Background: Acute kidney injury (AKI) is one of the most common complication observed in perinatal asphyxia. Early recognition is required for appropriate treatment and improve the outcome.Methods: It is a hospital based retrospective study conducted from august 2019 to December 2019. Total 85 full term neonates with perinatal asphyxia were included in the study. Renal functions were assessed by monitoring urine output, serum creatinine and ultrasonography. Acute kidney injury assessed by pRIFLE criteria and HIE staging is done by modified Sarnat and Sarnat staging. Severity of AKI is correlated with stages of HIE. AKI is managed as per unit protocol.Results: Total 85 perinatal asphyxia neonates were included in the study. Out of total 85 neonates, 25 (29.4%) neonates had evidence of acute kidney injury. Among 25 neonates with acute kidney injury, higher percentage was observed in male neonates which was 14 (56%) against 11 (44%) among female neonates. Predominantly, non oligouric acute kidney injury was observed among acute kidney injury neonates which accounted to 20 neonates (80%) (p-0.258). Serum creatinine between 1.5-2 mg/dl was observed in 18 (21.1%) neonates and 7 (8.2%) neonates had creatinine between 2-3 mg/dl. Sonological abnormality was noted in 2 (2.3%) neonates. Among neonates with non oligouric AKI, 3 (12%) neonates had HIE stage 1, 15 (60%) had HIE-2 and 7 (28%) had HIE-3. However, neonates with non oligouric AKI were higher among HIE 2 when compared to neonates with oligouric renal failure who were higher in HIE 3. No mortality occurred among these neonates.Conclusions: Majority of the neonates with perinatal asphyxia had non oliguric AKI which responded well to conservative treatment. AKI is most commonly seen in HIE stage 2 babies. Since non oligouric renal failure was a predominant finding among asphyxiated neonates, Serum creatinine monitoring remains main stay of diagnosis.
The incidence of neonatal hyperbilirubinemia (>15 mg/dl); NNF India national neonatal perinatal database network 2002-03 report was 3.3% for intramural deliveries and 22.1% for outborns. 1 In very low birth weight (VLBW) neonates, the incidence of significant jaundice (requiring phototherapy and or exchange transfusion) was 76.6%, with 37.3% requiring an exchange transfusion. 2 Neonatal hyperbilirubinemia is the most common reason for readmission after early hospital discharge. Concerns regarding jaundice have increased after reports of bilirubin induced brain damage occurring in healthy infants even without hemolysis.
Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.
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