Pediatric seminar (Kernicterus).pptx.......

Kernicterus

1. Technical College of Health /  Shekhan   Department of Nursing  3rd  year – 2nd course  Subject:  pediatric Prepared by:    Ahmad saadwn Supervised by : Dr.Muhammed hayder Kernicterus

2. Kernicterus , or bilirubin encephalopathy, is bilirubin-induced neurological damage, which is most commonly seen in infants. It occurs when the unconjugated bilirubin (indirect bilirubin) levels cross 25 mg/dL in the blood from any event leading to decreased elimination and increased production of bilirubin.

3. Term Weighing less than 1000 g Sepsis, Meningitis, Hemolysis, Asphyxia, Hypothermia, Hypoglycemia, Prematurity. unconjugated bilirubin > 25 mg/dL unconjugated bilirubin >10 mg/dL unconjugated bilirubin >20 mg/dL When does kernicterus occur?

4. Etiology 1- Polycythemia . 2-Hemolysis . 3-Hypoalbuminemia. 4-Obstruction in the Biliary System . 5-Breast Milk Jaundice.

5. Kernicterus risk factors 1- In term infants are (hemolysis, jaundice noted within 24 hours of birth) 2- Were born prematurely. 3- Don’t feed well.  4- Have a parent or sibling who had jaundice as an infant.  5- Were born to a mother with type O or Rh-negative blood type. 

6. Clinical manifestations 1- Lethargy, hypotonia. 2- High-pitched crying. 3-Decreased appetite. 4-Floppy or limp body . 5-Missing reflexes.

7. Treatment / Management 1-P hototherapy. 2-Blood exchange transfusion.

8. Complications of kernicterus 1- Cerebral palsy, 2- Lack of muscle tone. 3- Trouble coordinating movement. 4- Hearing loss and deafness. 5- Difficulty speaking. 6- Intellectual disability.

9. References Raines DA, Krawiec C, Jain S.  StatPearls [Internet].  StatPearls Publishing; Treasure Island (FL): Jan 2, 2023. Cephalohematoma. Cichoz-Lach H, Celiński K, Słomka M. Congenital nonhemolytic hyperbilirubinemias. Ann Univ Mariae Curie Sklodowska Med. 2004;59(1):449-52. Leung AK, Sauve RS. Breastfeeding and breast milk jaundice. J R Soc Health. 1989 Dec;109(6):213-7.  Bhutani VK, Johnson L. Kernicterus in the 21st century: frequently asked questions. J Perinatol . 2009 Feb;29 Suppl 1:S20-4. Odutolu Y, Emmerson AJ. Low bilirubin kernicterus with sepsis and hypoalbuminaemia . BMJ Case Rep. 2013 Apr 23;2013. Watchko JF. Kernicterus and the molecular mechanisms of bilirubin-induced CNS injury in newborns.  Neuromolecular Med. 2006;8(4):513-29.