Hyperbilirubinemia

Bilirubin adalah produk limbah yang diperoleh selama proses daur ulang sel darah merah yang telah usang. Limpa dan hati merupakan dua organ tubuh yang berperan penting dalam daur ulang sel darah merah. Bilirubin bekerja sebagai antioksidan seluler. Tingkat normal bilirubin langsung atau terkonjugasi dalam darah adalah 0-0,3 mg/dL (miligram per desiliter). Sedangkan kadar bilirubin total harus antara 0,3 hingga 1,9 mg/dL.

Media Keperawatan Indonesia, 2023

Hyperbilirubinemia can occur when the level of bilirubin in the blood is more than 5 mg/dL, clinically characterized by the presence of jaundice with physiological and non-physiological causes. The main treatment for cases of hyperbilirubinemia today is phototherapy. However, in recent years there have been alternative interventions carried out, one of which is baby massage. The purpose of this paper is to analyze the effect of giving massage on the bilirubin levels of infants who have hyperbilirubinemia based on empirical studies of the last 10 years. The writing design uses a literature review with inclusion criteria according to the PICOS format. Methods to find sources or articles through the Pubmed, Proquest, Scient Direct, and Google Scholar databases (2016-2021) published in English and Indonesian. The keywords used are related to hyperbilirubinemia and baby massage. Based on the 10 articles reviewed, it was found that baby massage was given 1 to 3 times a day with a duration of 15-20 minutes in every session. Evaluation of bilirubin levels can use serum bilirubin levels or transcutaneous bilirubin levels, besides that giving massage also increases the frequency of defecation which plays a role in removing bilirubin from the baby's body. Baby massage is expected to prevent and treat standardized hyperbilirubinemia so that it can become uniform and as an alternative intervention in reducing bilirubin levels in infants.

Hyperbilirubinemia is an increase of the blood bilirubin level due to physiological or non-physiologic factors, which is clinically characterized by jaundice. Bilirubin is produced in the reticuloendothelial system as the end product of heme catabolism through an oxidation-reduction reaction. Due to its hydrophobic nature, unconjugated bilirubin is carried in the plasma, tightly bound to albumin. In the liver, bilirubin is transported into hepatocytes, bound to ligandin. After being excreted to the small intestine through the bile ducts, bilirubin undergoes a reduction to become colorless tetrapyrole due to the action of intestinal microbes.This unconjugated bilirubin can be reabsorbed into the circulation; therefore, it increases total plasma bilirubin. The treatments of hyperbilirubinemia in neonati are phototherapy, intravenous immunoglobulin (IVIG), replacement transfusion, temporary breastfeeding cessation, and medical therapy Abstrak: Hiperbilirubinemia ialah terjadinya peningkatan kadar bilirubin dalam darah, baik oleh faktor fisiologik maupun non-fisiologik, yang secara klinis ditandai dengan ikterus. Bilirubin diproduksi dalam sistem retikuloendotelial sebagai produk akhir dari katabolisme heme dan terbentuk melalui reaksi oksidasi reduksi. Karena sifat hidrofobiknya, bilirubin tak terkonjugasi diangkut dalam plasma, terikat erat pada albumin. Ketika mencapai hati, bilirubin diangkut ke dalam hepatosit, terikat dengan ligandin. Setelah diekskresikan ke dalam usus melalui empedu, bilirubin direduksi menjadi tetrapirol tak berwarna oleh mikroba di usus besar. Bilirubin tak terkonjugasi ini dapat diserap kembali ke dalam sirkulasi, sehingga meningkatkan bilirubin plasma total. Pengobatan pada kasus hiperbilirubinemia dapat berupa fototerapi, intravena immunoglobulin (IVIG), transfusi pengganti, penghentian ASI sementara, dan terapi medikamentosa. Kata kunci: hiperbilirubinemia, bilirubin, biliverdin, siklus enterohepatik.

Indonesian Midwifery and Health Sciences Journal

condition that often occurs in neonates. This condition is important to note, because if the bilirubin levels are too high, it can lead to several complications in the brain, such as encephalopathy and cerebral palsy in infants.Objective: The objective of this study is to analyze which maternal and neonatal risk factors can cause hyperbilirubinemia in neonates. Methods: This study is an analytical study with a cross sectional approach. Population samples was taken from the perinatology room Dr. Rumkital. Ramelan Surabaya in January 2018 - December 2019, there were 252 samples and 122 samples who experienced hyperbilirubinemia. Data analysis using Chi Square test and logistic regression. Results: It was found that the type of delivery with cesarean section was the largest percentage with a p value of 0.106;; Most LBW with p value 0.038; male at most with a p value of 0.046. From the results of multivariate analysis, it was found that the variable birth weight had a greater influence ...