Role Of Intravenous Fluid Therapy in the Management of Non-Hemolytic Neonatal Hyperbilirubinemia; A Randomized Controlled Trial

Introduction: Neonatal jaundice (NJ) is common among the newborns which is often physiological however, in some cases it may become pathological. Timely detection and treatment for underlying cause may prevent severe consequences like bilirubin encephalopathy. Further, dehydration due to evaporative losses and poor intake of breast feed may worsen the condition and likely to require exchange transfusion which is associated with severe complications. This study was planned to evaluate the effect of fluid therapy in the management of NJ.

Methods: This randomized controlled trial was carried out in the department of pediatrics, Government Medical College, from April 2022 to April 2023. A total of 617 neonates diagnosed with NJ and exposed to intensive phototherapy were divided into two groups as Group 1 (received intravenous fluid (IV) with breast feeding) and group 2 (only breast feeding). The neonates were observed for the rate of fall of total serum bilirubin (TSB), duration of phototherapy and need of exchange transfusion level of rebound bilirubin.

Results: The age and birth weight were statistically similar in both the groups, but significant difference was noted with respect to gender, type of feeding and mode of delivery. The TSB levels decreased significantly in the intervention group compared to the control group at six,12and 24 hours after the treatment. The need of exchange transfusion was less in case group.

Conclusion: The IV fluid supplementations appear to accelerate the decrement of TSB levels and reduce requirement of exchange transfusion.