Liver-immaturity and treatment of kernicterus of the premature baby
There are different ways of showing that the liver of newborn normal children and even more of premature children is functionally immature.
This immaturity of the liver is the most important factor occasioning the kernicterus.
The kernicterus-situation can be defined through the contents of bilirubin in the blood of over 20 mg in 100 cc. with a low percentage of so-called direct bilirubin (under 10–15%).
Anoxaemia-defects of the brain, of the liver, or other organs raise the danger of kernicterus.
There is no prophylaxis or therapy for the icterus of premature babies which is not caused by incompatibility.
The only method is the exchange transfusion. It is not dangerous and can be performed even after the umbilicus has fallen off.
In spite of the exchange-transfusion a kernicterus-situation may occur a second time if bilirubin accumulated in the tissues is diffused into the blood. This requires a second exchange-transfusion.
Indications for exchange-transfusions:
Small premature children, critical situation more than 1 day.
heavier premature children, critical situation more than 3 days.
symptoms of anoxaemia require a rapid therapy, at the latest on the second day of a critical situation.
KeywordsBilirubin Premature Infant Newborn Infant Exchange Transfusion Direct Bilirubin
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