Electrolyte Imbalances Resulting from Phototherapy Use in Neonatal Hyperbilirubinemia in Suez Canal University Hospital’s Neonatal Intensive Care Unit.

Abstract

Background: Neonatal hyperbilirubinemia is a very common clinical problem during the neonatal period. It occurs due to excessive formation of unconjugated bilirubin and limited ability of neonatal liver to rapidly clear it from the blood. Phototherapy is one of the most effective ways available in preventing the neurotoxic complications of indirect hyperbilirubinemia, but it can cause unwanted side effects including electrolyte abnormalities. Aim: To estimate serum electrolyte levels in neonates before and after phototherapy and to detect electrolyte imbalances arising due to phototherapy if they ever occurred. Patients and methods: This prospective hospital based observational comparative study was conducted on forty eligible neonates admitted to Suez Canal University Hospital’s Neonatal Intensive Care Unit with unconjugated hyperbilirubinemia not associated with any co-morbidity. Results: Differences in serum electrolytes (sodium, potassium, ionized calcium, magnesium) and creatinine levels after different intervals of phototherapy were statistically significant (P value for all electrolytes were <0.001) ; all cases had normal serum electrolyte levels on admission, 45% of them developed hyponatremia, 30% had hypokalemia, 65% encountered hypocalcemia, 32.5% developed hypomagnesemia and 25% of cases had elevated serum creatinine level more than normal after 48 hours or more of phototherapy. There was a statistically significant relationship between gestational age and changes that occurred in serum sodium level after 48 hours or more of phototherapy (P value 0.001). Conclusion: Phototherapy results in remarkable decline in serum bilirubin level together with different effects on serum electrolytes (sodium, potassium, ionized calcium, magnesium) and creatinine.