Novel treatment strategy for Japanese newborns with high serum unbound bilirubin. Issue 1 (11th December 2012)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Pediatrics international. Volume 55:Issue 1(2013)
• Page Start: 54
• Page End: 59
• Publication Date: 2012-12-11
• Subjects: Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/j.1442-200X.2012.03726.x
• Languages: English
• ISSNs: 1328-8067

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ped3726-sec-0001" sec-type="section"> <title>Background</title> <p>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/dL who were treated according to a novel treatment protocol.</p> </sec> <sec id="ped3726-sec-0002" sec-type="section"> <title>Methods</title> <p>A prospective clinical study was conducted in newborns weighing >1500 g with serum UB ≥1.00 μg/dL who were admitted to Kobe University Hospital and Kakogawa Municipal Hospital, Japan from 2006 to 2011. Enrolled newborns were treated as follows: (i) if serum UB was 1.00–1.50 μg/dL, phototherapy and infusion were given with or without albumin or immunoglobulin therapy; and (ii) if serum UB was >1.50 μg/dL, exchange transfusion was performed immediately. Auditory brainstem responses were evaluated at the time of discharge.</p> </sec> <sec id="ped3726-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 89 Japanese newborns with UB ≥1.00 μg/dL were enrolled at a median age of 4 days. Of these, 85 had UB 1.00–1.50 μg/dL and four had UB >1.50 μg/dL. After being treated according to the protocol, no newborns were diagnosed with auditory brainstem response abnormalities.</p> </sec> <sec id="ped3726-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The present treatment protocol for Japanese newborns with serum UB ≥1.00 μg/dL may be useful for the prevention of bilirubin‐induced auditory abnormalities.</p> </sec> </abstract>