Question of the Week

Question :
Posted On : 17 Nov 2011
It is a common scenario in our NICU that babies suffering from neonatal sepsis develop direct hyperbilirubinemia. one baby {wt 2650 gms} is having total bil 35 mg percent Direct- 10 mg percent and Indirect- 25 mg percent. My query is that whether we should give phototherapy to this baby to decrease indirect fraction or we should discontinue phototherapy as it may lead to bronze baby syndrome. I mean what should be done if we found a baby with such a high direct or indirect bilirubin. whether to continue phototherapy or not _? what is the harm of phototherapy in these babies other than bronze baby syndrome _?
5
Expert Answer :
With neonatal sepsis and direct hyperbilirubinemia, there will also be deranged liver enzymes and abnormal coagulation profile. If there is evidence of liver damage, then phototherapy may not be useful. However if the indirect fraction rise above the danger mark of brain damage, then photherapy may be needed to prevent kernicterus. One need not give prolonged phototherapy. Rule out galactosemia in these children with neonatal sepsis and direct hyperbilirubinemia.
Answer Discussion :
S
sarah Ashour
Profile
kernicterous
13 years ago
A
ASAM SATISH KUMAR
Profile
phototherapy should be given as the indirect fraction is very high along with iv antibiotics
13 years ago
S
sara ali
Profile
should continue the phototherapy to decrease the risk of kernictrus.
the complication of the phototherapy could be dehydration.

13 years ago
S
saeedelsadek
Profile
i think we should reduce unconj. bilirubin using the phototherapy charts.
13 years ago
S
sanjay
Profile
we should continue phototherapy as indirect component is high and investigate for direct bilirubin
13 years ago




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