The effect of intravenous fluid therapy in icteric neonates during phototherapy: A randomized clinical trial -

Abstract

Jaundice is the most prevalent neonatal clinical complication. One of the causes of this disease is the insufficiency of mother's milk to feed the neonate. Therefore, fluid therapy is considered as one of the useful intervention to alleviate jaundice. This study was designed to examine the effect of intravenous fluid therapy on icteric neonates who are also treated by phototherapy. A clinical research was conducted on 100 icteric neonates hospitalized in the hospitals of the city of Kashan during the year 2014. They were randomly assigned into two equal groups of intervention and control groups. The case group was treated by photo plus fluid therapy whereas the control group was treated by the phototherapy only. The bilirubin level of neonates was measured at admission, 6, 12 and 24 hours after the start of the treatment in both groups. The rebound bilirubin level was measured 12 hours after the termination of the phototherapy. The results of analysis indicated that there was no significant difference in the bilirubin decrease between the photo plus fluid therapy and the phototherapy-only group after 6, 12 and 24 hours of treatment (p>0.05). However, when the bilirubin level of the treated group was very high there was a significant difference between the bilirubin decrease of the photo plus fluid therapy and the phototherapy group alone after 6, 12 and 24 hours of treatment (p<0.05). The level of bilirubin rebound in the photo plus fluid therapy was more than the control group and needed-phototherapy again; therefore, the time for the phototherapy in the photo plus fluid therapy was longer than the control group. Despite the fact that using fluid therapy in the group with very high level of bilirubin causes decrease of bilirubin level, it leads to the increase of bilirubin rebound and the need to use phototherapy again. Therefore, this treatment is useful for the cases of severe jaundice that require blood transfusion even though it results in longer periods of phototherapy and the length of hospitalization.