Treatment/Therapy | Icterus prolongatus – How dangerous is it?

Treatment/Therapy

In case of a mildly pronounced icterus prolongatus no treatment is necessary and the occurrence of consequential damage is very unlikely. However, the newborn baby should be checked regularly by transcutaneous bilirubin determination or blood tests in order to be able to start therapy in time if the values rise above the limit. It is also necessary for the baby to drink often and sufficiently (breast milk or complete infant formula).

Frequent meals stimulate the intestines and promote the excretion of bilirubin in the stool. Feeding water or tea should be avoided, since the child needs calories and no liquid (the bowel movement must be encouraged!). If the bilirubin value rises above a previously calculated limit value, the icterus prolongatus must be treated.

The therapy of choice here is phototherapy, in which the water-insoluble bilirubin is converted into a form that can be excreted by radiation. In cases where the bilirubin is very high and the newborn does not respond sufficiently to phototherapy, a blood exchange transfusion may be considered. In this case, the infant’s blood is gradually replaced with suitable donor blood (red cell concentrate) via an umbilical vein catheter.

However, a blood exchange transfusion is only necessary in very rare cases. An icterus prolongatus can be treated by phototherapy if the total bilirubin is increased above the phototherapy limit. The newborns lie unclothed under special fluorescent tubes, whereby the principle is similar to that of a solarium.

The children are turned over at regular intervals so that the entire skin can be irradiated. To protect the eyes against the radiation, the newborns must wear protective goggles. The skin is then irradiated with short-wave blue light with a wavelength of 460 nanometers. The irradiation converts the water-insoluble bilirubin that has accumulated in the blood into a water-soluble form that can be easily excreted. The therapy usually lasts between one and two days, but in any case until the bilirubin levels have fallen below the calculated limit.