Role of Intravenous Extra Fluid Therapy in Icteric Term Neonates Receiving Intensive Phototherapy


background: Jaundice is a common neonatal problem. This may be due to the limited ability of a neonate to metabolize indirect bilirubin, which predisposes to the risk of encephalopathy and long-term sequelae if not managed promptly. Sufficient hydration and good urine output improve the efficacy of intensive phototherapyThe aim of this study: was to evaluate the role of intravenous extra fluid supplementation in accelerating the reduction of serum bilirubin levels in neonates and to find out whether intravenous fluid supplementation decrease the total duration of phototherapy and the need for exchange transfusionMethods: This is a prospective clinical trial study that was conducted at phototherapy ward at Karbala teaching hospital for children, Iraq from January 2017 to December 2017. Fifty-two term neonates with non-hemolytic hyperbilirubinemia [total serum bilirubin ≥18 mg/dl (308 μmol /L) and <25 mg/dl (428 μmol /L)] were randomly divided into 2 equal groups; (non-supplemented group) received breast milk and or formula, and (supplemented group) given intravenous fluid besides breast milk or formula. Both groups exposed to intensive phototherapy. The rate of bilirubin decrement, duration of phototherapy, and rate of exchange transfusion were comparedResults: Rate of bilirubin decrement at 4 hours, 8 hours, 24 hours of study were significantly higher in supplemented group as compared to non-supplemented group (p- value ≤0.001). Duration of phototherapy required in non-supplemented and supplemented groups was 56.54 vs. 41.54 hours respectively (p-value =0.0001). No statistically significant effect of intravenous extra fluid supplementation on exchange transfusion rate between these two groups.Conclusions: Intravenous extra fluid supplementation in non-hemolytic jaundiced term neonates can accelerate decrement of serum bilirubin levels and decreases the duration of phototherapy