• Unbound bilirubin as a predictor of neurotoxicity — the question of the future?
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Unbound bilirubin as a predictor of neurotoxicity — the question of the future?

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.4(76):67-73; doi 10.15574/PP.2018.76.67

Dobrovanov O., Kralinsky K.
3rd Children's Clinic of Slovak Medical University, General hospital with Polyclinic, Lucenec, Slovakia
St. Elizabeth University of Health and Social sciences, Bratislava, Slovakia
2nd Children's Clinic of Slovak Medical University, Children faculty hospital with polyclinic, Banska Bystrica, Slovakia
Faculty of Health Care of Slovak Medical University in Bratislava, based in Banska Bystrica, Slovakia

Unbound bilirubin is a relatively new biochemical parameter that is more informative in assessing the risk of bilirubin-induced neurological dysfunction, respectively of kernikter, can also be one of the indication criteria for transsanguage transfusion. It is a fraction of bilirubin in serum or plasma that is not bound to proteins and better passes through the blood-brain barrier. It may happen that in the near future there will be a change of opinion on the measurement of serum unconjugated bilirubin, especially in risk groups of newborns and management of neonatal jaundice. The greatest obstacle to the routine use of this parameter is a method that should be adapted for routine use in clinical practice. Increasing evidence based on clinical trials, clinical experience, and research into the neurotoxicity of bilirubin supports the effort to accelerate the incorporation of unbound bilirubin into the routine evaluation of neonatal jaundice.

Key words: jaundice, management, newborn, oxidative stress, phototherapy, unbound bilirubin


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Article received: Aug 12, 2018. Accepted for publication: Nov 12, 2018.