Impact of phototherapy type and duration on serum electrolytes and blood glucose in neonatal hyperbilirubinemia: a prospective single-center cohort study

Abstract

Abstract Background Neonatal hyperbilirubinemia (NH) is among the common neonatal morbidities. Phototherapy is its most used therapeutic intervention. Different delivering systems and types are currently available. This study aimed to detect and compare the effects of the different phototherapy types on serum electrolytes and blood glucose and to study the effect of phototherapy duration on them. Results Five hundred healthy newborns with indirect NH were treated by different phototherapy types (conventional, light emitting diode LED, intensive) according to severity and availability. Serum sodium (Na), potassium (K), calcium (Ca), blood urea nitrogen (BUN), creatinine (Cr), and blood glucose (Glu) were measured repeatedly over 48 h of phototherapy. In this prospective cohort study, 273 (54.6%) neonates were exposed to conventional phototherapy, 145 (29.0%) to LED, and 82 (16.4%) to intensive phototherapy. A highly significant negative correlation was found between phototherapy duration and serum levels of Na, K, Ca, BUN, and Cr ( p < 0.001). There was a positive correlation between phototherapy duration and blood glucose level ( p = 0.005). Each type of phototherapy individually significantly affected the Na, K, Bun, Cr, and Ca levels after 48 h. Comparing the effects of the 3 different phototherapy types together, no significant differences apart from a decline in potassium level at 48 h ( p = 0.043) were recorded. Conclusions Serum electrolytes significantly decreased during phototherapy. These changes were affected by the phototherapy duration. The type of phototherapy had only some effect on serum potassium.