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'Like a shrivelled blood orange'--bilirubin, jaundice, and phototherapy

A F McDonagh, D A Lightner

    Pediatrics
    |March 1, 1985
    PubMed

    Insights

    This review covers bilirubin biochemistry in newborns, detailing its formation, metabolism, and disposition. It explains how blue light affects bilirubin and the mechanisms of phototherapy.

    Area of Science:

    • Biochemistry
    • Neonatal Medicine
    • Photochemistry

    Background:

    • Bilirubin is a key byproduct of heme metabolism.
    • Elevated bilirubin levels (hyperbilirubinemia) are common in newborns.
    • Understanding bilirubin's properties is crucial for managing neonatal jaundice.

    Purpose of the Study:

    • To review the biochemistry of bilirubin, focusing on newborn infants.
    • To explain the influence of molecular structure on bilirubin's biologic disposition.
    • To elucidate the mechanism of phototherapy in treating neonatal hyperbilirubinemia.

    Main Methods:

    • Literature review of bilirubin biochemistry.
    • Summary of bilirubin formation, properties, and metabolism.
    • Explanation of the chemical basis of phototherapy.

    Main Results:

    • Bilirubin's molecular shape, hydrogen-bonding, and polarity significantly impact its disposition.
    • Visible blue light alters bilirubin structure and metabolism.
    • Phototherapy utilizes light to degrade bilirubin, reducing its toxicity.

    Conclusions:

    • A comprehensive understanding of bilirubin biochemistry is essential for neonatal care.
    • Phototherapy is an effective treatment for neonatal jaundice, based on specific photochemical reactions.
    • Further research into bilirubin metabolism and phototherapy mechanisms is warranted.

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