Role of intravenous extra fluid therapy in icteric neonates receiving phototherapy

OBJECTIVE: To evaluate the role of intravenous extra fluid therapy in accelerating the reduction of jaundice in newborns who received phototherapy.

METHODS: This study was performed on 100 terms, jaundiced neonates who had a total bilirubin of 18mg/dl or more in the Pediatrics Ward of Ghaem Hospital, Mashhad, Iran from October 2007 to April 2008. The patients were randomly divided into 2 equal groups; group I (case group) were given extra parenteral fluid besides breast feeding, and group II (control group) received only breast milk. The rate of bilirubin decrement, length of hospital stay, and rate of blood exchange were compared.

RESULTS: The rate of serum bilirubin decrease per hour in the first 12 hours after admission in group I (0.41mg/dl [95%CI 0.1] versus 0.38mg/dl in group II [95% CI 0.3], [p=0.22]). It was 0.41mg/dl for group I (95% CI 0.0001), and 0.21mg/dl (95%CI 0.06) for group II in the second 12 hours (p=0.02). After 24 hours, it was 0.38mg/dl in group I (95% CI 0.0001), and 0.29mg/dl in group II (95% CI=0.09) (p=0.037). The mean hospital stay was 68.5 hours in group I, and 67.4 hours in group II (p=0.95).

CONCLUSION: Additional parenteral fluid therapy in icteric newborns can accelerate reduction in serum bilirubin levels in the first 24 hours.