Neonatal hyperbilirubinemia bilirubin encephalopathy: investigations into the diagnosis, epidemiology, pathogenesis, management and treatment of the jaundiced newborn

摘要

Jaundice is probably the most common newborn infant problem dealt with on a dailyudbasis by the family practitioner and paediatrician. Jaundice occurs when the liverudcannot clear a sufficient amount of bilirubin from the plasma. When the problem isudexcessive bilirubin formation or limited uptake or conjugation, unconjugated (i.e.,udindirect reacting) bilirubin appears in the blood and indirect hyperbilirubinemia is theudpredominant form of jaundice found in the newborn infant. In the vast majority ofudnewborns, hyperbilirubinemia is transient and benign but, in rare cases, the serumudbilirubin rises to a level that is toxic to the central nervous system. Understanding theudpathogenesis and epidemiology of neonatal hyperbilirubinemia; recognizing, theudproblems involved in appropriate surveillance and monitoring of the jaundiced infant andudthe factors contributing to bilirubin encephalopathy; and implementing treatment of theudjaundiced neonate in a timely fashion, are issues that have engaged clinicians andudresearchers for some 6 decades. This work will summarize my contributions to the fieldudof neonatal hyperbilirubinemia and it includes papers published between 1971 andud2007. The description of this work will not follow its chronological sequence, but will beuddivided into the categories of diagnosis, epidemiology, pathogenesis, management,udtreatment, and bilirubin encephalopathy.