PEDIATRICS Vol. 70 No. 4 October 1982, pp. 658-659
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Free Bilirubin Is of Importance

Richard P. Wennberg MD1 and Charles E. Ahlfors MD1

1 Division of Neonatology, Department of Pediatrics TB-193, University of California, Davis, Davis, CA 95616

The March issue of Pediatrics contains three important and provocative articles,1-3 which further our understanding of bilirubin neurotoxicity. However, the conclusion that unbound bilirubin is of minor1 or no importance2 in the pathogenesis of encephalopathy is not justified by the data presented.

On the contrary, the data of Ritter et al1 strongly support the clinical application of free bilirubin determinations. In sick babies, both pH and free bilirubin must be considered when interpreting binding tests.