

Date added: September 28, 2011 - Views: 87

Jaundice and the Newborn - Smoky Hill FMRP

Complications Chronic bilirubin encephalopathy (kernicterus) ... Decreased bilirubin clearance Deficiency of UGT UGT activity at 7 days of age is approx 1% of adult Reaches adult levels around ... etc Polycythemia Infants of diabetic mothers Pathologic jaundice--causes Disorders of bilirubin ...[Rupe-Abbey]Jaundice-in-the-Newborn.ppt

Date added: May 2, 2013 - Views: 26

Bilirubin Metabolism - Gee

Bilirubin Metabolism in the Liver. Uptake of Bilirubin by hepatocytes: Bilirubin dissociates from its carrier albumin & enters hepatocytes. Conjugation

Date added: August 11, 2014 - Views: 1

PowerPoint Presentation

... Due to immaturity of the enzymes involved in bilirubin conjugation High levels of unconjugated bilirubin are ... type of mental retardation known as kernicterus If bilirubin levels are ... Cells Fe released during heme metabolism Fe is distributed to topologically ...

Date added: October 29, 2011 - Views: 38

JAUNDICE Just Call Me Yellow - Emory University

JAUNDICE Just Call Me Yellow Mary Johnson RNC/MSN Gwinnett Hospital System Objectives At the end of the presentation; the participant will be able to: List 2 factors that place a neonate at risk for jaundice Describe the common treatment modalities for jaundice Discuss the difference between ...

Date added: October 25, 2011 - Views: 47

Neonatal Hyperbilirubinemia - University of Minnesota

Neonatal Hyperbilirubinemia Jaundice Yellowish discoloration of skin +/- sclera of newborns due to bilirubin Affects nearly all newborns Peak: 48-120 hours, typically 5-6 mg/dL, usually does not exceed 17-18 mg/dL Pathologic: TSB exceeds age (in hours) specific 95th percentile according to ...

Date added: October 8, 2011 - Views: 101

The Liver & Tests of Hepatic Function - Amazon S3

Bilirubin that deposits in brain tissue may cause irreversible brain damage “kernicterus”. ... nm from Abs at 455 nm Compare ALBUMIN levels to bilirubin levels to assess the ability to transport unconjugated bilirubin to the liver. If albumin levels are insufficient, unconjugated ...

Date added: February 13, 2014 - Views: 11

Neonatal Jaundice

Neonatal Jaundice By Dr. Nahed Al-Nagger Neonatal Jaundice Learning Objectives: Define hyperbilirubinemia. Differentiate between physiological and pathological jaundice.

Date added: November 12, 2011 - Views: 165

Obstructive Jaundice - Wikispaces

Jaundice Dr. Gehan Mohamed Dr. Abdelaty Shawky * Learning objectives Understand mechanism of Bilirubin formation and how its increase can lead to jaundice.

Date added: March 30, 2014 - Views: 5

Neonatal Hyperbilirubinemia

... Abnormality in ABR Hypotony: reverses with bilirubin levels Very rarely kernicterus Low birth weight infants: Damage most probably due to accompanying factors than to high bilirubin. Breast Feeding Jaundice Bilirubin after 4 days of age.

Date added: May 22, 2013 - Views: 8

Jaundice Noted in the First 24 Hours After Birth in a Large HMO

Overview Introduction Jaundice in newborns and kernicterus Infant safety seats on airplanes Stories vs Statistics; ... permanent brain damage from very high bilirubin levels Jaundice --Background 2 Phototherapy: Shining light on the babies skin -- helps lower bilirubin levels Exchange ...

Date added: September 12, 2011 - Views: 58

Neonatal Jaundice - New Born Baby

Bilirubin metabolism Clinical assessment of jaundice Area of body Bilirubin levels mg/dl Face 4-8 Upper trunk 5-12 Lower trunk & thighs 8-16 Arms and lower legs 11-18 ... Decide whether jaundice is physiological or pathological Look for evidence of kernicterus* in deeply jaundiced ...

Date added: March 23, 2014 - Views: 5

Neonatal Hyperbilirubinemia: An Update - University of ...

Neonatal Hyperbilirubinemia: An Update Bryan Burke, MD Arkansas Children’s Hospital University of Arkansas for Medical Sciences Definitions Hyperbilirubinemia: An unusually large amount of bilirubin in the blood resulting in jaundice.

Date added: March 22, 2012 - Views: 146

HIGH RISK NEWBORN - Suffolk County Community College

HIGH RISK NEWBORN Lecture 13 ... Single, double, triple phototherapy. Kernicterus: Indirect bilirubin of 20 > permanent brain damage; bilirubin encephalophathy. Signs: hi-pitched cry, seizures, hypotonia ... 2nd-3rd day. R/T low albumin (decreased binding sites for bilirubin). ^ levels of RBC’s.

Date added: January 27, 2012 - Views: 111

AFP Journal Review - Emory University

AFP Journal Review May 1, ... Pre-discharge measurement of bilirubin levels can help determine timing of follow-up examinations. ... c.1809 Kernicterus Bilirubin Metabolism Slide 7 Slide 8 Slide 9 Slide 10 Slide 11 Slide 12 Slide 13 Slide 14 Pathologic Jaundice Features Bored Yet??? ...

Date added: May 22, 2012 - Views: 30


... Due to immaturity of the liver enzymes High levels of unconjugated bilirubin are toxic to the newborn ... due to its fat solubility it can cross the blood-brain barrier and cause a type of mental retardation known as kernicterus If bilirubin levels are judged to be too high, ...

Date added: February 23, 2012 - Views: 56

a part - Department of Surgery: Residency Pages

Bilirubin Metabolism Pre-hepatic Hepatic Post-hepatic Bilirubin ... Kernicterus in newborns Bilirubin Metabolism: ... (sm), and liver-kidney microsomal (LKM) antibodies (for autoimmune hepatitis) Serum levels of iron, transferrin, and ferritin (for hemochromatosis) Serum levels of ...

Date added: May 30, 2012 - Views: 58

Adrenal Incidentaloma NIH State-of-the-art conference ...

... Association of neonatal hyperbilirubinemia with neurodevelopmental outcomes What is the relationship between peak bilirubin levels and/or ... bibliography of relevant review articles for potential additional studies Supplemental search for case reports of kernicterus was also ...

Date added: August 29, 2011 - Views: 16

Alterations in Hematologic Function - Pediatric Nursing

... seen within 3 months Bone Marrow Transplant Neonatal Hyperbilirubinemia Hyperbilirubinemia is defined as excessive levels of bilirubin in ... Kernicterus: bilirubin ... Reaction Allergic Reaction Hematologic Conditions Alteration in Hematologic Status Genetic ...

Date added: October 19, 2011 - Views: 38

Jaundice – Its Differential Diagnosis - Drsarma

Title: Jaundice – Its Differential Diagnosis Author: Dr. Sarma Last modified by: Dr. Sarma Created Date: 3/8/2007 4:39:56 PM Document presentation format

Date added: December 2, 2011 - Views: 89

Respiratory Therapy Licensure Alabama - Web Page Maker : Make ...

Unconjugated (indirect) bilirubin >13 mg/dl. Indirect levels rise by more than 5 mg/dl in a 24 hour period. Direct bilirubin >1.5 mg/dl. ... Most serious complication is kernicterus (bilirubin pigment deposited in brain tissue) leading to neuronal injury. Treatment. Treat cause. Phototherapy ...

Date added: August 16, 2013 - Views: 3

Blood Cells and Vessels - Dr Magrann

Red Blood Cell Breakdown. Hemoglobin in RBC’s is broken down to bilirubin. Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases.

Date added: February 7, 2014 - Views: 9

Using this template

Babies with very high bilirubin levels are at risk of developing kernicterus. Kernicterus is also known to occur at lower levels of bilirubin in term babies who ... Additional information: The use of transcutaneous bilirubinometers (TCBs) to monitor bilirubin levels, where clinically ...

Date added: August 9, 2014 - Views: 1

THE “NEAR TERM” NEWBORN: Not Ready for “Term Time”

Not Ready for “Term Time ... uptake and conjugation of bilirubin Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the blood ... of bilirubin Breastfeeding practices Kernicterus When bilirubin at high enough levels crosses the blood/brain barrier ...

Date added: October 13, 2011 - Views: 61

الشريحة 1 - An-Najah National University

... has been associated with near elimination of low-bilirubin kernicterus. Two approaches include: In an at-risk or ... phototherapy unit Exposed surface area in the infant Distance of the infant from light source How phototherapy reduce bilirubin levels in the first 24 hours of ...

Date added: May 2, 2013 - Views: 18