Fluid supplementation in term neonates with severe hyperbilirubinemia: a randomized controlled trial study

Abstract

Background: Severe neonatal jaundice can cause fatality and serious permanent effect, called kernicterus, in which the brain stem nuclei and basal ganglia are damaged. We are encouraged to work on efficacy of fluid supplementation in addition to photo therapy as a measure to reduce bilirubin level more efficiently.Methods: A randomized control trial study was conducted in Department of Paediatric Medicine, Neonatal Unit, R.G. Kar Medical College & Hospital, Kolkata, from April 2011 to March 2012. A total 100 term neonates presenting with severe non-hemolytic hyperbilirubinemia (>18 mg/dl to <25 mg/dl) were enrolled as study population. The study subjects were divided into two equal groups, study group and control group by randomization. The study group was given IV fluid supplementation in addition to photo therapy. Total serum bilirubin (TSB) level assessed periodically and results compared with control group.Results: The study results reveal a statistically significant association between the percent fall in TSB at 12 (Chi2= 7.18, p=0.000) and 24 hours (Chi2=10.69, p=0.000) in the intervention arm compared to the control group.Conclusions: Fluid supplementation along with double surface phototherapy in term neonates presenting with severe hyperbilirubinemia decreases the rate of exchange transfusion and duration of phototherapy.