Icterícia em recém-nascidos prematuros: revisão narrativa da literatura
DOI:
https://doi.org/10.34119/bjhrv6n4-346Keywords:
hiperbilirrubinemia, icterícia, prematurosAbstract
A hiperbilirrubinemia neonatal é causada, principalmente, pelo desequilíbrio entre o excesso de produção de bilirrubina a partir da degradação da hemoglobina, juntamente com a depuração deficiente por meio do fígado imaturo. O nascimento prematuro predispõe à hiperbilirrubinemia mais grave e prolongada, secundária a problemas como infecções, dificuldades alimentares, estados catabólicos, desidratação, tendências hemorrágicas e albumina sérica baixa. O cérebro imaturo e a barreira hematoencefálica aumentam o risco de lesão neurológica, necessitando, portanto, de tratamento com fototerapia em níveis mais baixos do que em bebês nascidos a termo. Assim, bebês prematuros requerem monitoramento rigoroso dos níveis de bilirrubina, muitas vezes, por um período prolongado. O monitoramento padrão da hiperbilirrubinemia geralmente inclui uma amostra venosa diagnóstica da bilirrubina sérica total para determinar a necessidade de terapia. Como não há nenhuma diretriz para o tratamento desses bebês, as unidades de terapia intensiva neonatal estabelecem, na maioria das vezes, critérios próprios para esses recém-nascidos, com base no peso ao nascer ou na idade gestacional. Diante do exposto, o propósito deste trabalho foi categorizar, com base em revisão narrativa da literatura, a ocorrência de hiperbilirrubinemia em prematuros. Também foram investigadas sua avaliação e forma de tratamento.
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