- General Drug Summary
- Description
- A sterile non-pyrogenic suspension of microspheres of human serum albumin with perflutren (a highly fluorinated small molecule) for contrast enhancement during indicated ultrasound imaging procedures.
- Also Known As
- Serum albumin precursor
- Categories
- Serum substitutes
- Structure
- Summary In Neonatal Jaundice
-
24 record(s) for Serum albumin Effective in Inducing Remission in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 22922094
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Beyond plasma bilirubin: the effects of phototherapy and albumin on brain bilirubin levels in Gunn rats. Journal of hepatology, 2013 Jan [Go to PubMed]
- Severe unconjugated hyperbilirubinemia, as occurs in Crigler-Najjar disease and neonatal jaundice, carries the risk of neurotoxicity. This neurotoxicity is related to the increased passage of free bilirubin (UCB(free)), the fraction of bilirubin that is not bound to plasma proteins, into the brain. We hypothesized that albumin treatment would lower the UCB(free) fraction, and thus decrease bilirubin accumulation in the brain.
We treated chronic (e.g., as a model for Crigler-Najjar disease) and acute hemolytic (e.g., as a model for neonatal jaundice) moderate hyperbilirubinemic Gunn rats with phototherapy, human serum albumin (HSA) or phototherapy+HSA.
In the chronic model, adjunct HSA increased the efficacy of phototherapy; it decreased plasma UCB(free) and brain bilirubin by 88% and 67%, respectively (p<0.001). In the acute model, adjunct HSA also increased the efficacy of phototherapy; it decreased plasma UCB(free) by 76% (p<0.001) and completely prevented the hemolysis-induced deposition of bilirubin in the brain. Phototherapy alone failed to prevent the deposition of bilirubin in the brain during acute hemolytic jaundice.
We showed that adjunct HSA treatment decreases brain bilirubin levels in phototherapy-treated Gunn rats. We hypothesize that HSA decreases these levels by lowering UCB(free) in the plasma. Our results support the feasibility of adjunct albumin treatment in patients with Crigler-Najjar disease or neonatal jaundice.
- 20047841
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- (EZ)-Cyclobilirubin formation from bilirubin in complex with serum albumin derived from various species. Journal of photochemistry and photobiology. B, Bio, 2010 Feb 12 [Go to PubMed]
- We determined the specificity of photochemical changes of bilirubin in complex with serum albumin from various species. There were no general trends in the configurational photoisomerizations of (ZE)-bilirubin/(ZZ)-bilirubin and (EZ)-bilirubin/(ZZ)-bilirubin associated with the albumins from various species as compared to those associated with human serum albumin. The absorbance spectra of bilirubin in complex with albumins from various species differed, indicating that the three-dimensional structures of (ZZ)-bilirubin bound to the various serum albumins, which are substrates of (ZE)- and (EZ)-bilirubin, differ among species. The rates of conversion of the (EZ)-bilirubin isomer into the structural cyclobilirubin isomer were similar for the albumins of chicken, rat, rabbit, dog, bovine, and pig, and were significantly slower than the rate for human serum albumin. This suggests that the three-domain human albumin has evolved to allow ready conversion of (EZ)-bilirubin to (EZ)-cyclobilirubin. Cyclobilirubin fomation in a bilirubin-alpha-fetoprotein solution was much lower than that in a bilirubin-human serum albumin solution. It is believed that the ability of human serum albumin to facilitate the photochemical change of bilirubin was evolutionarily selected in response to neonatal jaundice in humans.
- 557276
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Bilirubin displacing effect of stabilizers added to injectable preparations of human serum albumin. Acta paediatrica Scandinavica, 1977 Mar [Go to PubMed]
- Stabilizers added to preparations of human serum albumin before heat treatment were tested for bilirubin displacing effect, using the peroxidase method. It was found that N-acetyltryptophan and sodium caprylate displace bilirubin from its complex with human serum albumin in vitro. The quantitative findings were used for a rough estimate of the effect of these substances on the free bilirubin concentration in blood plasma, expected when stabilized albumin preparations are given intravenously for prevention of kernicterus. The calculated effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase. Sodium mandelate displaces less strongly.
- 1130188
- Serum albumin
- Effective in Inducing Remission
- Case Report
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Studies on photopherapy in newborn infants. Influence on protein binding of bilirubin and salicylate and on activity of acetylsalicylic acid esterase. Acta paediatrica Scandinavica, 1975 Mar [Go to PubMed]
- Phototherapy of newborn infants with hyperbilirubinemia was shown to result in an increase in hematocrit values and in the activity of the erythrocyte enzyme acetylsalicylic acid esterase. The elevation of the enzyme activity also could be produced in light-treated rabbits and in vitro after illumination of blood from adult volunteers. The binding of bilirubin to serum albumin and of salicylate to plasma proteins did not alter, nor did the concentrations of albumin or total proteins in plasma. It is concluded that light does not increase the unbound fraction of bilirubin in blood.
- 1198058
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase
- Available bilirubin binding sites of serum from newborns determined by a direct spectrometric method using bromphenol blue. Scandinavian journal of clinical and laboratory in, 1975 Oct [Go to PubMed]
- A new direct spectrometric micromethod for the determination of the available bilirubin binding sites of serum (S-ABBS) using bromphenol blue has been applied to 298 blood specimens collected from infants immediately before starting the first exchange transfusion. A relative number fraction of 0.07 of the material, characterized by having the lowest S-ABBS values, includes seven of the nine cases (i.e. a relative number fraction of 0.78) with autoptically verified kernicterus (KI). The two infants with KI but higher S-ABBS values differed in having severe neurological symptoms before the examination. The mean substance concentration of bilirubin in these nine sera was 288 mumol/l. The correlation of KI to the body mass at birth, to the substance concentration of serum albumin, and to the substance concentration of serum bilirubin is given, and the sources of error concerning the method are discussed. The present method is proposed for determining a type of quantity that is important, among other types of dat, in deciding on the need for exchange transfusion in icteric (premature) newborns.
- 10078270
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Oral treatment for jaundice using immobilized bilirubin oxidase. Artificial organs, 1992 Aug [Go to PubMed]
- Jaundice is characterized by an excessive accumulation of bilirubin in the blood and tissues. A novel approach to reduce plasma levels of bilirubin by blocking its enterohepatic circulation was investigated. The treatment consisted of oral administration of immobilized bilirubin oxidase, which could oxidize bilirubin in the intestine to less toxic and more water-soluble products. In vivo administration of 0.1 to 2.0 mg/day of immobilized enzyme over a four-day period to chronically jaundiced Gunn rats effectively lowered plasma bilirubin levels, but only when the molar ratio of total serum bilirubin to rat serum albumin (B/RSA) was larger than 0.35. Plasma bilirubin concentration decreased in that group from an initial value of 11.3 to 6.3 mg/dl (-40%, n = 5) after eight days. This decrease was statistically significant (p < 0.05 by Student's t test). However, administration of bilirubin oxidase to rats with a B/RSA ratio less than 0.35 (n = 10) resulted in no statistically significant change in plasma bilirubin concentration.
- 7208154
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Phototherapy-induced covalent binding of bilirubin to serum albumin. Pediatric research, 1980 Dec [Go to PubMed]
- Bilirubin displays a detectable fluorescence emission only when it is complexed with serum albumin, whereas free bilirubin has a very low fluorescence yield. Actually, nearly complete disappearance of bilirubin emission was obtained when the unirradiated human serum albumin-bilirubin complex was precipitated with acetone to extract the pigment; complete removal of protein-bound bilirubin (as monitored by fluorescence spectroscopy) was achieved by repeating the acetone extraction after incubation of the complex in the phosphate buffer, pH 7.4, containing 7 M guanidinium chloride; the latter compound causes on extensive unfolding of protein molecules. On the other hand, in the case of irradiated solutions, even after denaturation of the protein with 7 M guanidinium chloride, a detectable amount of bilirubin-type fluorescent material was found to be associated with albumin. This finding clearly shows that bilirubin and/or some photoproduct underwent in part a photoinduced covalent binding with human serum albumn. Fragmentation of the bovine albumin polypeptide chain according to the procedure detailed in the experimental section yielded only one peptide-containing material fluorescent in the 530 nm region. This fact underlines the selective nature of the photobinding reaction. The amino acid composition of the isolated peptide is shown in Table 2; the composition is closely similar with that found for peptide 187-397 of native bovine serum albumin. In the case of the jaundiced babies who were subjected to phototherapy, we were able to demonstrate that only after 7 to 9 hr of exposure to light a detectable amount of bilirubin-type fluorescent material was present even at the end of the serum treatment with acetone and guanidinium chloride (see Fig. 1; Table 1). Fractional precipitation of the serum proteins by addition of controlled amounts of ammonium sulphate showed that the fluorescent material was present only in the albumin fraction. The photoadduct disappeared about 15 to 20 days after the phototherapy had ben discontinued. This period of time represents the natural turnover period of human serum albumin.
- 3658800
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- [Disorders of acid-base equilibrium in neonatal physiologic jaundice]. La Pediatria medica e chirurgica : Medical and sur, [Go to PubMed]
- 38 healthy term jaundiced infants were tested. On 3rd day of life we obtained a blood sample from a peripheric vein to determine red blood cells and reticulocytes count, serum albumin, total, conjugated and unconjugate bilirubin. On 3rd, 4th, 5th, 6th day of life 4 standard heparinized microtubes were filled after lancing the heel: 2 microtubes to estimate the mean value of total bilirubin, 2 for the mean value of pH. The urine pH was evaluated every morning. The results of total bilirubin (T.B.), pH, pCO2 and Base Deficit were analyzed using T-test. All tested infants were free-bilirubin jaundiced. Infants treated with phototherapy had a T.B. ranging from 15.2 mg/dl on 3rd day of life to 10.5 mg/dl on 6th, while in controlled infants T.B. never exceeded 10 mg/dl. In treated infants the pH was higher than in controlled ones: p was less than 0.001 on 4th day, less than 0.005 on 5th day and less than 0.001 on 6th day. In both groups the urine pH ranged from 5 to 6.5 every day. The marked increase in respirator rate during phototherapy is a well known side effect. But a significant decrease in pCO2 was present before starting phototherapy. A mixed disturbance of acid-base balance could be suspected: an already existing mild metabolic acidosis in phototherapy group with respiratory alkalosis due to anion gap variety, with unknown determining causes. We relate the initial metabolic acidosis to the depressed oxidative phosphorylation (with lactic acidosis) in the neonatal liver.(ABSTRACT TRUNCATED AT 250 WORDS)
- 1939683
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Neonatal bilirubin exposure and psychoeducational outcome. Journal of developmental and behavioral pediatrics, 1991 Oct [Go to PubMed]
- The association between neonatal bilirubin exposure and psychoeducational outcome was investigated in a group of grade school children 9 to 11 years old who required neonatal intensive care between 1977 and 1980. Seventy-four children were evaluated with four measures of psychoeducational outcome, including the Kaufman Mental Processing and Achievement Scales, the Beery Visual Motor Integration Test, and the Vineland Adaptive Behavior Scale. A measure of bilirubin binding calculated directly from the albumin concentration correlated significantly with the Kaufman Mental Processing Composite, although other more direct measures of bilirubin exposure (such as maximum serum bilirubin, direct measures of binding, and cumulative bilirubin exposure) did not. Thus, it is possible that the impact on psychoeducational outcome is the result of some other effect of low serum albumin itself, in addition to its ability to bind bilirubin. The correlation of the calculated albumin-determined binding value with the Kaufman ental Processing Composite suggests that this level, rather than total serum bilirubin, may be more appropriate in determining clinical management.
- 7198860
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Effect of exchange transfusion on serum reserve albumin for binding of bilirubin and index of serum bilirubin toxicity. Acta paediatrica Scandinavica, 1981 Sep [Go to PubMed]
- Seventeen newborn infants, who received their first exchange transfusion due to hyperbilirubinaemia and/or rhesus haemolytic disease, were studied. The exchange transfusions were performed with fresh, citrated blood. During the exchange transfusion a marked increase in the serum reserve albumin concentration for binding of bilirubin measured by the [14C]-MADDS method was observed, followed by a smaller decrease after the transfusion. Plasma pH increased both during and after the exchange transfusion. During the exchange transfusion a drastic fall in index of serum bilirubin toxicity was observed, followed by a smaller increase after the transfusion. Citrate was not found to interfere in the binding of bilirubin to albumin. The results are in agreement with the clinical finding that an exchange transfusion performed with fresh, citrated blood effectively reduced the risk of bilirubin encephalopathy. The ratio in serum of binding albumin, i.e. bilirubin plus reserve albumin, to total albumin failed to be incresed by the exchange transfusion, and a decrease occurred after the transfusion. These findings indicate the presence in infant serum of non-binding albumin. Donor albumin with intact binding potential is partly transformed into the non-binding variety in the course of one hour after the transfusion. In the most severely rhesus sensitized infant a drastic decline of the serum albumin binding capacity was seen during the first day of life.
- 8820620
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- The influence of clinical status on total bilirubin binding capacity in newborn infants. Journal of tropical pediatrics, 1996 Feb [Go to PubMed]
- The relationship between total bilirubin binding capacity (TBBC) and clinical status was investigated in order to assess the risk of bilirubin toxicity in 83 infants with jaundice in this study. Infants with respiratory distress, acidosis, hypoglycaemia, sepsis, asphyxia-anoxia and hypercarbia were accepted as ill and the remainders were well. Sephadex G-25 gel filtration method was used to determine TBBC. Serum albumin levels, TBBC and TBBC/albumin molar ratios were lower in ill premature and mature infants. Acidosis was the major risk factor for bilirubin toxicity in ill infants. Therefore, clinical status should be taken into consideration in the management of jaundiced infants.
- 888807
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The concentration is directly related to gestational age.
- Influence of gestational age and clinical status on bilirubin-binding capacity in newborn infants. Sephadex G-25 gel filtration technique. American journal of diseases of children (1960), 1977 Aug [Go to PubMed]
- Total bilirubin-binding capacity was measured by Sephadex G-25 gel filtration in 43 clinically well and 45 clinically ill newborn infants between 26 and 41 weeks' gestation. In the well patients, bilirubin-binding capacity, serum albumin concentration, and the molar-binding ratio of bilirubin to albumin were directly related to gestational age. In the sick patients, serum bilirubin-binding capacity and albumin concentration also correlated with gestational age; however, from 32 to 41 weeks' gestation, the mean values for the sick infants were significantly lower than for the well infants. In the sick infants, the molar binding ratio of bilirubin to albumin was also lower than in the well patients and did not correlate with gestational age. The data are in agreement with previous clinical findings indicating an increased risk for low-bilirubin kernicterus among immature infants and suggest that some critically ill term infants may be at risk for kernicterus at serum bilirubin levels below 20 mg/100 ml.
- 2058389
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The character of binding properties contribute to the risk of bilirubin toxicity.
- The serum reserve albumin concentration for monoacetyldiaminodiphenyl sulphone and auditory evoked responses during neonatal hyperbilirubinaemia. Acta paediatrica Scandinavica, 1991 Apr [Go to PubMed]
- Auditory brainstem evoked responses (ABR) were recorded in 9 neonates with hyperbilirubinaemia. Pathological recordings were found in two children showing absence of waves and prolonged latencies. There was no correlation between latencies to waves and the total serum bilirubin concentration. The serum reserve albumin concentration for monoacetyldiaminodiphenyl sulphone (MADDS) was, however, inversely related to the latencies in the ABR recordings. Our findings suggest that the binding properties of serum albumin contribute to the risk of bilirubin toxicity and that, in this study, the reserve albumin concentration for MADDS seemed to be of greater significance than the total bilirubin concentration.
- 6827417
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Influence of free fatty acids and glucose infusion on serum bilirubin and bilirubin binding to albumin: clinical implications. The Journal of pediatrics, 1983 Mar [Go to PubMed]
- We studied the risk of a large group of jaundiced neonates for bilirubin encephalopathy by serial assessment of their reserve serum albumin binding capacity as measured by the saturation index test. In 1271 infants with serum bilirubin concentration greater than 10 mg/dl, 12% had a saturation index (SI) of 7% or greater and therefore were clinically at or near risk for bilirubin encephalopathy. Treatment with glucose infusion (1 gm/kg over one hour) was highly effective in lowering the SI (delta = -3.7%. P less than 0.001). In none of the infants did SI rebound to 7% or greater within 24 hours after the infusion. In a detailed study of 19 infants who received glucose, the highly significant (P less than 0.001) fall in SI (delta = -3.7%) was accompanied by an equally significant rise in serum values for insulin (delta = +21.6 mcu/ml) and fall in serum free fatty acids (delta = -0.51 mEq/L). Many factors in the study, such as prematurity, hemolysis, acidosis, and hypoxemia, could have predisposed the infants t the risk of bilirubin encephalopathy. However, the facility by which most (93%) of the infants with high SI, including those who were premature or had evidence of hemolysis or respiratory insufficiency, responded to infusion of glucose indicates that serum free fatty acids may be the principal factor contributing to the high saturation index and therefore an underestimated factor in bilirubin binding to albumin.
- 963887
- Serum albumin
- Effective in Inducing Remission
- Review
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- The interactions between iophenoxic acid, iopanoic acid, bilirubin and human serum albumin as studied by fluorescence and Sephadex gel filtration. Clinica chimica acta; international journal of cli, 1976 Sep 6 [Go to PubMed]
- Iophenoxic acid increases the fluorescence of bilirubin bound to human serum albumin at drug/albumin molar ratios lower than 1, while iopanoic acid decreases it. The fluorescence enhancement results probably from a change in the fluorescence efficiency due to an iophenoxic acid-induced conformational change in the albumin, which in turn causes displacement of bilirubin from the protein. Iophenoxic acid does not affect the high-affinity bilirubin binding site of albumin. Therefore any enhancement in bilirubin fluorescence caused by the drug indicates that bilirubin is bound to the low-affinity binding sites of albumin. The use of iophenoxic acid in the determination of the extent of saturation of the high-affinity bilirubin binding site of albumin may be of value in the clinical management of infants with neonatal jaundice.
- 18282419
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The changing of serum albumin concentration is a index for testing the effective of UCS bilirubin.
- [Predictive value of umbilical cord blood bilirubin level for subsequent neonatal jaundice]. Zhonghua er ke za zhi. Chinese journal of pediatri, 2007 Nov [Go to PubMed]
- To investigate the predictive value of umbilical cord serum (UCS) bilirubin for subsequent jaundice in healthy term newborns.
Five hundred and twenty-three healthy term newborns (275 boys, 248 girls) were selected. The cord blood total serum bilirubin concentration and the serum albumin concentration were determined. All the infants were assessed for jaundice daily by measurement of transcutaneous bilirubin (TCB). When the infant's TCB was >or= 18 within the first 24 h after birth, >or= 21 at 48 h, >or= 25 at or after 72 h, the venous total serum bilirubin (TSB) was determined and treatment against jaundice was applied as needed. The infants were aligned into four groups according to their UCS bilirubin levels, starting from < 30 micromol/L(group 1); >or= 30 micromol/L(group 2); >or= 36 micromol/L(group 3); >or= 42 micromol/L(group 4). The frequency of hyperbilirubinemia and phototherapy (PT) were compared among the four groups. An analysis of UCS bilirubin as a predictor of later development of jaundice was performed. The characteristics of the infants who became jaundiced (jaundiced group) were compared with the normal infants (non-jaundiced group).
A clear correlation between UCS bilirubin level and the development of hyperbilirubinemia was found in all populations of the four groups. Only eight of the 194 infants in group 1 showed a TCB index >or= 25. TSB values > 205 micromol/L but < 257 micromol/L were observed in 2 newborns. None of the infants in this group showed TSB > 257 micromol/L or needed PT. Thirty-two infants in group 2 showed TCB >or= 25, 12 infants had TSB > 205 micromol/L but < 257 micromol/L, 2 infants had TSB > 205 micromol/L and received PT. In group 3, one infant developed hyperbilirubinemia at 48 h after birth and received PT. Thirty-nine infants showed TCB >or= 25, 16 infants TSB > 205 micromol/L but < 257 micromol/L, 2 infants had TSB > 205 micromol/L and also received PT. In group 4, 4 infants showed a range of TSB from 200 to 215 micromol/L at 48 h and received PT. Twenty-two infants showed TCB >or= 25, 17 of them showed TSB > 205 micromol/L but < 257 micromol/L, and 5 of them had TSB > 205 micromol/L and received PT. The frequency of TSB > 205 micromol/L increased from 1.03% in group 1, 5.77% in group 2, 19.75% in group 3 and to 42.5% in group 4. None of the 194 newborns in group 1 needed phototherapy, whereas 0.96%, 3.70% and 22.5% of the newborns in groups 2 - 4, needed PT. The frequency of patients with hyperbilirubinemia or phototherapy increased with increasing UCS bilirubin levels. For the prediction of TCB >or= 25 using a UCS bilirubin cut-off level, such as >or= 35 micromol/L, we found a positive predictive value of 45.68% and sensitivity of 68.27%. It is significant to predict neonatal jaundice by UCS bilirubin levels (P < 0.001). In the jaundiced group (TCB >or= 25) UCS bilirubin levels were significantly higher than those in the non-jaundiced group (t = 10.96, P < 0.001). No significant differences were found in the cord blood serum albumin concentration (t = 2.38, P > 0.05), the gestational age (t = -0.90, P > 0.05), and birthweight (t = 0.10, P > 0.05) between the jaundiced and non-jaundiced groups.
UCS bilirubin level is useful in predicting the subsequent jaundice in healthy term infants. The use of UCS bilirubin values may help detect infants at low or high risk for hyperbilirubinemia and minimize an unnecessary prolongation of hospitalization.
- 8115210
- Serum albumin
- Effective in Inducing Remission
- Review
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Criteria for exchange transfusion in jaundiced newborns. Pediatrics, 1994 Mar [Go to PubMed]
- A widely published set of exchange transfusion criteria lowers critical bilirubin concentrations when the serum albumin falls to < 2.5 g/dL. Although acknowledging the role of bilirubin-albumin binding in bilirubin neurotoxicity, this approach may inadvertently produce two critical bilirubin concentrations. This study investigates using the bilirubin/albumin ratio instead of the single albumin concentration to eliminate this potential ambiguity in the criteria.
The bilirubin/albumin ratio was defined as a reliable indicator of bilirubin-albumin binding if the frequency curves of specific unbound bilirubin concentrations are normally distributed functions of the ratio. Therefore the bilirubin/albumin ratios at which the unbound bilirubin reached 10, 15, and 20 nmol/L were determined by the peroxidase method in 35 well full-term, 10 ill full-term, and 19 ill preterm neonates. The frequency curves for each unbound bilirubin concentration plotted against the bilirubin/albumin ratio were tested for normality.
The frequency of each unbound bilirubin concentration was a normally distributed function of the bilirubin/albumin ratio. Furthermore, the mean ratio at which each unbound bilirubin occurred did not differ significantly among the groups of neonates.
The bilirubin/albumin ratio is a simple, nonambiguous way of incorporating the serum albumin concentration into exchange transfusion criteria.
- 7191809
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Bilirubin-albumin binding affinity and serum albumin concentration during intensive phototherapy (blue double light) in jaundiced newborn infants. European journal of pediatrics, 1980 Sep [Go to PubMed]
- Thirty newborn infants with normal birth weights and uncomplicated hyperbilirubinaemia were studied. Twenty three of these were treated continuously for 24 h with intensive phototherapy (blue double light), and seven untreated infants served as controls. During the treatment the serum concentrations of total bilirubin and unbound bilirubin in diluted serum measured by the peroxidase method were markedly reduced. The binding affinity of bilirubin to its high affinity site on serum albumin was not affected. During the treatment a slight decrease of the serum albumin concentration occurred, and the possible causes of this observation are discussed.
- 784927
- Serum albumin
- Effective in Inducing Remission
- Review
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Gentamicin and albumin-bilirubin binding. An in vivo study. The Journal of pediatrics, 1976 Sep [Go to PubMed]
- Ten newborn infants were given gentamicin intramuscularly. Over a postinjection interval of 12 hours, no significant change occurred in the total binding capacity of serum albumin for bilirubin or in concentrations of serum bilirubin levels. There was no correlation between concentrations of serum gentamicin and the total binding capacity or serum bilirubin. This study provides in vivo data that supports recent in vitro experiments showing that gentamicin does not alter bilirubin-albumin binding.
- 1164793
- Serum albumin
- Effective in Inducing Remission
- Review
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- in the jaundiced neonate. Clinical chemistry, 1975 Oct [Go to PubMed]
- We report a fluorometric technique for determination of albumin-titratable bilirubin in the jaundiced neonate. Although bilirubin alone has very little native fluorescence, considerable emission is observed in the presence of albumin under acid conditions. Analysis of the plasma sample alone and in the presence of excess human serum albumin solution appears to reflect the bilirubin tightly bound to albumin and the total serum bilirubin, respectively. The difference between these two values has been designated as"
albumin-titratable bilirubi"
. Where the concentration of albumin-titratable bilirubin is considerable, a typical saturation effect is observed. In samples where the circulating bilirubin is strongly bound to endogenous alumin, no change in fluorescence is seen when exogenous albumin is added. Results correlate well with the clinical picture.
- 7136621
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Comparison between two preparations of human serum albumin in treatment of neonatal hyperbilirubinaemia. Acta paediatrica Scandinavica, 1982 Jan [Go to PubMed]
- Thirty-six newborn infants with normal birth weights and with uncomplicated hyperbilirubinaemia, treated with light, were studied. At onset of phototherapy the infants received intravenously 1 g human serum albumin (HSA) per kg body weight as a 9% solution. Two different preparations of HAS were used and compared. One of these, HSAI, contained sodium caprylate and N-acetyltryptophan, 5 mmol/l of each, as stabilizers. HSAII contained only caprylate, 5 mmol/l. Nineteen infants received HSAI and seventeen infants HSAII. The reserve albumin for binding of bilirubin, measured by the [14C] MADDS method, was low in both preparations in vitro. During the infusion, the serum concentrations of albumin and reserve albumin increased and the serum unconjugated bilirubin concentration decreased, resulting in a fall in the index of plasma bilirubin toxicity in all infants. After completion of the infusion, the serum concentrations of albumin and reserve albumin declined, and a slight rise in index occurred. The increase inthe serum reserve albumin concentration was markedly higher during infusion of HSAII than of HSAI. It is concluded that infusion of both HSA preparations during phototherapy provides an immediate protection against bilirubin encephalopathy. HSAI is inferior to HSAII, probably due to its content of N-acetyltryptophan.
- 1255322
- Serum albumin
- Effective in Inducing Remission
- Review
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Variance in albumin loading in exchange transfusions. The Journal of pediatrics, 1976 Apr [Go to PubMed]
- To assess the rationale of albumin priming prior to exchange transfusions, 42 hyperbilirubinemic infants who required exchange transfusions were randomly assigned to one of two groups. Group I consisted of 15 infants who were given intravenously 1 gm/kg of salt-poor human serum albumin one hour before the exchanges. Group II, which consisted of 27 infants, received simple exchanges. No statistical differences were found in variations in reserve albumin-binding capacity, bilirubin, albumin, or red cell bilirubin at pre and one-hour post albumin infusion in the primed infants. The amount of bilirubin removed per kilogram is directly correlated to plasma bilirubin concentration (r=0.87). No significant difference in efficiency on bilirubin removal was seen between the two groups. Beneficial effects of albumin therapy was apparent only in those infants with low RABC as determined by the sephadex gel filtration technique.
- 20832127
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Auditory neuropathy spectrum disorder in late preterm and term infants with severe jaundice. International journal of pediatric otorhinolaryngo, 2010 Nov [Go to PubMed]
- To evaluate if severe jaundice is associated with acute auditory neuropathy spectrum disorder in otherwise healthy late preterm and term neonates.
In a prospective observational study, all neonates who were admitted with severe jaundice at which exchange transfusion may be indicated as per American Academy of Pediatrics guidelines had comprehensive auditory evaluation performed before discharge to home. Neonates with infection, perinatal asphyxia, chromosomal disorders, cranio-facial malformations, or family history of childhood hearing loss were excluded. Comprehensive auditory evaluations (tympanometry, oto-acoustic emission tests, and auditory brainstem evoked responses) were performed by an audiologist unaware of the severity of jaundice. Total serum bilirubin and serum albumin were measured at the institutional chemistry laboratory using the Diazo and Bromocresol purple method, respectively.
A total of 13 neonates with total serum bilirubin concentration at which exchange transfusion is indicated as per American Academy of Pediatrics were admitted to the Neonatal Intensive Care Unit over 3 month period. Six out of 13 neonates (46%) had audiological findings of acute auditory neuropathy spectrum disorder. There was no significant difference in gestational age, birth weight, hemolysis, serum albumin concentration, peak total serum bilirubin concentrations, and peak bilirubin:albumin molar ratio between six neonates who developed acute auditory neuropathy and seven neonates who had normal audiological findings. Only two out of six infants with auditory neuropathy spectrum disorder had clinical signs and symptoms of acute bilirubin encephalopathy.
Our findings strongly suggest that auditory neuropathy spectrum disorder is a common manifestation of acute bilirubin-induced neurotoxicity in late preterm and term infants with severe jaundice. Our findings also suggest that comprehensive auditory evaluations should be routinely performed in neonates with severe jaundice irrespective of the presence of clinical findings of acute bilirubin encephalopathy.
- 9382221
- Serum albumin
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- [Hyperbaric oxygenation in the intensive therapy of hypoconjugation neonatal jaundice]. Anesteziologiia i reanimatologiia, [Go to PubMed]
- Sixty-three newborns aged 4 +/- 1 days with hypoconjugation icterus and bilirubinemia of 313 to 524 mumoles/liter, prematurity of the I-II degree, birth injuries to the CNS, hypothyrosis, maternal diabetes mellitus, and threatened encephalopathy were examined. All patients were divided in 2 identical groups: controls (n = 30) and main (n = 33). The only difference was addition of HBO sessions to the basic complex of intensive care. In contrast to the controls, in the main group the level of indirect bilirubin was decreased 40% more intensively, the conjugation function of the liver for direct bilirubin was reliably improved by days 3-4 of therapy, by day 5 the enzymatic function of the liver was reliably normalized, mixed acidosis was arrested during the first day of treatment in more than 90% of patients, adequate glycemia and serum albumin concentrations were attained sooner, and the need in extracorporeal detoxication decreased.
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2 record(s) for Serum albumin Effective in Basic Research in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 7388087
- Serum albumin
- Effective in Basic Research
- In Vitro Study
- Summary
- The effect is a delay of the decrease of free bilirubin concentration, or even a temporary increase.
- Effect of theophylline on the riboflavin-sensitized photodegradation of bilirubin in vitro. Biology of the neonate, 1980 [Go to PubMed]
- Under in vitro conditions, theophylline accelerates the rate of bilirubin photodestuction sensitized by riboflavin, but does not do so in absence of this dye. The effect depends on the concentrations of theophylline and/or riboflavin, on the bilirubin/albumin ratio, and seems to implicate bilirubin unbound to serum albumin. Possible causes of the theophylline action and clinical implication regarding thephototherapy of neonatal jaundice are discussed.
- 2719994
- Serum albumin
- Effective in Basic Research
- NA
- Summary
- The inevitable product of tryptophan and nonesterified fatty acids (NEFA),which can plays its role with detecting the index of tryptophan and NEFA
- Free tryptophan decrease in jaundiced newborn infants during phototherapy. Biology of the neonate, 1989 [Go to PubMed]
- Tryptophan and nonesterified fatty acids (NEFA) are bound to serum albumin. NEFA displace tryptophan from their binding sites. Since NEFA decrease during phototherapy, we examined reciprocal variations of NEFA, total and free tryptophan in jaundiced newborn infants during phototherapy. After 24 h of phototherapy, we noticed a significant decrease of both NEFA and free tryptophan (p less than 0.001). Free tryptophan variations might affect the synthesis of cerebral neutrotransmitter 5-hydroxytryptamine, which depends on the passing of free tryptophan through the blood-brain barrier.
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1 record(s) for Serum albumin Effective in Maintaining Remission in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 23056760
- Serum albumin
- Effective in Maintaining Remission
- Clinical Trial
- Summary
- B/A ratio in conjunction with TSB can improve the specificity and prevent unnecessary invasive therapy
- Bilirubin/Albumin Ratio for Predicting Acute Bilirubin-induced Neurologic Dysfunction. Iranian journal of pediatrics, 2011 Mar [Go to PubMed]
- The aim of this study was to evaluate the bilirubin albumin (B/A) ratio in comparison with total serum bilirubin (TSB) for predicting acute bilirubin-induced neurologic dysfunction (BIND).
Fifty two term and near term neonates requiring phototherapy and exchange transfusion for severe hyperbilirubinemia in Children's Medical Center, Tehran, Iran, during September 2007 to September 2008, were evaluated. Serum albumin and bilirubin were measured at admission. All neonates were evaluated for acute BIND based on clinical findings.
Acute BIND developed in 5 (3.8%) neonates. B/A ratio in patints with BIND was significantly higher than in patients without BIND (P<0.001). Receiver operation characteristics (ROC) analysis identified a TSB cut off value of 25 mg/dL [area under the curve (AUC) 0.945] with a sensitivity of 100% and specificity of 85%. Also, according to the ROC curve, B/A ratio cut off value for predicting acute BIND was 8 (bil mg/al g) (AUC 0.957) with sensitivity of 100% and specificity of 94%.
Based on our results, we suggest using B/A ratio in conjunction with TSB. This can improve the specificity and prevent unnecessary invasive therapy such as exchange transfusion in icteric neonates.
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1 record(s) for Serum albumin Not Effective to Patients in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 7324912
- Serum albumin
- Not Effective to Patients
- Clinical Trial
- Summary
- The effect of albumin therapy was mainly an unexpected increase of the non-binding fraction f serum albumin, while the increase of the serum reserve albumin concentration was small and the concentration of bilirubin-albumin was not changed.
- Albumin administration combined with phototherapy in treatment of hyperbilirubinaemia in low-birth-weight infants. Acta paediatrica Scandinavica, 1981 Sep [Go to PubMed]
- Fifty-nine jaundiced light treated newborn infants with low birth weight were studied. At onset of phototherapy 30 infants received 1 g human serum albumin per kg body weight as a 9% solution containing sodium caprylate and N-acetyltryptophan as stabilizers. 29 infants did not receive human serum albumin and served as controls. Blood samples were taken before initiation of the therapy and again 24 and 48 h thereafter, and the following determinations were made: Serum concentrations of unconjugated bilirubin, albumin, reserve albumin for binding of bilirubin by the [14C]-MADDS method, packed cell volume and pH. Before infusion of albumin it was found that the binding fraction of serum albumin, i.e. the sum of the serum concentrations of bilirubin-albumin and reserve albumin, constituted about half of the total serum albumin concentration. The other half was non-binding, in agreement with previous findings in neonates. The effect of albumin therapy was mainly an unexpected increase of the non-binding fraction f serum albumin, while the increase of the serum reserve albumin concentration was small and the concentration of bilirubin-albumin was not changed.
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2 record(s) for Serum albumin NA in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 7359254
- Serum albumin
- NA
- Clinical Trial
- Summary
- serious neonatal illness is associated with a marked reduction in bilirubin-binding capacity and affinity and an increased risk of kernicterus in preterm infants.
- Free bilirubin concentrations and bilirubin-binding affinity in term and preterm infants. The Journal of pediatrics, 1980 Mar [Go to PubMed]
- Free bilirubin concentration, bilirubin-binding capacity, and bilirubin-binding affinity were determined by peroxidase oxidation in 66 newborn infants. Twelve healthy term infants whose unconjugated bilirubin concentration was 15.8 +/- 3.7 mg/dl (mean +/- SD) had a binding capacity of 31.9 +/- 3.7 mg/dl (bilirubin: albumin molar ratio = 0.89 +/- 0.07) and Ka = 28 +/- 11 x 10(7)/M. Twelve term infants with clinical complications of asphyxia, acidosis, respiratory distress, or sepsis, and 17 preterm infants with no complications had lower serum albumin concentrations and slightly reduced binding capacity and affinity compared to the healthy term infants. Free bilirubin concentrations were similar in these three groups, averaging 8 to 9 nmol/l in each group. Twenty-five preterm infants with complications had significantly higher free bilirubin (19 +/- 11 nmol/l), lower binding capacity, and lower binding affinity than any of the other three groups (P less than 0.01 for all comparisons). Five of the 25 sick pretrm infants had kernicterus at autopsy. These five infants were similar to the other 20 in birth weight, gestational age, serum bilirubin, and serum albumin level, but had significantly higher free bilirubin and significantly lower binding capacity and affinity. The data suggest that serious neonatal illness is associated with a marked reduction in bilirubin-binding capacity and affinity and an increased risk of kernicterus in preterm infants. The mechanism by which neonatal morbidity decreases bilirubin binding is not known.
- 2058388
- Serum albumin
- NA
- Clinical Trial
- Summary
- it is still possible that a low reserve albumin concentration for MADDS is a risk factor for bilirubin encephalopathy.
- Albumin binding properties in relation to bilirubin and albumin concentrations during the first week of life. Acta paediatrica Scandinavica, 1991 Apr [Go to PubMed]
- In 19 non-jaundiced and 22 jaundiced neonates, the serum albumin and bilirubin concentrations were measured during the first week of life. Some of the neonates were followed longitudinally. The albumin binding properties were evaluated by determining the reserve albumin concentration for monoacetyldiaminodiphenyl sulphone (MADDS), a deputy ligand for bilirubin. The reserve albumin concentration for MADDS increased with postnatal age. The reason for this increase is still unexplained. There was an inverse relation between the bilirubin and the reserve albumin concentrations, but when the bilirubin concentration increased by 1 mumol/l, the reserve albumin concentration for MADDS decreased by only 0.2 mumol/l. This shows that the reserve albumin concentration for MADDS does not give a direct measure of the bilirubin binding ability of the serum albumin molecule. In spite of this, it is still possible that a low reserve albumin concentration for MADDS is a risk factor for bilirubin encephalopathy.