Electrolyte changes in the neonates receiving phototherapy
DOI:
https://doi.org/10.18203/2349-3291.ijcp20203170Keywords:
Neonatal hyperbilirubinemia, Phototherapy, Potassium, Sodium and calciumAbstract
Background: Neonatal jaundice is the most commonly observed clinical condition of early neonatal period. It remains a common cause of readmission and important cause of concern for the parents and clinicians. Therefore, appropriate management of neonatal hyperbilirubinemia is of paramount importance. Phototherapy plays a significant role in its management but this modality is not devoid of complications. Authors studied electrolyte changes in the neonates, who received phototherapy.
Methods: This perspective hospital based observational study conducted over the period of one year on 90 eligible admitted neonates who received phototherapy as per AAP guideline. Serum bilirubin, sodium, potassium and calcium were determined before and after termination of phototherapy. The first samples were considered as controls and compared with the samples collected after termination of phototherapy.
Results: The incidence of LBW babies in this study was 21.9%, while mean birth weight and gestational age was2.76±0.38 kg and 38.34±0.88 weeks respectively. Mean duration of phototherapy was 38.48±09.34 hours. The mean sodium, potassium and calcium level before therapy were 146.6±6.2 mg/dl, 4.7±0.47 mg/dl and 9.4±0.73 mg/dl respectively. Authors found statistically significant changes in the electrolyte’s levels (Na+ 141.3±6.1, K+ 4.2±0.51 and Ca+2 8.4±0.68 respectively), after phototherapy however none of any neonate shown any clinical signs of dyselectolytemia.
Conclusions: Neonates undergoing phototherapy are at greater risk of dyselectrolytemia especially in preterm babies therefore close clinical and biochemical monitoring is required for the prompt management of any significant electrolyte imbalance.
References
Paludetto R, Mansi G, Raimondi F, Romano A, Crivaro V, Bussi MD, et al. Moderate hyperbilirubinemia induces a transient alteration of neonatal behavior. Pediatr. 2002;110:e50.
Kiviahan C, Jams EJ. The natural history of neonatal jaundice. Pediatr. 1984;74:364-70.
Martin CR, Cloherty JP. Neonatal hyperbilirubinemia. In Manual of Neonatal Care. In Cloherty JP, Eichenwald EC, Stark AR. 5thedn; Philadelphia, Lippincott Williams and Wilkins; 2004:185-221.
Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in neonates: Types, causes, clinical examinations, preventive measures and treatments: a narrative review article. Iran J Public Health. 2016;45(5):558-68.
Yadav RK, Sethi RS, Sethi AS, Kumar L, Chaurasia OS. The evaluation of effect of phototherapy on serum calcium level. People’s J Sci Res. 2012;5(2):1-4.
Mesic I, Milas V, Medimurec M, Rimar Z. Unconjugated pathological jaundice in newborns. Coll Antropol. 2014;38(1):173-8.
Bowman J. Thirty-five years of Rh prophylaxis. Transfusion. 2003;43:1661-6.
Cremer RJ, Perryman PW, Richards DH. Influence of light on the hyperbilirubinaemia of infants. Lancet. 1958;1(7030):1094-7.
Romagnoli C, Polidore G, Cataldi L, Tortorolo G, Segni G. Phototherapy- induced hypocalcemia. J Pediatr. 1979;94(5):815-6.
Hakanson D, Penny R, Bergstrom WH. Calcemic responses to photic and pharmacologic manipulation of serum melatonin. Pediatr Res. 1987;22(4):414-6.
Hunter KM, Abrams SA. Abnormalities of serum calcium and magnesium. In: JP Cloherty, EC Eichenwald, AR Stark (Eds.) Manual of Neonatal care.7th ed. Philadelphia: Lippincott Williams and Wilkins; 2004:297-300.
Suneja S, Kumawat R, Saxena R. Effect of phototherapy on various biochemical parameters in neonatal hyperbilirubinaemia: a clinical insight. Indian J Neonat Med Res. 2018;6(2):PO13-PO18.
Reddy AT, Bai KV, Shankar SU. Electrolyte changes following phototherapy in neonatal hyperbilirubinemia. Inter J Sci Res. 2013;6(14):2319-7064.
Bezboruah G, Majumder AK. Electrolyte imbalances resulting from phototherapy in neonatal hyperbilirubinemia. J Dent Med Sci. 2019;18(8):51-8.
Rangaswamy KB, Yeturi D, Gowda ANBL, Krishna C, Samyuktha. Study of sodium and potassium changes in term neonates receiving phototherapy. Int J Contemp Pediatr. 2019;6:1076-9.
Rozario CI, Pillai PS, Ranamol T. Effect of phototherapy on serum calcium level in term newborns. Int J Contemp Pediatr. 2017;4:1975-9.
Taheri PA, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcemia in term neonate. Iran J Pediatr. 2013;23(6):710-1.
