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Evaluation of high risk neonates for electrolyte imbalances following phototherapy

Anik Kumar Majumder and Gayatri Bezboruah

Background: Neonatal hyperbilirubinemia is the leading cause of NICU readmission. Excess bilirubin may enter into the brain and causes bilirubin encephalopathy. Therefore appropriate treatment is of paramount important and phototherapy is the mainstay of treatment. Phototherapy has its own adverse effects amongst them electrolytes imbalance is a common complication.
Aims and objectives: To evaluate the high risk neonates for electrolyte imbalances following phototherapy and compare the electrolyte changes between term and preterm neonates.
Methods and materials: A prospective hospital-based observational comparative study conducted on 206 eligible neonates admitted in NICU receiving phototherapy from 1st July 2017 to 31st June 2018. Serum bilirubin and electrolytes were determined before (controls) and after the termination of phototherapy or 48 hours of phototherapy whichever is earlier and analyzed and compared by using SPSS.
Results: In our study, 80 were LBW, 71 were preterm neonates and 8 were post term neonates. LBW (26.25%) had developed hypocalcemia following phototherapy more than normal weight neonates (7.94%) which was statistically significant. 25.34% preterm were having hypocalcemia as compared to 10.24% term neonates which were also statistically significant (p<0.022). Incidences of hyponatremia following phototherapy in LBW (18.75%) and preterm (18.31%) were significantly more than normal weight (10.32%), term neonates (11.02%). 10% LBW neonates had developed hypokalemia compare to 4.23% of normal weight neonates. We found no correlation between incidences of hypomagnesemia with gestational age. The mean values of all electrolytes were more declined following phototherapy in LBW and preterm than normal birth weight, term neonates.
Conclusion: Preterm and LBW neonates are in high risk group for developing electrolyte imbalances and they need continuous monitoring.

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