{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T11:27:52Z","timestamp":1768649272364,"version":"3.49.0"},"reference-count":19,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"published-print":{"date-parts":[[2013]]},"abstract":"Extremely low birth weight (ELBW; <1,000 g) infants<b> <\/b>have poor outcomes, often compromised by bilirubin neurotoxicity. We measured unbound bilirubin (B<sub>f<\/sub>) and unbound free fatty acid (FFA<sub>u<\/sub>) levels in 5 ELBW infants in a trial examining the effects of pharmacologic ductal closure on infants treated with Intralipid infusion (3 g\/kg\/day). The levels for all infants (mean \u00b1 SD) were: total serum bilirubin (TSB) 4.6 \u00b1 1.7 mg\/dl, FFA<sub>u<\/sub> 376 \u00b1 496 n<smlcap>M<\/smlcap>, and B<sub>f<\/sub> 42 \u00b1 30 n<smlcap>M<\/smlcap>. Of the 3 infants who died, 2 had TSB <5.9 mg\/dl but FFA<sub>u<\/sub> >580 n<smlcap>M<\/smlcap> and B<sub>f<\/sub> >75 n<smlcap>M<\/smlcap>. Multiple regression revealed a major effect on B<sub>f<\/sub> levels due to FFA<sub>u<\/sub>, indicating that Intralipid elevated levels of FFA<sub>u<\/sub> and B<sub>f<\/sub>. Indomethacin or ibuprofen reduced B<sub>f<\/sub> levels, most likely by reducing FFA<sub>u<\/sub> levels through lipase inhibition. Because displacement of B<sub>f<\/sub> by FFA<sub>u<\/sub> decouples B<sub>f<\/sub> from TSB, phototherapy may not reduce the risk of bilirubin or FFA<sub>u<\/sub> toxicity in Intralipid-treated ELBW infants.<\/jats:p>","DOI":"10.1159\/000349995","type":"journal-article","created":{"date-parts":[[2013,8,19]],"date-time":"2013-08-19T07:38:39Z","timestamp":1376897919000},"page":"184-187","source":"Crossref","is-referenced-by-count":20,"title":["Unbound Free Fatty Acids from Preterm Infants Treated with Intralipid Decouples Unbound from Total Bilirubin Potentially Making Phototherapy Ineffective"],"prefix":"10.1159","volume":"104","author":[{"given":"Thomas","family":"Hegyi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suganya","family":"Kathiravan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary E.","family":"Stahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew H.","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Kleinfeld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2013,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803024"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2010.01688.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0148607185009002144"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(88)80129-X"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/0148607110362529"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2011.176412"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1021\/bi060703e"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000343097"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2012.71"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1385\/CP:1:1:041"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-916333"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-0846"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/adc.62.2.156"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2006.09.006"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1177\/0148607186010006627"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159\/000314893"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.M500151-JLR200"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.130625"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-1981(01)00171-8"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/349995","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/349995","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:13:52Z","timestamp":1745432032000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000349995"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2013,9,1]]},"published-print":{"date-parts":[[2013,9,27]]}},"URL":"https:\/\/doi.org\/10.1159\/000349995","archive":["Portico"],"relation":{},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"value":"1661-7800","type":"print"},{"value":"1661-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013]]}}}