Hyperbilirubinemia Connected with Parenteral Administration of Higher Amounts of Fluids in Premature Infants

Abstract

During a study on the influence of different amounts of fluid intake on water and electrolyte metabolism in the first 3 days of life, a high incidence of hyperbilirubinemia was observed in infants receiving a large water load (150 ml/kg/24 h) intravenously. The amount of meconium excreted during the 3-day period in newborns with total parenteral alimentation was significantly lower than in controls. Hyperbilirubinemia is considered to be due to the enterohepatic circulation of bilirubin present in the retained meconium. The role of slight hemolysis and insufficient stimulation of choleresis is discussed.

Induction of Early Meconium Evacuation: Is It Effective in Reducing the Level of Neonatal Hyperbilirubinemia?

“…5 This was supported by clinical observations that earlier meconium evacuation was indeed associated with lower bilirubin levels and decreased risk for clinically significant neonatal jaundice. [10][11][12][13][14][15] Several studies have evaluated the effect of stimulating early meconium evacuation on serum bilirubin levels. Cotrell et al 9 have shown that rectal stimulation not only enhanced early meconium evacuation, but also caused a mean reduction of 1 mg/dL in serum bilirubin levels.…”

“…8,9 Previous studies have shown that early meconium evacuation was associated with lower bilirubin levels and decreased risk for clinically significant neonatal jaundice. [10][11][12][13][14][15] It thus seemed plausible that meconium evacuation facilitated with the use of glycerin suppositories might prevent the effect of increased enterohepatic recirculation on serum bilirubin, thus decreasing the risk of neonatal jaundice. However, to date, the data are inconclusive; some claim that it works, 16 whereas others show no effect.…”