Effect of Fluid Supplementation in Severe Neonatal Hyperbilirubinemia

Objective: To evaluate the role of intravenous extra fluid supplementation in accelerating the reduction of serum bilirubin level in neonates and to Find out whether fluid supplementation decrease the total duration of photo therapy and need of exchange transfusion. Methods: Study was conducted at Neonatal ICU at civil, hospital, Ahmedabad over period of 6 months. Eighty four healthy breast-fed neonates with indirect non-hemolytic hyperbilirubinemiawere assigned randomly to receive either breast milk exclusively (case group; n=42) or intravenous fluid in addition to breast milk (control group; n=42). The rate of decrement of serum bilirubin, total duration of phototherapy and exchange transfusion rate were compared. Results: The rate of serum bilirubin decrement per hour in the first 6 hours is 0.58 in group I versus 0.37 in group II (P=<0.0001, z score). It was 0.48 in group I and 0.35 (p<0.0001, z score) for first 12 hours of admission. No. of neonates underwent exchange transfusion were 6 in group I and 13 in group II (p=0.03, fischer exact test). The duration of phototherapy was also shorter in group I (48 ± 16)as compared to group II (62 ± 24) (p=0.002, t-test). Conclusion : Fluid supplementation in severe non hemolytic hyperbilirubinemia can accelerate decrement of serum bilirubin. It also decreases the need of total duration of phototherapy and exchange transfusion.