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Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemia
Author(s) -
Boo NY,
Lee HT
Publication year - 2002
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2002.00746.x
Subject(s) - medicine , enteral administration , neonatal intensive care unit , gestational age , randomized controlled trial , abdominal distension , vomiting , jaundice , bilirubin , anesthesia , pediatrics , gastroenterology , parenteral nutrition , pregnancy , biology , genetics
Objective : To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy. Methods : A randomized controlled study was carried out in the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia over a 12‐month period. Fifty‐four healthy term infants with severe hyperbilirubinemia were randomized to receive either solely enteral feeds ( n = 27) or both enteral and intravenous ( n = 27) fluid during phototherapy. Results : There were no significant differences in the mean birthweight, mean gestational age, ethnic distribution, gender distribution, modes of delivery and types of feeding between the two groups. Similarly, there was no significant difference in the mean indirect serum bilirubin (iSB) level at the time of admission to the NICU between the enteral (359 ± 69 μmol/L [mean ± SD]) and intravenous group (372 ± 59 μmol/L; P = 0.4). The mean rates of decrease in iSB during the first 4 h of phototherapy were also not significantly different between the enteral group (10.4 ± 4.9 μmol/L per h) and intravenous group (11.2 ± 7.4 μmol/L per h; P = 0.6). There was no significant difference in the proportion of infants requiring exchange transfusion ( P = 0.3) nor in the median duration of hospitalization ( P = 0.7) between the two groups. No infant developed vomiting or abdominal distension during the study period. Conclusion : Severely jaundiced healthy term infants had similar rates of decrease in iSB levels during the first 4 h of intensive phototherapy, irrespective of whether they received oral or intravenous fluid supplementation. However, using the oral route avoided the need for intravenous cannulae and their attendant complications.