Effect of Photothrapy on Serum Sodium and Potassium in Neonates with Hyperbilirubinemia

Introduction: Neonatal hyperbilirubinemia is the leading cause of NICU readmission and also the most common abnormal physical finding during the first week of life for which most of the neonates are admitted to NICU. Hence appropriate management of this is of paramount importance. Phototherapy plays a significant role in treatment. However, this treatment modality has side effect on the serum electrolytes. Aims and Objectives: To evaluate the changes in serum sodium and potassium in neonates receiving phototherapy and to find the high risk neonates for the changes and to compare the effect in between preterm and term neonates receiving phototherapy. Methods and materials: A prospective hospital based observational comparative study conducted on 206 eligible neonates admitted in NICU from 1st July 2017 to 31st June 2018. Serum bilirubin and Sodium (Na), Potassium (K) were determined before (controls) and after termination of phototherapy or 48 hours of phototherapy whichever is earlier and analyzed and compared by using SPSS (Version 21.0). Results: Out of 206 neonates, 127 were term, 8 were post term and 71 were preterm.80 neonates (38.83%) were LBW and out of them 45 were male and 35 were female. The mean weight was 2.61?0.5141kg. In our study, mean TSB after and before phototherapy was 18.13?2.414 and 13.73?1.955 with a significant fall in the TSB level after phototherapy (p less than0.0001).71.84% of neonates had a reduction of S. sodium from the initial value, in which 67.96% had a reduction of less than5% and 3.88% had a reduction of 5-10% from the base value which was significant (pless than0.0001). A reduction of S. potassium (64.08% cases) following phototherapy but the incidences of having hypokalemia were not statistically significant.18.75% of LBW and 18.31% preterm neonates had developed hyponatremia compared to only 10.32% of normal birth weight and 11.02% term neonates had developed hyponatremia following phototherapy. A significant reduction of mean serum potassium levels were found after phototherapy but no association was found between incidence with gestational age or birth weight. Conclusion: Phototherapy causes significant imbalances in serum sodium level and reduction in serum potassium level. Preterm and LBW neonates are found to be high-risk group in our study and they need continuous close monitoring.