Korean Journal of Pediatrics 2005;48(10):1102-1106.
Published online October 15, 2005.
Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn
Jong Hee Hwang1, Ji Hyun Lee2, Yu Jin Kim2, Su Hyun Koo2, Jang Hun Lee2, Chang Won Cho3, Yun Sil Chang2, Won Soon Park2
1Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University, Korea
2Department of Pediatrics, Seoul National University Bundang Hospital, Korea
3Department of Pediatrics, College of Medicine, Sungkyunkwan University, Seoul, Korea
중증 고빌리루빈혈증(혈청 빌리루빈 >25 mg/dL)의 발병 원인과 치료 및 예후
황종희1, 이지현2, 김유진2, 구수현2, 이장훈2, 최창원3, 장윤실2, 박원순2
1인제대학교 의과대학 일산백병원 소아과
2분당서울대학교병원 소아과
3성균관대학교 의과대학 소아과학교실
Correspondence: 
Won Soon Park, Email: wspark@smc.samsung.co.kr
Abstract
Purpose
: The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL.
Methods
: Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment : Group I(phototherapy only, n=42), Group II(exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis.
Results
: A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2(2,852?,085 g) compared to Group 1(3,137?37 g)(P<0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2(45?6 mg/dL) compared to Group 1(29? mg/dL) (P<0.05). But there were no significant differences in neurologic outcome.
Conclusion
: Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.
Key Words: Jaundice , Hyperbilirubinemia , Kernicterus , Newborn


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