A STUDY ON ELECTROLYTE CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINAEMIA

BACKGROUND Hyperbilirubinemia is the most common ailment requiring medical attention in newborns. Neonatal hyperbilirubinemia nearly affects 60% of term & 80% of preterm neonates during the first week of life. Neonatal jaundice has much higher incidence in premature babies and often requires therapeutic intervention. Neonatal physiological jaundice could result either due to increased breakdown of foetal erythrocytes or low concentrations of hepatic glucuronyl transferase. Hypocalcaemia is one of the known adverse effects of phototherapy. 90% of the preterm and 75% of the full-term neonates develop hypocalcaemia post phototherapy. We intended to study the effects of photo therapy on serum electrolytes (Na+, K+, Ca++). METHODS It is a prospective interventional study. Neonates who were born or admitted to 'Sardar Vallabhbhai Patel Postgraduate Institute of Pediatrics (SVP PG IP), Sriram Chandra Bhanja (SCB) Medical College and Hospital, Cuttack, Odisha, from October 1st, 2016 to September 30th, 2018 receiving phototherapy for unconjugated hyperbilirubinemia after 24 hrs. of life without any co-morbidities were studied. RESULTS Serum calcium and serum sodium levels decrease with increasing duration of phototherapy. The comparative correlation between the preterm and term neonates considering the change in calcium level before and after phototherapy shows more change in values in term neonates. CONCLUSIONS Electrolyte changes are seen more commonly in pre-term neonates. The incidence of hypocalcemia was 22%, it was 51.6% at >48 hrs. duration of phototherapy (PT) and 52.9% in preterm neonates. The incidence of hyponatremia was 10%, it was 19.3% at >48 hrs. duration of PT and 29.4% in preterm neonates. The mean serum calcium levels before and after PT were 1.08 +/- 0.135 mmol/L and 1.008 +/- 0.161 mmol/L respectively.