PEDIATRICS Vol. 71 No. 6 June 1983, pp. 909-912
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Effect of Serum Hyperosmolality on Opening of Blood-Brain Barrier for Bilirubin in Rat Brain

Dag Bratlid MD, PhD1, William J. Cashore MD1, and William Oh MD1

1 From the Department of Pediatrics, Women and Infants Hospital of Rhode Island, and Section of Pediatrics, Brown University Program in Medicine, Providence, Rhode Island

The effect of hyperosomolality on the blood-brain barrier for bilirubin was studied in rats. Hyperbilirubinemia was induced in the chronically catheterized rat by infusion of bilirubin at a rate of 30 mg/kg/h for three hours. After two hours of bilirubin infusion, three levels of hyperosmolality were induced by bolus of urea at three different doses: 50, 75, and 100 mmol/kg, respectively. The serum osmolality rose from 297 mosm/L in the control group to 345, 383, and 400 mosml/L in the three respective groups. No significant differences were found between the groups in levels of total or free serum bilirubin, serum albumin, blood pH, and blood gases. A significant dose relationship was found in both brain bilirubin and brain albumin content with reference to the serum hyperosmolality. The results indicate that hyperosmolality causes opening of the blood-brain barrier for bilirubin in the rat. It may be speculated that this adverse phenomenon (hyperosmolality) may play a role in the pathogenesis of kernicterus in infants whose serum bilirubin levels are below the range of saturated bilirubin binding capacity.

Key Words: blood-brain barrier • hyperbilirubinemia • hyperosmolality • kernicterus

Submitted on November 19, 1982
Accepted on January 18, 1983




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