Hyperbilirubinemia, Kernicterus And Jaundice Treatment
Hyperbilirubinemia is a process that occurs in the body when the waste product produced by the breaking down of red blood cells, known as bilirubin, is found in substantial levels of a person’s blood serum. Gone untreated, Hyperbilirubinemia can lead to jaundice, which can usually be described as a yellowing of someone’s skin, the whites of their eyes, or in their bodily secretions. The human body is built to withstand appropriate levels of bilirubin; however, newborns can sometimes have high levels of bilirubin which, if gone untreated, can cause serious brain injuries in addition to jaundice.
Bilirubin exists in a person’s blood in two different types. They are known as either unbound or bound to protein. In order to find a person’s total serum bilirubin, or TSB, the amount of bound and unbound proteins are added up. When a person suffers from high levels of bilirubin that is unbound to protein, a condition known as kernicterus, a form of cerebral palsy, can occur. There is no known cure for kernicterus, but it can be prevented with the proper monitoring of red blood cells. If not properly observed, kernicterus can lead to devastating injuries, including developmental delays, hearing loss, partial blindness, impaired eye muscles, dental issues, and various physical movement disorders.
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Kernicterus And Jaundice
Kernicterus became nearly a non-issue with the application of light or phototherapy systems. In recent years, however, the number of children with kernicterus has begun to rise again. The use of phototherapy systems has not changed and nothing can be attributed to this resurgence of kernicterus other than negligence. Because it should be such a rare medical occurrence, if your child has kernicterus then there is a good chance his or her levels of bilirubin were not properly monitored or treated.
Some physicians still believe that the shade or deepness of yellow skin or eyes in a jaundiced baby is a direct correlation to the amount of bilirubin in a baby’s blood. This, however, is not true; and just because a baby is only slightly jaundiced does not mean that the baby has no chance of suffering from kernicterus. In some babies with very pale, white skin this is sometimes the case; however, in cases with children who have darker skin, it is much more difficult to determine how jaundiced the baby actually may be. It is also a misconception that only babies with a high level of bilirubin can be diagnosed with kernicterus. Even babies with low levels of bilirubin can be diagnosed with kernicterus if gone untreated.
This is not to say that all babies who are jaundiced will be diagnosed to kernicterus. An average newborn’s liver takes a few days to begin properly working. Thus, it is common for babies to show jaundice between the second and fifth days of their lives due to their liver function. However, when a baby becomes jaundiced within the first twenty-four hours of his or her life, this is generally a sign of hyperbilirubinemia. Also, if jaundice is prevalent after the first week of life, there are also chances that he or she will experience the dangerous injuries of kernicterus if gone untreated.
How Physicians Can Prevent Kernicterus
In order to prevent hyperbilirubinemia from causing kernicterus, medical professionals should take several things into consideration. Doctors should know of any Rh or ABO blood incompatibilities between the mother and her baby. If there is any bruising during the birthing process, especially due to the use of assistive devices such as forceps or a vacuum extractor, the risk for kernicterus rises. If the mother experiences any type of traumatic injury, such as a fall or car accident, the risk of Kernicterus can rise. If the family history includes regular instances of jaundice, risks can rise. And if there are any type of liver disorders or genetic diseases, such as Gilbert’s Syndrome or Crigler-Najjar Syndrome, the baby should be closely monitored for hyperbilirubinemia and kernicterus.
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Unusually elevated levels of bilirubin can be treated successfully with phototherapy systems. As soon as phototherapy is stopped, it is extremely important for nurses and doctors to closely monitor bilirubin levels for the off chance that the bilirubin levels will rise to dangerous heights. It is common practice to check TSB concentration levels within 48 and 72 hours after phototherapy is stopped. This is to ensure safe bilirubin levels and prevent the development of Kernicterus.
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Caring for a child who is the victim of kernicterus is unforgiving and can devastate you and your family both with medical bills and personal anguish. If your child suffers from kernicterus because of hyperbilirubinemia, call the Pittsburgh birth injury lawyers at Richards & Richards for a free consultation. Our firm has been helping people and their families with medical malpractice claims in the Pittsburgh area since 1968. We are experienced and devoted. Call today at 412-261-2620.