Bilirubin forms as a product of the breakdown of red blood cells in the liver. Hyperbilirubinemia occurs when too much bilirubin exists in the blood, tissues and fluids of the body. Bilirubin has a reddish-yellow color and it causes jaundice, or a yellowing of the skin, whites of the eyes and body fluids, in people who have higher-than-normal levels. Treatment for hyperbilirubinemia depends on many factors, including the cause of the hyperbilirubinemia and the level of bilirubin in the blood.
Phototherapy
According to Lucile Packard Children’s Hospital at Standford, about 60 percent of full-term newborns and 80 percent of premature babies develop jaundice. Jaundice usually occurs in response to the baby's limited ability to excrete bilirubin in the first days of his life. Phototherapy uses a special, blue light to decrease excess bilirubin levels in the blood. The special light turns bilirubin into a more water-soluble form, so that the liver and kidneys can excrete it out of the body. Phototherapy requires day and night usage and it may take several hours to start working.
Fiber Optic Blanket
A fiber optic blanket involves phototherapy because it uses a special light to decrease excess bilirubin levels. The caregiver places the blanket underneath the baby. The length of time that the baby uses the blanket depends on the doctor’s specifications. The doctor may recommend using the blanket alone or in combination with regular phototherapy.
Exchange Transfusion
Exchange transfusion treats severe cases of hyperbilirubinemia that fail to respond to phototherapy. Exchange transfusion involves the removal of small amounts of damaged blood and the replacement of fresh blood through an umbilical vein. The procedure helps to increase the red blood cell count and lower the levels of bilirubin. Exchange transfusions are usually repeated until the bilirubin levels drop to a normal range.
Surgery
Jaundice in adults results from an underlying medical condition and it often resolves on its own. However, some medical conditions require treatment in order to decrease hyperbilirubinemia. Obstruction of the bile ducts--the tube that carries bile from the liver or gallbladder to the small intestine, can result from a gallstone, damage and scarring, or biliary atresia, a congenital condition associated with abnormal development of the bile ducts. These conditions lead to the backup and pooling of bile--a yellowish-green fluid produced in the liver and secreted into the small intestine to get rid of waste products--behind the obstruction. The backup of bile leads to an increase of bilirubin in the blood. Surgery can help remove or treat the obstruction of the bile ducts, allowing for proper excretion of bile into the small intestine.
