Electrolyte changes in neonates ≥ 35 weeks gestation receiving phototherapy for neonatal jaundice

Abstract

Introduction: Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period. High serum bilirubin levels can be toxic for central nervous system development and may cause behavioural and neurological impairment (Kernicterus) even in term newborns. Phototherapy is one of the most effective ways available in preventing the neurotoxic complications of indirect hyperbilirubinemia. Methodology: It is a prospective interventional study. Ethical clearance was obtained from institutional ethical committee. Neonates who were born or admitted to a tertiary care centre from September 2020 to August 2021, receiving Light Emitting Diode(LED) phototherapy for unconjugated hyperbilirubinemia after 24 hrs of life without any co-morbidities were involved in the study. Results: A total of 100 neonates were involved of which 55 were males and 45 were females (Figure 1). The mean sodium, potassium and calcium level before therapy were 147.6±5.2, 4.9±0.3, and 9.6±0.6 respectively. After phototherapy the mean sodium, potassium and calcium level were 142.3±5.6, 4.1±0.5 and 8.5±0.7 respectively. There was significant difference in sodium level before and after phototherapy with p-value= 0.02. But, in level of Potassium there But, in level of Potassium there was no significant difference (p=0.31) due to phototherapy before and after. Before phototherapy none of baby had hyponatremia while after phototherapy 8.7% cases had hyponatremia. Similarly, hypocalcaemic was present in 4.2% cases before phototherapy and after phototherapy 28.3% cases had hypocalcaemic which was found significant statistically. Conclusion: Neonatal hyperbilirubinemia can easily pickup on clinical examination however require quick and on the spot treatment. If not treated properly, it leads to many complications. Currently the best treatment option for jaundice is photo therapy.