Effect of Phototherapy on Electrolytes, Liver and Kidney Functions During Treatment of Neonatal Hyperbilirubinemia. A Prospective-Analytical Study

Abstract

Background: Neonatal jaundice is a frequent problem affecting the newborn with various etiologies. Although phototherapy is considered the standard treatment for neonatal hyperbilirubinemia, it has some complications, as erythematous rashes, diarrhea, hyperthermia and electrolyte disturbance. Objective: To assess the effect of phototherapy on liver enzymes, renal functions, and serum electrolytes in jaundiced neonates before and after phototherapy and to assess changes in biochemical parameters according to mode of treatment including using Bilisphere then phototherapy, IVIG & Bilisphere then phototherapy and phototherapy only. Methods: One hundred neonates with unconjugated hyberbilirubinemia were enrolled. Jaundiced neonates were placed under phototherapy at a distance of 45-50 cm. Laboratory investigations were done before and after phototherapy. Results: Mean (± SD) TSB and DSB significantly declined after phototherapy with p value <0.001. Also, Mean (± SD) levels of AST and ALT showed statistically significant decrease after phototherapy (p<0.001). In addition, Mean (± SD) creatinine and urea levels showed statistically significant decrease after phototherapy (p<0.001).We also found statistically significant decrease in potassium and Calcium levels (p-value < 0.001) after treatment. As regards mode of treatment, we found a statistical significant decrease in TSB, creatinine and calcium among the different modes of treatment (p<0.001). Conclusion: Neonatal hyperbilirubinemia is considered a treatable condition and much of its ill-effects can be eliminated by proper intervention.However, continuous observation of electrolytes as potassium, sodium and calcium is needed as disturbance in their levels is of concern.