Effect of Phototherapy on Various Biochemical Parameters in Neonatal Hyperbilirubinaemia: A Clinical Insight
Introduction: Neonatal Hyperbilirubinaemia (NH) is a very common complication in newborns. It occurs due to excessive formation of unconjugated (indirect) bilirubin and inability of neonatal liver to rapidly clear it from blood. Phototherapy is the first and most common treatment for jaundice in...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2018-04-01
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| Series: | Indian Journal of Neonatal Medicine and Research |
| Subjects: | |
| Online Access: | http://www.ijnmr.net/articles/PDF/2230/34772_CE[VSU]_F_(AnG)_PF1(VSU_AnG)_PFA(AnG)_PB(VSU_AnG).pdf |
| Summary: | Introduction: Neonatal Hyperbilirubinaemia (NH) is a very
common complication in newborns. It occurs due to excessive
formation of unconjugated (indirect) bilirubin and inability of
neonatal liver to rapidly clear it from blood. Phototherapy is
the first and most common treatment for jaundice in newborns
and in most cases is the only treatment required.
Aim: To assess the changes in various other biochemical
parameters including proteins, enzymes, lipids, urea,
creatinine and uric acid levels in plasma/serum of pre and
post phototherapy treated in full term jaundiced neonates.
Materials and Methods: This prospective hospital based
comparative study was conducted in the Department of
Biochemistry and Paediatrics, Vardhman Mahavir Medical
College and Safdarjung Hospital, New Delhi, India, from
November 2016 to March 2017, after obtaining ethical
clearance from institutional ethical committee and informed
consent from parents or guardians of neonates. The study
included 119 neonates (64 males and 55 females) who were
receiving phototherapy and their data was recorded on a
predesigned proforma. Biochemical assay was measured
using commercially available system pack kits on Fully
Automated Clinical Chemistry Analyser, ADVIA -2400 for the
biochemical parameters. The significance of the difference
between the groups was assessed by student’s ‘t’-test for
pair matched samples. The p-value of <0.05 were considered
statistically significant.
Results: Levels of bilirubin profile were elevated significantly
in patients prior to phototherapy and returned to normal
generally after 48 hours to 96 hours of phototherapy. Levels
of hepatic enzyme markers namely AST, ALP and LDH were
also elevated significantly in the pre phototherapy group
which declined significantly after phototherapy (p<0.05).
Levels of total cholesterol, triglycerides and VLDL showed
significant decline in our study (p<0.05, <0.005 and <0.001
respectively), however no significant changes were observed
in LDL and HDL levels in the patients treated for phototherapy.
Our study also observed significant decline in uric acid
(p<0.001), creatinine (p<0.005), total serum proteins (p<0.001)
and albumin levels (p<0.001). There was also significant decline
in the levels of electrolytes including sodium, potassium,
chloride and calcium (p<0.001 in each case).
Conclusion: Though, it is well known that phototherapy has
a beneficial effect in treatment of NH but its effect on other
biochemical parameters is also noteworthy and therefore the
neonate should be assessed accordingly while on treatment
with phototherapy |
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| ISSN: | 2277-8527 2455-6890 |