HIPERBILIRUBINEMIA

Definition
• Increased total bilirubin levels in the first week of
birth. Maximum normal levels are 12-13 mg%
(205-220 mmol/L).
• Elevated plasma levels of bilirubin 2 standard
deviation or more than expected levels based on
infant age or more than presentil 90.
• Bilirubin levels in the blood exceed 1 mg/dL
(17,1 umol/L)
 Etiology
• Excessive Production
• Disruption in uptake and conjugate hepatic
processes
• Transportation Interruption
• Erection disorder
 Clinical Manifestation

• Letargi • Belly belly

• Seizures • Enlargement of the liver
• Deaf, speech disorders, • Feces are colored like
mental retardation putty
• When the baby lives in old • Vomiting, anorexia,
age with muscle spasms, fatigue
convulsions, stenosis • The color of urine is
accompanied by muscle dark
tension
 Pathophysiolgy
Pembentukan
Bilirubin

Transportasi
Bilirubin

Asupan
Blirubin

Konjugasi
Bilirubin

Eksresi
Bilirubin
 Pathophysiology

• Bilirubin is the orange jelly crystalline pigment

which is the final form of heme cation breakdown
through the oxidation-reduction process.
• The first oxidation step is biliverdin which is
formed from heme with the help of heme
oxygenase enzyme.
Ikterus klinis

• 60% dari neonatus

• Ikterus yang nyata: Bilirubin serum > 5 mg/
dl
Pemberian minum untuk mencegah dan mengobati Ikterus
Neonatorum
• Ibu harus menyusui bayinya setidaknya 8 sampai 12 kali
setiap hari untuk beberapa hari pertama
• Penurunan asupan kalori/dehidrasi  Ikterus
• Suplementasi dengan air atau air dekstrosa tidak akan
mencegah atau mengobati hiperbilirubinemia
-FOTOTERAPI
BUKAN SINAR UV!
• Panjang gelombang cahaya 450 sampai 460 nm
• Gelombang sinar biru: 425 sampai 475 nm
• Gelombang sinar putih: 380 sampai 700 nm
• Spectral Irradiance: 30 µW/cm2 /nm