Abstract
This report describes the risk incidence of a large group (N= 1271) of jaundiced neonates to bil toxicity through measurement of serum albumin saturation by salicylate displacement (saturation index or SI) and the role of FFA and GI in this problem. RESULTS: 12 jaundiced neonates (bil=13.9 mg/dl) with high SI (7.8±0.6%), history of poor oral intake but no hemolytic disease nor drug exposure were treated with GI at a rate of lg/kg/h for 1-2 h. After GI, there was a significant (p<0.01) fall in SI (Δ= -4.1%), bil (Δ= -0.9 mg/dl), FFA (Δ= -0.48 mEq/L) principally oleic (Δ= -6.5%) and linoleic (Δ= -3.2%) acids and a rise in serum insulin (Δ= +17.8 mcu/ml, p<0.005). These changes were not due to simple dilution since serum total protein did not significantly fall (Δ= -0.2 g/dl, p<0.10). Routine SI measured in 1271 infants with bil ≥ 10 mg/dl showed 154 (12%) infants to have SI (> 7%): 50% were fullterm, only 24% had hemolytic disease and none had exposure to drugs. GI was given to 82 of these infants (mean bil=14.7 mg/dl; mean SI=8.0%). After GI, there was a significant (p<0.01) fall in bil (Δ= -1.2 mg/dl) and SI (Δ= -3.7%) in 76/82 (93%) infants treated. No rebound to high SI occurred within 24 h after GI. CONCLUSION: Our study indicates that by routine testing, a high percentage (12%) of infants with bil ≥ 10 mgs% are at or near risk to bilirubin toxicity as indicated by a SI ≥ 7%. These infants should be identified since treatment with GI is simple and highly effective in lowering both bil and SI probably through a mechanism of insulin release. The favorable response in most cases to GI indicates that serum FFA, particularly oleic and linoleic acids, play a major role clinically in bil binding to albumin.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ostrea, E., Bassel, M., Faulry, C. et al. 1388 THE INFLUENCE OF FREE FATTY ACIDS (FFA) AND GLUCOSE INFUSION (GI) ON SERUM BILIRUBIN (BIL) AND BILIRUBIN BINDING TO ALBUMIN. Pediatr Res 15 (Suppl 4), 674 (1981). https://doi.org/10.1203/00006450-198104001-01417
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-01417