Bilirubinemia in nonerythroblastotic premature infants. 1. The correlation of peak plasma total bilirubin concentration with clinical course and postmortem findings in one hundred forty new-born premature infants.

Abstract

The clinical syndrome known as kernicterus1can usually be prevented even though all the conditions predisposing to it are still unknown. In full-term and premature erythroblastotic infants, exchange transfusion therapy for the prevention of kernicterus has been highly successful. In the nonerythroblastotic premature infant, however, the prevention of kernicterus remains a far more complex and, as yet, incompletely solved therapeutic problem. As in erythroblastotic full-term infants, it appears that some relationship exists in premature infants between the concentration of bilirubin in the plasma or serum and the development of kernicterus. The nature of this relationship, from our experience, is not linear. Nevertheless, exchange transfusions are being performed on premature infants to prevent kernicterus, the same criterion being applied for transfusion as has been used in transfusing erythroblastotic infants, namely, attainment of 20 mg. per 100 ml. concentration of serum total bilirubin.2In Meyer's study,3based on observation