Hyperbilirubinemia

-excess production of bilirubin in the blood

Causes of Hyperbilirubinimea:

 Physiologic jaundice. ...

 Breastfeeding failure jaundice. ...
 Breast milk jaundice. ...
 Jaundice from hemolysis. ...
 Jaundice related to inadequate liver function.

*In Physiologic Jaundice:

-often happens to premature babies.

- Infant jaundice usually occurs because a baby's liver isn't

mature enough to get rid of bilirubin in the bloodstream.

-nagkakaroon ng Bilirubin because the blood type isn’t

compatible between the mother and the baby.
-During labor and delivery-> this is the chance that the mother
and fetal blood mix because of the detachment of the
placenta.
-If the blood mix: their will be a hemolysis-> destruction of the
RBC and releases Hemoglobin when hemoglobin breaks it
releases Bilirubin.
*destruction of RBC can lead to anemia.
*Bilirubin-needs to be broken down to be excreted and
everything that break down has to leave the body. If product
did not excreted it will accumulate in the blood.
*kernicterus- high amount of bilirubin in the blood of
the baby that may lead to brain damage.
- It occurs within 24 hours after birth, and is characterized by a
rapid rise in a baby's bilirubin level. The most likely cause is blood
incompatibility or liver disease.  -kelan to nagsstart?
-How does bilirubin level rise- If bilirubin accumulate in the liver-
liver will be damage.
- Jaundice (yellowish skin and eyes) occurs when too much
bilirubin builds up in blood. Because this liver disease doesn't
cause serious problems, treatment isn't necessary.
- A newborn's immature liver often can't remove bilirubin quickly
enough, causing an excess of bilirubin. Jaundice due to these
normal newborn conditions is called physiologic jaundice, and it
typically appears on the second or third day of life.
- What happens if bilirubin is not excreted?
Bilirubin is not present in the urine of normal, healthy
people. Results that are higher may mean that you have
a liver problem, hepatitis, or gallstones. Higher levels
may also mean that you have: A blood infection (called
blood poisoning or septicemia)
- Why is bilirubin not excreted in the kidney?
This unconjugated (or “indirect”) bilirubin is released into
the plasma, where it is tightly bound to albumin. Because
unconjugated bilirubin is insoluble in water, it cannot be
excreted in urine or bile.
Newborns produce more bilirubin than adults do because of greater
production and faster breakdown of red blood cells in the first few
days of life. Normally, the liver filters bilirubin from the bloodstream
and releases it into the intestinal tract.
- How is newborn bilirubin excreted?
Bilirubin (a yellow substance) is naturally removed by the
liver and then excreted in stool and urine. Bilirubin levels
become high when bilirubin is made faster than it can be
removed. Jaundice is common in newborns since two to
three times more bilirubin is made than in adults.
-saan to nangyayari?
Paano nangyayari?
*CAUSED:
-immature liver
-Infection
-medications
-blood disorders
-liver disease
-combination of increased bilirubin production secondary to
accelerated destruction of erythrocytes, decreased excretory
capacity secondary to low levels of ligandin in hepatocytes, and low
activity of the bilirubin-conjugating enzyme uridine
diphosphoglucuronyltransferase (UDPGT).
Symptoms:
-include yellowing of the skin and the whites of the eyes that appears
within days after birth.
treatment
-(phototherapy) can help resolve moderate or severe cases.
Tests to check for the bilirubin level of the baby:

Cause by a blood incompatibility between the mother and a child.

So when labor labor and delivery comes we cannot prevent the
maternal blood can go to tube.

-So what will happen there is the blood of the mother will consider
as a foreign substance to the body of the baby. And the body of the
baby will trigger and produce antibodies. The blood will mix to the
neonatal blood and their will be a hemolysis-> Rbc will produce
Bilirubin and this accumulation of bilirubin in the blood can become
a dangerous to the baby.

Too much bilirubin in the blood is called kernicterus-brain damage.

*intervention is Phototheraphy to -it has a fluorescent light to

reduce the bilirubin level in the babys blood by photoisomerization.

*
From the
Book 📙

Hyperbilirubinemia
What is it?
-Excessive level of accumulated bilirubin in the blood
characterize by Jaundice or Icteus.
- common finding in the: newborn and in most instances is relatively
benign.
- in extreme cases, it can indicate a pathologic state.
*JAUNDICE/ ICTERUS ->yellowish discoloration of the skin • Genetic predisposition to increased production (e.g., Native
Americans, Asians)
and other organs.

Pathophysiology
*Bilirubin
-One of the breakdown products of Hemoglobin-> that is
result from the RBC destruction.
*circulatory system/circulation->where RBC destroyed
RBC destroyed- Circulatory system-breakdown and products
released-hemoglobin splits into 2 fraction: heme and globin
*globin(protein) portion - is used by the body
*Heme portion- is converted to unconjugated bilirubin, an
insoluble substance bound to albumin.

-------

Possible causes of Hyperbilirubinemia:

• Physiologic (developmental) factors (e.g., prematurity)
• An association with breastfeeding or breast milk
• Excess production of bilirubin (e.g., hemolytic disease, biochemical
defects, bruises)
• Disturbed capacity of the liver to secrete conjugated bilirubin
(e.g., enzyme deficiency, bile duct obstruction)
• Combined overproduction and underexcretion (increased
hemolytic process)
• Some conditions or disease states (e.g., glucose-6-phosphate
dehydrogenase [G6PD] deficiency, hypothyroidism, galactosemia,
infant of a diabetic mother)