Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemia

Ny, Boo; Ht, Lee

doi:10.1046/j.1440-1754.2002.00746.x

Cited by 28 publications

(23 citation statements)

References 16 publications

(14 reference statements)

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“…A similar study by Boo et al showed effectiveness of fluid supplementation is reducing serum bilirubin level. 9 Our study provides the fluid deficit along with half of the maintenance requirements by the IV rather than oral route, because the effectiveness of oral rehydration may not be sufficiently reliable and fast in the setting of critical hyperbilirubinemia. One of the mechanisms by which fluid supplementation could have helped is expansion of intravascular volume, leading to slight dilutional lowering of TSB.…”

Section: Discussionmentioning

confidence: 99%

Fluid supplementation in term neonates with severe hyperbilirubinemia: a randomized controlled trial study

Bandyopadhyay

Maiti

2017

Int J Contemp Pediatr

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Background: Severe neonatal jaundice can cause fatality and serious permanent effect, called kernicterus, in which the brain stem nuclei and basal ganglia are damaged. We are encouraged to work on efficacy of fluid supplementation in addition to photo therapy as a measure to reduce bilirubin level more efficiently.Methods: A randomized control trial study was conducted in Department of Paediatric Medicine, Neonatal Unit, R.G. Kar Medical College & Hospital, Kolkata, from April 2011 to March 2012. A total 100 term neonates presenting with severe non-hemolytic hyperbilirubinemia (>18 mg/dl to <25 mg/dl) were enrolled as study population. The study subjects were divided into two equal groups, study group and control group by randomization. The study group was given IV fluid supplementation in addition to photo therapy. Total serum bilirubin (TSB) level assessed periodically and results compared with control group.Results: The study results reveal a statistically significant association between the percent fall in TSB at 12 (Chi2= 7.18, p=0.000) and 24 hours (Chi2=10.69, p=0.000) in the intervention arm compared to the control group.Conclusions: Fluid supplementation along with double surface phototherapy in term neonates presenting with severe hyperbilirubinemia decreases the rate of exchange transfusion and duration of phototherapy.

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Section: Discussionmentioning

confidence: 99%

Fluid supplementation in term neonates with severe hyperbilirubinemia: a randomized controlled trial study

Bandyopadhyay

Maiti

2017

Int J Contemp Pediatr

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“…However, with the increased use of LED lights, the beneficial effect of fluid supplementation in neonates without dehydration becomes questionable, as LED lights have a much lower heat output and therefore less insensible water loss [12,14]. Intravenous fluid support has no effect on the rate of decrease in serum bilirubin and decrease in duration of phototherapy in healthy term newborns with no dehydration [22,23].…”

Section: Fluid Supplementation/hydrationmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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Introduction: Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management. Areas covered: This review focusses on the current neonatal management and outcome of hemolytic disease and discusses postnatal treatment options as well as literature on long-term neurodevelopmental outcome. Expert commentary: Despite major advances in neonatal management, multiple issues have to be addressed to optimize postnatal management and completely eradicate kernicterus. Except for strict adherence to guidelines, improvement could be achieved by clarifying the epidemiology and pathophysiology of HDFN. Several pharmacotherapeutic agents should be further researched as alternative treatment options in hyperbilirubinemia, including immunoglobulins, albumin, phenobarbital, metalloporphyrins, zinc, clofibrate and prebiotics. Larger trials are warranted to evaluate EPO, folate and vitamin E in neonates. Long-term follow-up studies are needed in HDFN, especially on thrombocytopenia, iron overload and cholestasis.ARTICLE HISTORY

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“…Till date three trials have evaluated the role of fluid supplementation in neonatal jaundice [5,7,8] Table 3 Multiple logistic regression analysis G6PD glucose 6 phosphate dehydrogenase extracted the raw data from two previous trials [5,8] for the present study as they had same eligibility criteria and protocol for fluid supplementation. The protocol of fluid supplementation in the third trial [7] was different from both the included trials. The authors could identify only 17 Non-responders in both the trials.…”

Section: Discussionmentioning

confidence: 99%

“…However, when full term neonates with severe hyperbilirubinemia were given fluids in addition to phototherapy, the serum bilirubin decreased much faster [7]. The authors have previously shown the effects of intravenous (IV) fluid supplementation in full term neonates with severe non-hemolytic hyperbilirubinemia in two randomized controlled trials (including one unpublished data) [5,8].…”

Section: Introductionmentioning

confidence: 99%