1 / 24

The Metabolic Characteristics of Bilirubin in Newborns

The Metabolic Characteristics of Bilirubin in Newborns. Wu jinlin Department of Pediatrics West China Second University Hospital Sichuan University. Baby on Phototherapy. Introduction of Neonatal Jaundice. Jaundice is quite common in neonatal period.

marcus
Download Presentation

The Metabolic Characteristics of Bilirubin in Newborns

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. The Metabolic Characteristics of Bilirubin in Newborns Wu jinlin Department of Pediatrics West China Second University Hospital Sichuan University

  2. Baby on Phototherapy

  3. Introduction of Neonatal Jaundice • Jaundice is quite common in neonatal period [1] 60% of term infants and 80% of preterm infants [2] Visible jaundice from sclera, mucosa and skin

  4. respiratory failure bilirubin encephalopathy neonatal death Introduction of Neonatal Jaundice • Can cause serious consequences [1] Actue phase

  5. cerebral palsy epilepsy mental retardation auditory and visual disfunctions [2] lifelong neurologic sequelae— kernicterus

  6. The Metabolic Characteristics of Bilirubin in Newborns Why jaundice is so prevalent in neonatal period ???

  7. shunt bilirubin Y&Z protein UDPGT Albumin β-glucuronidase Enterohepatic Circulation Normal Bilirubin Metabolism

  8. What’s the distinct metabolic characteristics of bilirubin in newborns comparing with our adults?

  9. Neonatal Bilirubin Metabolism 1. Increased bilirubin production in newborns 2. Insufficient binding between bilirubin and albumin 3. Deficient bilirubin conjugation in the hepatocyte 4. Increased enterohepatic circulation of bilirubin 5. Others

  10. 1. Increased bilirubin production (1) Increased oxygen partial pressure PO2 bilirubin PO2 RBC RBC

  11. 1. Increased bilirubin production (2) Short survival of neonatal erythrocyte Preterm: ﹤70 days Term: 80 days [1] Life span of RBC Adult: 120 days [2] Turnover rate of neonatal hemoglobin: 2 times faster than that of adults

  12. heme shunt bilirubin bone marrow precusor 1. Increased bilirubin production (3) Over production of shunt bilirubin

  13. Neonatal Bilirubin Metabolism 1. Increased bilirubin production in newborns 2.Insufficient binding between bilirubin and albumin 3. Deficient bilirubin conjugation in the hepatocyte 4. Increased enterohepatic circulation of bilirubin 5. Others

  14. GAalbumin bilirubin-albumin complex • low content of serum albumin • different degree of acidosis at birthbinding affinity B A A B B B B B B A B B B A A B A B B serum 2. Insufficient Binding between Bilirubin and Albumin

  15. Neonatal Bilirubin Metabolism 1. Increased bilirubin production in newborns 2. Insufficient binding between bilirubin and albumin 3.Deficient bilirubin conjugation in the hepatocyte 4. Increased enterohepatic circulation of bilirubin 5. Others

  16. Y carrier protein increases rapidly 5~10 days later conjugation of bilirubin with glucuronic acid • UDPGT reaches the adult’s values 1 week after birth 3. Deficient Bilirubin Conjugation in the Hepatocyte

  17. Neonatal Bilirubin Metabolism 1. Increased bilirubin production in newborns 2. Insufficient binding between bilirubin and albumin 3. Deficient bilirubin conjugation in the hepatocyte 4.Increased enterohepatic circulation of bilirubin 5. Others

  18. 4. Increased Enterohepatic Circulation of Bilirubin • intestinal flora is not fully developed • abundant β-glucuronidase • delayed excretion of meconium

  19. Neonatal Bilirubin Metabolism 1. Increased bilirubin production in newborns 2. Insufficient binding between bilirubin and albumin 3. Deficient bilirubin conjugation in the hepatocyte 4. Increased enterohepatic circulation of bilirubin 5.Others

  20. hunger 5. Others cephalohematoma intracranial hemorrhage dehydration acidosis …… hypoxia

  21. [2] Pathogenesis : over-production of bilirubin immature liver function Summary [1] Jaundice is much more frequent in neonates

  22. Thank you

More Related