Bilirubinemia Clinical Trial
Official title:
Role of Fluid Supplementation in Neonatal Unconjugated Hyperbilirubinemia
Hyperbilirubinemia is a common neonatal problem. bilirubin is potentially toxic to central
nervous system and can cause serious permanent complication called kernicterus, in which
brain stem nuclei and basal ganglia are damaged,resulting in cerebral palsy.In
Hyperbiliubinemia,rapid reduction of serum bilirubin level is of utmost importance.
Two commonly used mode of therapy are phototherapy and exchange transfusion. Phototherapy has
some side effects such as diarrhea, skin rash, dehydration, overheating, mother-baby bonding
disruption.On the other hand, complication of exchange transfusion include infections,
emboli,anemia,apnea and hypocalcemia.
while IV fluid supplementationis postulated to decrease bilirubin concentration directly
through a reduction of haemoconcentration, increasing enteral feed volume is proposed to
decrease bilirubin concentration through reduced enterohepatic circulation via an increased
gut peristalsis.
Bilirubin encephalopathy or kernicterus Unconjugated bilirubin is lipid soluble and therefore
can cross the blood brain barrier .There it can deposit in areas of the brain, with a
predilection for deposition in the basal ganglia, auditory pathways, and oculomotor nucleus.
This deposition and accompanying damage result in the classical symptoms associated with
kernicterus. Hypoxia, acidosis, prematurity, and genetic predispositions all increase the
risk for kernicterus.In well term babies risk for kernicterus increases after bilirubin
levels cross (20 mg/dL) and it is very high above (30 mg/dL). In preterm babies the threshold
for damage from bilirubin could be as low as(20mg/dl). The risk increases with increasing
serum levels of unconjugated bilirubin.
Acute bilirubin encephalopathy presents as lethargy, high pitched cry, poor feeding, abnormal
tone, opisthotonus, upgaze palsy and seizures. Aggressive treatment at this stage can reduce
the damage caused. Chronic bilirubin encephalopathy leads to conditions like choreoathetoid
cerebral palsy, high frequency hearing loss, dental dysplasias and oculomotor palsies.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT03259581 -
Safety of Transarterial Chemoembolization (TACE) in the Setting of an Elevated Bilirubin
|
Phase 1 | |
| Completed |
NCT05692648 -
Effect of Repositioning Frequency Neonates Receiving Phototherapy
|
N/A |