Hyperbilirubinemia is a higher level of bilirubin in the blood. Bilirubin occurs naturally in the body but the levels generally stay within a limited range in most people. When the bilirubin levels are out of balance, it can cause problems in the rest of the body. Generally, there are no significant problems associated with too low of bilirubin levels (hypobilirubinemia). But too much bilirubin can be toxic.
Hyperbilirubinemia can be caused by a number of factors but is a common problem in newborns. Shortly after delivery, when the baby’s liver has to take over liver function to remove bilirubin, limited ability to process bilirubin can cause heightened levels of the substance. Hemolytic diseases can also increase bilirubin levels. Liver problems can also be a cause of hyperbilirubinemia in newborns.
Doctors should be aware of bilirubin levels and liver function in newborns. When a doctor fails to properly monitor the mother or newborn, or fails to properly treat blood imbalances, it can lead to serious injury in the baby. When a doctor’s negligence causes injury or harm, the doctor may be responsible for compensating the family for the costs of treatment, loss of income, and other losses.
What is Hyperbilirubinemia?
Hyperbilirubinemia involves elevated levels of bilirubin in the blood. Higher-than-normal levels of bilirubin can be a problem for newborns when bilirubin is measured above 340 µmol/l. Hyperbilirubinemia is critical above 425 µmol/l. Bilirubin is generally measured with a blood test, showing the concentration of bilirubin in the blood.
High levels of bilirubin can cause the substance to accumulate in the grey matter of the central nervous system (CNS). This can cause temporary to permanent damage, depending on the concentration of bilirubin and how long the levels are elevated before the underlying condition is treated. In some cases, untreated hyperbilirubinemia can be fatal. It can also cause permanent brain or neurological damage.
Elevated bilirubin levels are associated with jaundice. Jaundice is caused by high levels of bilirubin. Jaundice is common in babies in the first week of life and is usually resolved without serious permanent damage. Jaundice becomes a problem when the bilirubin levels are too high or continue for too long without reduction.
Bilirubin is a chemical in hemoglobin, the substance that carries oxygen in the red blood cells. When the red blood cells break down, the body builds new red blood cells to replace them. The old red blood cells are processed by the liver and excreted through the body. If the liver cannot process the red blood cells quickly enough, the bilirubin builds up in the blood. This can make the skin appear yellowish.
Hyperbilirubinemia and BIND
Bilirubin-induced neurologic dysfunction (BIND) is associated with hyperbilirubinemia. Hyperbilirubinemia can cause the substance to accumulate in the grey matter of the central nervous system (CNS), causing permanent damage. BIND involves neurologic injury or brain injury caused by elevated levels of serum bilirubin in the blood.
Causes of Hyperbilirubinemia
There are a number of causes of hyperbilirubinemia, depending on the levels of bilirubin and the source of bilirubin build-up. In newborns, neonatal hyperbilirubinemia may be caused by the newborn’s liver not being able to sufficiently process bilirubin. This can occur during the transition between when the placenta processes bilirubin in the womb to the liver’s takeover after the baby is born.
Other causes of hyperbilirubinemia in babies can involve liver damage, genetic disorders, hemolytic disease, or infection. The risk of developing hyperbilirubinemia increases for babies with a low gestational age, low birth weight, infants of diabetic mothers, and infants of mothers with hemolytic diseases (Rh disease).
Diagnosing hyperbilirubinemia may depend on when symptoms appear and the cause of increased bilirubin. Jaundice that appears shortly after birth may be more serious. Jaundice that appears within a few days may be less serious. However, any jaundice should be properly monitored and treated. Diagnosing hyperbilirubinemia usually involves testing bilirubin levels, red blood cell counts, or other tests for Rh disease or other conditions.
Early recognition of possible bilirubin concerns can be the best way to prevent more serious problems like kernicterus, BIND, or bilirubin encephalopathy. Delays in identifying liver problems, high bilirubin levels, and delayed treatment can increase the risk of serious injury or harm, and require more extensive treatment.
Treatment for Hyperbilirubinemia in Philadelphia
Philadelphia has one of the best children’s hospitals in the country. When children are born with hyperbilirubinemia in the Philadelphia-area, they may be able to seek treatment in the Children’s Hospital of Philadelphia (CHOP). According to CHOP, treatment options for children depend on the cause of the condition and levels of bilirubin in the body. Treatments may include:
- Photolight therapy
- Blood transfusion
- Hydration with breast milk
- Fiberoptic blanket
- Treatment of the underlying condition
Parents may be unfamiliar with phototherapy. Phototherapy is a treatment option that places the baby under ultraviolet light for up to several hours at a time. This can improve bilirubin levels. While protecting the baby’s eyes and maintaining a steady body temperature, the baby’s bilirubin levels are checked regularly to make sure the treatment is effective.
A fiberoptic blanket is another type of phototherapy, using a blanket with embedded lights to treat the baby’s skin, that may be used in combination with regular phototherapy.
It is also important for parents to understand that just because a doctor is a specialist practicing in a well-respected hospital, it does not necessarily mean the doctor cannot make mistakes. Even the best doctors can make mistakes that cause serious injury to the patient. If you suspect possible medical errors caused your child’s injuries, talk to a birth injury attorney about how to get the answers the hospital won’t give you.
Philadelphia Birth Injury Attorneys
If a medical error caused a birth injury to your child, talk to an experienced medical malpractice attorney about holding the doctors and healthcare systems accountable for their carelessness. Our lawyers have successfully represented families in Philadelphia and Pennsylvania recovering damages caused by medical negligence. Do not hesitate to contact Gilman & Bedigian today for a free consultation.