SUPPLEMENTAL INTRAVENOUS FLUIDS AS A TREATMENT MODALITY FOR SEVERE NON-HEMOLYTIC NEONATAL HYPERBILIRUBINEMIA

Document Type : Original Article

Abstract

Background: Phototherapy is a standard treatment for neonatal hyperbilirubinemia. During phototherapy, since photoproducts that cause the decrease in serum bilirubin are eliminated in bile and urine, so adequate hydration should enhance the effectiveness of phototherapy.
Aim of work: To evaluate the role of intravenous (IV) fluid supplementation in decreasing total serum bilirubin (TSB) levels and duration of phototherapy in severe non-hemolytic neonatal hyperbilirubinemia.
Patient and Methods: This prospective study was carried out on 48 full-term neonates with indirect non-hemolytic hyperbilirubinemia in the neonatal intensive care unit (NICU), at Menoufia University Hospitals. Included neonates were assigned randomly to receive either intravenous fluid during the first 8 hours of phototherapy in addition to breast milk (Group 1, n=24) or exclusive breast milk (Group 2, n=24). TSB was documented at presentation and then at 12, 24, 48, 72, 96, 120, and 144 hours after admission. Both groups' rates of TSB reduction and the duration of phototherapy were compared.
Result: There was a significant difference in mean TSB (19.62 in group 1 versus 18.98 in group 2). Following IV fluid supplementation, TSB levels showed significant reduction at 12, 24-, 48-, 72- and 96-time hours (p < 0.001) in group 1 (supplemented IV fluid group) compared to exclusive breast milk (Group 2). Moreover, supplemented IV fluid group had a significantly shorter duration of phototherapy and NICU stay.
Conclusion: Additional IV fluid supplementation during the initial 8 hours with phototherapy in neonatal hyperbilirubinemia may considerably shorten the overall phototherapy time and TSB level in severe non-hemolytic newborn hyperbilirubinemia.

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