The effect of hat on phototherapy-induced hypocalcemia in jaundiced full-term neonates

Ezzeldin, Zahraa; Mansi, Yasmeen; Abdel-Hamid, Tamer A.; Sabry, Mohamed

doi:10.2147/rrn.s83393

Cited by 6 publications

(1 citation statement)

References 7 publications

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“…Studies have revealed that phototherapy involves a risk of hypocalcemia. [41][42][43] Thus, the risk of hypocalcemia induced by long courses of phototherapy maybe decreased by shorting the duration of phototherapic time through supplementation with the supplementation of B. animalis CP-9, particularly in the first 24 h of the therapeutic period. However, several limitations of study should be discussed.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study

et al. 2022

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Background: Probiotics had been used to decreased bilirubin level in neonatal jaundice (NJ) without being further studied mechanism and stratification. The intestinal pathogen Escherichia coli produced β-glucuronidase would increase enterohepatic circulation and elevate serum bilirubin levels (SBLs) which might worsen the disease process of NJ. Study objective:We hypothesized that some probiotics could decrease bilirubin level through inhibiting the growth of E. coli. It's assumed that adjuvant probiotic intervention might accelerate the phototherapy for NJ and alleviate the severity of the NJ. Besides, it's further study the efficacy of the probiotic intervention in NJ among the full-term and preterm newborns.Materials and methods: Firstly, the Bifidobacterium animalis subsp. lactis CP-9 was screened for its anti-E. coli activity. Then, it was orally administered to newborns with NJ in combination with conventional phototherapy (wavelength 425-457 nm) to determine its efficacy. 83 neonatal patients whose serum bilirubinemia was at a concentration of ≥ 15 mg/dL were participated the double-blind randomized trial and conducted in the neonatal ward of China Medical University Children's Hospital (CMUCH, Taichung, Taiwan). The test was conducted in 2 groups: experimental group: phototherapy + B. animalis subsp. lactis CP-9 (n = 43; 5 × 10 9 CFU/capsule) and control group: phototherapy + placebo (n = 40). The SBL and total phototherapy duration were measured.Results: The experimental group showed improved serum bilirubin decline rate (−0.16 ± 0.02 mg/dL/h; P = .009, 95% CI -0.12 to -0.2), particularly in the first 24 hour of in-hospital care, and reduced total phototherapy duration (44.82 ± 3.23 h; P = .011, 95% CI: 51.3-38.2) compared with the control group. Especially, probiotics had a significant therapeutic effect (serum bilirubin decline rate: −0.18 ± 0.02 mg/dL/h, 95% CI -0.12 to -0.23, P = .014; phototherapy duration: 43.17 ± 22.72 h, 95% CI 51.9-34.3, P = .019) in the low-risk subgroup (full-term newborns).Conclusions: In conclusion, B. animalis subsp. lactis CP-9 synergistically improves treatment outcomes of NJ during in-hospital phototherapy including reduced total phototherapy duration and improved serum bilirubin decline rate, particularly in full-term newborns.Abbreviations: B. animalis CP-9 = Bifidobacterium animalis subsp. lactis CP-9, E. coli = Escherichia coli, MRS agar plates = de Man, Rogosa, and Sharpe agar plates, NJ = neonatal jaundice, SBLs = serum bilirubin levels.

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Section: Discussionmentioning

confidence: 99%

Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study

et al. 2022

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Phototherapy induced hypocalcemia in neonates: A case

Goyal¹,

Sharma²,

Dabi³

2018

Indian J Child Health

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Objective: The objective of the study was to evaluate the adverse effects of phototherapy both total and ionic calcium levels in neonates. Methods: A case–control prospective study was conducted in the Department of Pediatrics, over a period of 15 months. All neonates preterm or term with icterus in phototherapy range formed the study group(s). Serum calcium total and ionized were measured on a serial basis. Results: Neonates in the study group had significant fall in total serum calcium after phototherapy (0.94±0.49 mg/dl). Similarly, ionized serum calcium also decreased after phototherapy in study group (0.56±0.36 mg/dl), p<0.001 statistically significant. The overall incidence of hypocalcemia was 9.6%, higher in preterm (11.7%) than term (8.5%) neonates. Jitteriness and irritability both were seen in 25% of the neonates. None of the neonate had convulsion, but it may occur if the level falls further. Conclusions: While giving phototherapy to a premature baby or a sick baby we should monitor serum calcium levels. Prophylactically oral supplementation of calcium may be considered in newborns receiving phototherapy as it induces hypocalcemia.

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An observational study: Correlation of serum calcium levels in relation to phototherapy in term newborns

Gupta¹,

Mandot²,

Goyal³

2020

Indian J Child Health

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Background: Hyperbilirubinemia is one of the most prevalent problems in neonates. Jaundice is observed during the 1st week of life in approximately 60% of term neonates and 80% of preterm neonates. Phototherapy is one of the routine methods for the management of hyperbilirubinemia. Objective: The objective of this study was to assess the effect of phototherapy on serum calcium levels in term newborns with neonatal hyperbilirubinemia. Materials and Methods: Full-term newborns admitted in the postnatal ward with hyperbilirubinemia were included in the study population. Serum calcium estimation was done before phototherapy and all newborns were subjected to double surface phototherapy. After 24–48 h of phototherapy, serum calcium was estimated again and compared with the earlier value. Results: A total of 50 newborns were included in the study. After phototherapy, serum calcium levels were 7.31–7.60 mg/dl in 20 newborns, 7.61–7.90 mg/dl in 19 newborns, 7.0–7.30 mg/dl in 7 newborns, and 7.91–8.20 mg/dl in 4 newborns. This reduction in calcium level was found to be statistically significant (p<0.05). None of them were symptomatic. Conclusion: This implies that decrease in calcium levels is one of the major complications of phototherapy. It was also identified in the study that the babies given phototherapy for longer duration showed higher chances of hypocalcemia.

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The effect of hat on phototherapy-induced hypocalcemia in jaundiced full-term neonates

Cited by 6 publications

References 7 publications

Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study

Adjuvant probiotic Bifidobacterium animalis subsp. lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study

Phototherapy induced hypocalcemia in neonates: A case

An observational study: Correlation of serum calcium levels in relation to phototherapy in term newborns

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