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hyperbilirubinemia after extracorporeal circulation surgery:A recent and prospective study

World Journal of Gastroenterology 2006年第41期12卷 6722-6726页

作者： Yong An Ying-Bin Xiao Qian-Jin Zhong Department of Cardiovascular Surgery Xin-Qiao Hospital Third Military Medical University Chongqing 400037 China

AIM： To clarify the incidence and nature of postoperative hyperbilirubinemia in patients after modern extracorporeal circulation, to analyze possible perioperative risk factors, and to elucidate the clinical significance of postoperative hyperbilirubinemia associated mortality and morbidity. METHODS： Between March 2005 and May 2006, three hundred and eighty six consecutive patients undergoing extracorporeal circulation surgery due to a variety of cardiac lesions were investigated prospectively. The incidence of postoperative hyperbilirubinemia was defined as a serum total bilirubin concentration of more than 51 μmol/L. Several perioperative parameters were compared by logistic regression between hyperbilirubinemia and non-hyperbilirubinemia patients to determine possible risk factors contributing to postoperative hyperbilirubinemia and mortality. RESULTS： Overall incidence of postoperative hyperbilirubinemia was 25.3% （98/386）. In patients with postoperative hyperbilirubinemia, 56.2% reached peak total bilirubin concentration on the first postoperative day, 33.5% on the second day, and 10.3% on the seventh day. Eighty percent of the increase of total bilirubin resulted from an increase of both conjugated and unconjugated bilirubin. Development of postoperative hyperbilirubinemia was associated with a higher mortality （P 〈 0.01）, longer duration of mechanical ventilation （P 〈 0.05） and longer ICU stay time （P 〈 0.05）. Preoperative total bilirubin concentration, preoperative right atrium pressure, numbers of valves replaced and of blood transfusion requirement were identified as important predictors for postoperative hyperbUirubinemia. CONCLUSION： Early postoperative hyperbilirubinemia after modern extracorporeal circulation is mainly caused by an increase in both conjugated and unconjugated bilirubin, and is associated with a high mortality. Important contributing factors are the preoperative total bilirubin concentration, preoperative severity of right atrial pressu

关键词： Extracorporeal circulation Open-heart surgery hyperbilirubinemia Liver function

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Extreme hyperbilirubinemia: An indicator of morbidity and mortality in sickle cell disease

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World Journal of Hepatology 2019年第3期11卷 287-293页

作者： John Paul Haydek Cesar Taborda Rushikesh Shah Preeti A Reshamwala Morgan L McLemore Fuad El Rassi Saurabh Chawla Department of Medicine Emory University School of Medicine Division of Digestive Diseases Department of Medicine Emory University School of Medicine Department of Hematology and Medical Oncology Emory University School of Medicine

BACKGROUND Sickle cell disease(SCD) is a disorder that results in increased hospitalizations and higher mortality. Advances in management have resulted in increases in life expectancy and led to increasing awareness of sickle cell hepatopathy(SCH).However, its impact in patients on the natural history and outcomes of SCD is not known. Our study aims to describe the prevalence of extreme hyperbilirubinemia(EH), one form of SCH, its effect on morbidity and mortality,and correlations between sickle cell genotype and SCH type. We hypothesize that EH is associated with higher morbidity and *** To investigate the effects of EH on morbidity and mortality among patients with *** This retrospective cohort study was performed using a database of patients with SCD treated at Grady Memorial Hospital between May 2004 and January *** with EH(defined as total bilirubin above 13.0 mg/dL) were identified. A control group was identified from the same database with patients with total serum bilirubin ≤ 5.0 mg/dL. Electronic medical records were used to extract demographic information, laboratory values, radiology results, current medications, need for transfusions and mortality data. Two samples T-test, chi-squared test and Fisher's exact test were then used to compare the parameters between the two *** Out of the database, fifty-seven charts were found of patients with bilirubin > 13 mg/dL. Prevalence of severe SCH as defined by EH was 4.8%(57/1172). There were no demographic differences between patients with and without *** genotypic differences existed between the two groups, with hemoglobin SS SCD being much higher in the EH group(P < 0.001). Patients with severe EH had a significant elevations in alanine aminotransferase(157.0 ± 266.2 IU/L vs 19.8 ± 21.3 IU/L, P < 0.001), aspartate aminotransferase(256.5 ± 485.9 U/L vs 28.2 ± 14.7 U/L, P < 0.001) and alkaline phosphatase(218.0 ± 176.2 IU/L vs 85.9 ± 68.4 IU/L, P < 0.001). Patients

关键词： Sickle cell disease Sickle cell hepatopathy Liver diseases Extreme hyperbilirubinemia Mortality

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Characteristics of brainstem auditory evoked potential of neonates with mild or moderate hyperbilirubinemia

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Neural Regeneration Research 2007年第11期2卷 660-664页

作者： Xiaoqing Guo Xiuhong Pu Tao An Qian Li Meng Qiu Qiong Wu Yanlan Tan Department of Pediatrics the 309 Clinical Division General Hospital of Chinese PLA Beijing 100091 China

BACKGROUND： Brainstem auditory evoked potential （BAEP） has been widely used to evaluate the functional integrity and development of injured auditory system and brain, especially to objectively evaluate the function of auditory system and brain stem of very young babies, such as neonates and sick babies. OBJECTIVE： To observe the changes of BAEP of neonates with hyperbilirubinemia, and to investigate the relationship of bilirubin concentration and BAEP. DESIGN： An observation experiment. SETTING： Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA. PARTICIPANTS： Fifty-eight neonates with mild or moderate hyperbilirubinemia exhibiting jaundice within 24 hours after born, who received the treatment in the Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA between January 2004 and May 2007, were recruited in this study. The involved neonates, 31 boys and 27 girls, had gestational age of 37 to 46 weeks. They had no history of birth asphyxia, and were scored 8 to 10 points when born. Written informed consents of examination and treatment were obtained from the guardians of the neonates. This study was approved by the Hospital Ethics Committee. According to serum total bilirubin value, the neonates were assigned into 3 groups： low-concentration bilirubin group （n =16）, moderate-concentration bilirubin group （n =27） and high-concentration bilirubin group （n =15）. According to mean daily bilirubin increase, the subjects were sub-assigned into bilirubin rapid increase group （n =39） and bilirubin slow increase group （n = 19）. METHODS： After admission, all the neonates received drug treatment. Meanwhile, their 116 ears were examined with a myoelectricity evoked potential equipment （KEYPOINT） in latency, wave duration, amplitude and wave shape differentiation of each wave of BAEP. BAEP abnormal type was observed and abnormal rate of BAEP was calculated. MAIN OUTCOME MEASURES： ①Abnormal rate and abnorm

关键词： hyperbilirubinemia brainstem auditory evoked potential neonates

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Treatment of hyperbilirubinemia with blood purification in China

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World Journal of Gastroenterology 2006年第46期12卷 7467-7471页

作者： Zhi-Jun Duan Lei-Lei Li Jia Ju Zhi-Hong Gao Gao-Hong He Department of Gastroenterology First Affiliated Hospital of Dalian Medical University Dalian 116011 Liaoning Province China R&D Center of Membrane Science and Technology Dalian University of Technology Dalian 116012Liaoning Province China

The incidence of hyperbilirubinemia is high clinically, which is difficult to cure by medication, surgery or interventional therapies. Non-bioartificial liver is the main alternative in the blood purification for hyperbilirubinemia, which includes plasma exchange, hemoperfusion, hemodialysis, molecular adsorbent recycling system and so on. The research results and clinical experiences in China show that these methods are effective in lowering high levels of bilirubin with fewer side effects. The hyperbilirubinemias of different causes, with different complications or accompanying different diseases can be treated by different methods. Bioartificial liver, hybrid artificial liver support system and adsorbent membrane material have also been studied and their development in reducing hyperbilirubinemias has been achieved. This article gives a brief overview on the actuality and research improvement in blood purification for hyperbilirubinemia in China.

关键词： hyperbilirubinemia Blood purification Treatment China Review

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Evaluation of the safety and efficacy of glucocorticoid therapy for hyperbilirubinemia in patients with hepatocellular carcinoma who have undergone transcatheter arterial chemoembolization

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Oncology and Translational Medicine 2020年第2期6卷 81-86页

作者： Jingyan Wang Linzhi Zhang Xiaoming Peng Yun Zhao Lin Zhou Department of Interventional Radiology The Fifth Medical Center of PLA General HospitalBeijing 100039China

Objective The aim of this study was to analyze the safety and efficacy of glucocorticoid treatment for hyperbilirubinemia in patients with hepatocellular carcinoma(HCC)who have undergone transcatheter arterial chemoembolization(TACE).Methods We conducted a retrospective analysis of the clinical data of 198 patients with HCC who were admitted to The Fifth Medical Center of PLA General Hospital from June 2014 to August 2019 and underwent TACE *** patients were divided into glucocorticoid(GCC)treatment group and control *** liver-protecting procedures were used in both *** treatment group also received intravenous injections of methylprednisolone sodium succinate for 3–5 *** in bilirubin concentration,mean duration of hospitalization,and complications were compared between the two groups to investigate the safety and efficacy of GCCs for treatment of hyperbilirubinemia after TACE *** Bilirubin concentrations were significantly lower in the treatment group than in control group on days 3 and 5 after GCC/conventional liver-protecting treatment(Phyperbilirubinemia in patients with HCC who have undergone TACE is safe and associated with rapid decline in bilirubin concentration and shorter hospital stay compared with patients who did not receive GCCs.

关键词： glucocorticoid primary liver cancer hyperbilirubinemia transcatheter arterial chemoembolization(TACE)

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Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen:A case report

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Chinese Journal of Traumatology 2023年第4期26卷 236-243页

作者： Kai Wang Yun-Xuan Deng Kai-Wei Li Xin-Yu Wang Chao Yang Wei-Wei Ding Division of Trauma and Surgical Intensive Care Unit Research Insttute of General SurgeryAffliated jinling HospitalMedical Schoolof Nanjing UniversityNanjing20002China The First School of Clinical Medicine Southern Medical UniversityNanjing210002China

Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or *** enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the ***,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day *** exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was ***,the patient was transferred to our trauma center for septic shock and *** salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was *** the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding ***,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding *** was alleviated with the increase in chyme *** 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular *** BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.

关键词： Blunt bowel injury Open abdomen Enteral nutrition Chyme reinfusion hyperbilirubinemia Case report

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Pharmacological Monitoring of Capecitabine in a Gastric Cancer Patient with hyperbilirubinemia

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Journal of Biosciences and Medicines 2023年第3期11卷 120-126页

作者： Yanting Gu Qinghua Lang Dongmei Chen Jianying Zhang Zheng Liu Ling Gao Department of Pharmacy China Aerospace Science & Industry Corporation 731 Hospital Beijing China Department of Nursing Liupanshui Municipal People’s Hospital Liupanshui China Department of Nursing Zhongshan People’s Hospital of Guangdong Province Zhongshan China

Objective: To examine therapeutic drug monitoring in managing hyperbilirubinemia caused by capecitabine in patients with gastric adenocarcinoma with extensive liver metastases. Results: The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 615 UI/l, alanine aminotransferase 385.9 UI/l), hyperbilirubinemia (total bilirubin at 246.1 μmol/l), and alkaline phosphatase at 694.6 UI/l. We initiated capecitabine based combination chemotherapy, and the clinical pharmacist conducted a full-course medication monitoring of the patient’s treatment including design of individualized dosing regimens and monitoring of bilirubin, infection, cancer pain, parenteral nutrition support and adverse events. After 21 days of supervision by clinical pharmacist and clinicians, the patient’s bilirubin and transaminase decreased progressively, with aspartate aminotransferase, total bilirubin and alkaline phosphatase falling back to 57 UI/l, 69.8 μmol/l, 307.2 UI/l, respectively. The patient’s condition improved significantly at the time of discharge, with the jaundice subsided, and the bloating relieved. Conclusion: Due to adverse reactions, capecitabine requires medication monitoring during use. The relationship between effectiveness and adverse effects is controversial. Adverse reactions should not be the sole criterion for the use of drugs. Clinical pharmacists can improve the safety and effectiveness of patients’ medications and promote rational drug use by monitoring patients, which may be useful to help the doctors identify the high-risk patients for taking efficient treatment strategy decisions.

关键词： Clinical Pharmacist Capecitabine Gastric Cancer hyperbilirubinemia Therapeutic Drug Monitoring

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Clinical effects of phototherapy combined with albumin administration on hyperbilirubinemia in newborns

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中西医结合护理（中英文） 2018年第3期4卷 1-3页

作者： GAO Yan LI Shenmei XU Yunyun LIU Qiuju ZHANG Yiyuan Department of Neonatology Affiliated Hospital of Guilin Medical University

Objective To investigate the effects of phototherapy combined with albumin administration on hyperbilirubinemia in newborns. Methods Totally 64 newborns with neonatal hyperbilirubinemia were randomly divided into the control group and the study group,with 32 cases in each group. The newborns in control group received phototherapy and routine care,while those in study group were administrated with intravenous injection of albumin in addition to phototherapy and routine care. The concentration of total serum bilirubin,newborns' body weight and amount of milk intake were measured before and after phototherapy. Results There was a significant difference in the milk intake between two groups after phototherapy( P 0. 05). Conclusion Combined application of phothotherapy and albumin administration on neonatal hyperbilirubinemia could promote the newborns' appetite and improve the recovery of the neonates,but the effect on reducing blood bilirubin level and weight gain needs further study.

关键词： neonatal hyperbilirubinemia albumin phototherapy weight gain

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Effect of ursodeoxycholic acid combined with bifidobacterium quadruple preparations on myocardial enzyme, immune function and inflammatory response of hyperbilirubinemia neonatal

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Journal of Hainan Medical University 2018年第7期24卷 39-42页

作者： Song-Mei Yang Yu-Mei Liang Yan-Ni Feng Mei Lin Yan Huang Neonatal Pediatrics Department Affiliated Hospital of Youjiang Medical College for NationalitiesBaise 533000GuangxiChina

Objective: To investigate the effects of myocardial enzyme, immune function and inflammatory response by ursodeoxycholic acid combined with bifidobacterium quadruple preparations on hyperbilirubinemia neonatal. Methods: A total of 100 cases of neonatal hyperbilirubinemia in our hospital from June 2016 to May-2017 were selected and divided into control group and observation group by random number table, 50 cases in each group. Two groups of neonatal were given routine symptomatic treatment. The control group was treated with ursodeoxycholic acid and the observation group was treated with Bifidobacterium tetralogy of live bacteria on the basis of the control group. The two groups of neonatal were both treated for 7 d. The serum levels of CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α were measured before and after the treatment of the two groups. Results: Before treatment, there was no significant difference in serum CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α levels between the 2 groups. After treatment: 2 groups of serum CK-MB, CK, LDH, AST, CD8+, CRP, TNF-α levels significantly decreased compared with the group before treatment, CD3+, CD4+ and CD4+/CD8+ levels were significantly increased after treatment, and the observation group with serum CK-MB, CK, LDH, AST, CD8 +, CRP, TNF-α levels were significantly lower than the control group, CD3+, CD4+ and CD4+/CD8+ levels were significantly higher than the control group, the differences were statistically significant. Conclusion: Ursodeoxycholic acid combined with Bifidobacterium quadruple viable tablets can can reduce the activity of myocardial enzyme, improve the state of spectrum index of neonatal hyperbilirubinemia.

关键词： Ursodeoxycholic acid Bifidobacterium quadruple preparations hyperbilirubinemia neonatal Myocardial enzyme Immune function Inflammatory response

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Predictive value of serum NSE, umbilical cord blood albumin levels in hyperbilirubinemia full-term neonates with brain injury

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Journal of Hainan Medical University 2020年第19期26卷 42-46页

作者： Hua-Mei Yang Yi Deng Li Wang Zheng-Rong Tang Yan-Chang Qiu Yong Xie Zhen Meng Luo-Xin Huang Department of neonatology The Second Affiliated Hospital of Guilin Medical CollegeGuilin 541199China Department of clinical medicine Guilin Medical UniversityGuilin 541199China

Objective:To investigate the predictive value of of serum NSE,umbilical cord blood albumin levels in hyperbilirubinemia full-term neonates with brain ***:300 cases of hyperbilirubinemia full-term neonates in our hospital during January 2018 to November 2019 were chosen as hyperbilirubinemia group,200 cases of healthy full-term neonates who were delivered in our hospital during the same period and whose general information matched were chosen as normal control *** to whether the hyperbilirubinemia group had brain injury,they were further divided into bilirubin encephalopathy group(n=34)and non-bilirubin encephalopathy group(n=266).NSE,umbilical cord blood albumin levels in hyperbilirubinemia group and normal control group were *** data,NSE and umbilical cord blood albumin levels between bilirubin encephalopathy group,non-bilirubin encephalopathy group were *** factors associated with brain injury in full-term newborn with hyperbilirubinemia were analyzed by logistics regression,predictive value of NSE and umbilical cord blood albumin on brain injury in full-term newborn with hyperbilirubinemia were evaluated by ROC ***:NSE level in hyperbilirubinemia group was higher than that in normal control group(P0.05).Incidence of jaundice,anemia,indirect bilirubin peak,total bilirubin peak and NSE level in bilirubin encephalopathy group were higher than those in non-bilirubin encephalopathy group,level of umbilical cord blood albumin was lower than that in non-bilirubin encephalopathy group(Phyperbilirubinemia with brain injury(P<0.05).When NSE was 67.09 ng/mL,the yoden index was the highest,with sensitivity and specificity of 79.70%,55.88

关键词： hyperbilirubinemia Full-term newborn Brain damage NSE Albumin of cord blood

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