Effects of Fluid Therapy with Phototherapy in Neonatal Hyperbilirubinemia

Jaundice is one of the most common problems of neonatal period. It is important because of toxic effect of unconjugate bilirubin on brain and its many severe complications so that invention of a new approach to achieve earlier recovery has always been an issue.

The purpose of this study was to determine the effect of intravenous fluid therapy in addition to phototherapy in reduction of serum bilirubin of affected neonates admitted in hospitals.

The present study was carried out on 60 neonates with indirect hyperbilirubinemia, weighting over 2500 grams, age over 72 hours, total serum bilirubin 17-25 mg/dl, direct bilirubin < 2mg/dl and without systemic and hemolytic diseases (except for glucose-6-phosphotase deficiency) in Imam Sajjad Hospital of Yasuj from May to September 2001. Patients were randomly divided into the study group and control group. In control group, only conventional phototherapy was used and in the study group, intravenous fluidtherapy dextrose water 10%,1.5 times as much as maintenance requirement with NaCl 3 meq/100 cc fluid for a 24 - hour duration, in addition to conventional phototherapy. The patients were discharged when their serum bilirubin reached 12 mg/dl.

Statistically, no significant difference was found between the two groups in terms of age, weight and level of serum bilirubin in admission time. The mean duration of admission in study group was 3.23 days and in control group 4.53 days (P= 0.00005). Also the mean of total serum bilirubin in control and study groups after 24 and 48 hours following treatment were reduced to 16.27 mg/dl and 15. 18 mg/dl (P= 0.039) and 14.29 mg/dl and 12.65 mg/dl (P= 0.0006), respectively.

Maintaining adequate hydration with fluids containing 10% dextrose for infants receiving phototherapy results in faster decline in serum bilirubin level and, therefore, earlier discharge from hospital.