THE EFFECT OF PHOTOTHERAPY ON SERUM ELECTROLYTES IN NEONATES WITH HYPERBILIRUBINEMIA: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
Neonatal hyperbilirubinemia, Phototherapy, Serum electrolytes, Hyponatremia, Hypocalcemia, Neonatal jaundice
Abstract
Background: Phototherapy is the standard treatment for neonatal hyperbilirubinemia, but its effect on serum electrolytes remains poorly understood. This study aimed to evaluate the impact of phototherapy on serum sodium (Na⁺), potassium (K⁺), and calcium (Ca²⁺) levels in neonates with hyperbilirubinemia.
Methods: A prospective observational study recruited over fifty neonates (gestational age ≥35 weeks) with hyperbilirubinemia requiring phototherapy were enrolled. Serum electrolyte levels were measured before and 24 hours after phototherapy. Subgroup analyses were performed based on gestational age and phototherapy duration. Statistical analysis included paired t-tests, correlation analysis, and multivariate regression.
Results: Significant reductions in serum electrolyte levels were observed post-phototherapy: sodium decreased from 138.5 ± 2.1 mEq/L to 136.3 ± 2.0 mEq/L (p < 0.001), potassium from 4.6 ± 0.3 mEq/L to 4.3 ± 0.2 mEq/L (p = 0.002), and calcium from 9.8 ± 0.4 mg/dL to 9.4 ± 0.3 mg/dL (p < 0.001). Preterm neonates and those receiving phototherapy for >48 hours experienced greater electrolyte changes. Hyponatremia (12%) and hypocalcemia (8%) were the most common abnormalities. Gestational age and phototherapy duration were independent predictors of sodium and calcium changes, respectively.
Conclusion: Phototherapy for neonatal hyperbilirubinemia is associated with significant reductions in serum sodium, potassium, and calcium levels, particularly in preterm neonates and those undergoing prolonged treatment. Regular monitoring of electrolytes is recommended to prevent complications. These findings highlight the need for individualized management strategies in neonates receiving phototherapy.
References
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19. Maisels, M. J., & McDonagh, A. F. (2008). Phototherapy for neonatal jaundice. New England Journal of Medicine, 358(9), 920-928.
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Shereen Khan
Postgraduate Department of Physiology, Government Medical College Srinagar
Saima Farooq
Postgraduate Department of Physiology, Government Medical College Srinagar
Suhail Ahmad
Postgraduate Department of Physiology, Government Medical College Srinagar
Mushtaq Ahmad Wani
Department of paediatrics, District Hospital Ganderbal
Mahpara Nyiem
Postgraduate Department of Physiology, Government Medical College Srinagar