Thomas Hegyi1, Alan Kleinfeld2, Andrew Huber2, Barry Weinberger3, Naureen Memon4, Weichung Joe Shih5, Mary Carayannopoulos1, William Oh6. 1. Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of NJ, New Brunswick, NJ. 2. Fluoresprobe Sciences, San Diego, CA. 3. Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY. 4. MidAtlantic Neonatology Associates, Goryeb Children's Hospital, Morristown, NJ. 5. Rutgers School of Public Health, Rutgers University, New Brunswick, NJ. 6. Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI.
Abstract
OBJECTIVE: To assess the effects of a soybean lipid emulsion infusions on levels of unbound (free) bilirubin (Bf) and unbound free fatty acids (FFAu) as well as changes in Bf and total serum bilirubin (TSB) during phototherapy in infants born preterm. STUDY DESIGN: Ninety-seven infants born preterm (birth weight: 500-2000 g; gestational age: 23-34 weeks) were enrolled to investigate the effect of 0, 1, 2, and 3 g/kg/d of intralipid infusion on Bf and FFAu. Pre- and postphototherapy TSB, FFAu, and Bf also were analyzed in 91 infants to assess the effects of phototherapy. FFAu levels were measured with the fluorescent probe ADIFAB2 and Bf by the fluorescent Bf sensor BL22P1B11-Rh during intralipid infusion and at start and end of phototherapy. TSB and plasma albumin were measured by the diazo and bromcresol green techniques, respectively. Bilirubin-albumin dissociation constants were calculated based on Bf and plasma albumin. RESULTS: Bf and FFAu increased with increasing intralipid dosage across all gestational ages. TSB and Bf were correlated significantly when infants received 0 or 1 g/kg/d of intralipid but not at greater doses of intralipid (2 and 3 g/kg/d). Although phototherapy effectively reduced both TSB and Bf in the total phototherapy group (by 32% and 12%, respectively), it reduced TSB, but not Bf, in infants less than 28 weeks of gestation. CONCLUSIONS: Increasing intralipid doses result in increasing FFAu levels, which are associated with increased Bf independent of TSB. In infants born extremely preterm (<28 weeks of gestation), phototherapy effectively reduces TSB but not Bf.
OBJECTIVE: To assess the effects of a soybeanlipid emulsion infusions on levels of unbound (free) bilirubin (Bf) and unbound free fatty acids (FFAu) as well as changes in Bf and total serum bilirubin (TSB) during phototherapy in infants born preterm. STUDY DESIGN: Ninety-seven infants born preterm (birth weight: 500-2000 g; gestational age: 23-34 weeks) were enrolled to investigate the effect of 0, 1, 2, and 3 g/kg/d of intralipid infusion on Bf and FFAu. Pre- and postphototherapy TSB, FFAu, and Bf also were analyzed in 91 infants to assess the effects of phototherapy. FFAu levels were measured with the fluorescent probe ADIFAB2 and Bf by the fluorescent Bf sensor BL22P1B11-Rh during intralipid infusion and at start and end of phototherapy. TSB and plasma albumin were measured by the diazo and bromcresol green techniques, respectively. Bilirubin-albumin dissociation constants were calculated based on Bf and plasma albumin. RESULTS:Bf and FFAu increased with increasing intralipid dosage across all gestational ages. TSB and Bf were correlated significantly when infants received 0 or 1 g/kg/d of intralipid but not at greater doses of intralipid (2 and 3 g/kg/d). Although phototherapy effectively reduced both TSB and Bf in the total phototherapy group (by 32% and 12%, respectively), it reduced TSB, but not Bf, in infants less than 28 weeks of gestation. CONCLUSIONS: Increasing intralipid doses result in increasing FFAu levels, which are associated with increased Bf independent of TSB. In infants born extremely preterm (<28 weeks of gestation), phototherapy effectively reduces TSB but not Bf.
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Authors: Thomas Hegyi; Barry Weinberger; Naureen Memon; Mary Carayannopoulos; Andrew H Huber; Alan M Kleinfeld Journal: J Matern Fetal Neonatal Med Date: 2018-12-17
Authors: Thomas Hegyi; Alan Kleinfeld; Andrew Huber; Barry Weinberger; Naureen Memon; Weichung Shih; Mary Carayannopoulos; William Oh Journal: J Matern Fetal Neonatal Med Date: 2018-03-12
Authors: Thomas Hegyi; Alan Kleinfeld; Andrew Huber; Barry Weinberger; Naureen Memon; Weichung Joe Shih; Mary Carayannopoulos; William Oh Journal: J Matern Fetal Neonatal Med Date: 2018-04-18
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