Newborn Jaundice Technologies: Unbound Bilirubin and Bilirubin Binding Capacity in Neonates

Neonatal jaundice (hyperbilirubinemia), which is extremely common in neonates, can be associated with neurotoxicity. A safe level of bilirubin has not been defined in either premature or term infants. Emerging evidence suggest that the level of unbound (or “free”) bilirubin has a better sensitivity...

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Bibliographic Details
Published in:Seminars in perinatology 2011-06, Vol.35 (3), p.134-140
Main Authors: Amin, Sanjiv B., MD, MS, Lamola, Angelo A., PhD
Format: Article
Language:English
Subjects:
Bilirubin - blood
Bilirubin - metabolism
binding affinity
Fluorometry - methods
free bilirubin
Humans
Infant, Newborn
Jaundice, Neonatal - blood
Neonatal and Perinatal Medicine
reserve binding capacity
Serum Albumin - metabolism
Serum Albumin, Human
Spectrophotometry - methods
total binding capacity
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Summary:Neonatal jaundice (hyperbilirubinemia), which is extremely common in neonates, can be associated with neurotoxicity. A safe level of bilirubin has not been defined in either premature or term infants. Emerging evidence suggest that the level of unbound (or “free”) bilirubin has a better sensitivity and specificity than total serum bilirubin for bilirubin-induced neurotoxicity. Although recent studies suggest the usefulness of free bilirubin measurements in managing high-risk neonates, including premature infants, no widely available method exists to assay the serum free bilirubin concentration. To keep pace with the growing demand, in addition to reevaluation of old methods, several promising new methods are being developed for sensitive, accurate, and rapid measurement of free bilirubin and bilirubin binding capacity. These innovative methods need to be validated before adopting for clinical use. We provide an overview of some promising methods for free bilirubin and binding capacity measurements with the goal to enhance research in this area of active interest and apparent need.
ISSN:0146-0005
1558-075X
DOI:10.1053/j.semperi.2011.02.007