Abstract
In order to investigate an apparent increase in the number of NICU newborns (NBs) with unexplained DHB, a retrospective analysis of all NBs admitted to the NICU over an 18 month period was conducted. The study revealed 11 newborns with undiagnosed DHB defined as direct bilirubin> 2 mg/dl or> 10% of the total bilirubin level. Four of the 11 NBs had identifiable factors which are known to cause DHB. Two of the 4 NBs had severe perinatal asphyxia with elevated liver enzymes and 2 NBs had prolonged hyperalimentation due to gastrointestinal adnormalities. All of the remaining 7 NBs (Group 1) did not have a diagnosable nor identifiable cause, but all had received CH 30-40 mg/kg q 4-6 h for sedation while on the ventilator. In these NBs, the DHB began to decrease within 2 days of the last CH dose. We next reviewed all charts of NBs who had received more than one dose of CH for sedation and did not have DHB (Group 2) .The table compares these two groups including the total CH dose/kg received.
In summary, prolonged administration of CH appears to be associated with DHB in NBs in a dose response and temporal manner. Similar CH-induced hepatic toxicities have been reported in adults and animals. The human NB may be more sensitive to CH due to decreased metabolic clearance of CH and its active metabolite.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Muraskas, J., Lambert, G., Ayuste, O. et al. NEONATAL DIRECT HYBERBILIRUBINEMIA (DHB) ASSOCIATED WITH CHLORAL HYDRATE (CH) DOSAGE. Pediatr Res 21 (Suppl 4), 239 (1987). https://doi.org/10.1203/00006450-198704010-00432
Issue Date:
DOI: https://doi.org/10.1203/00006450-198704010-00432