Frequency of electrolyte imbalance in neonates receiving phototherapy.

Abstract

Objective: To determine the frequency of electrolyte imbalance in neonates receiving phototherapy. Study Design: Cross Sectional study. Setting: Department of Pediatrics, National Institute of Child Health (NICH), Karachi, Pakistan. Period: July 2024 to December 2024. Methods: A total of 192 neonates between 2^nd and 14^th day of life, and presenting with jaundice and hyperbilirubinemia (total serum bilirubin>5 mg/dl) were analyzed. Demographic details were documented. Blood samples were sent for the evaluation of baseline serum bilirubin, and electrolyte levels. Duration of phototherapy was 48 hours. Post-treatment after 48-hours, serum bilirubin, and electrolyte evaluation was performed. Results: In a total of 192 neonates, 105 (54.7%) were male. The mean age, and gestational age were 8.24± 2.61 days, and 38.5±1.44 weeks. After 48 hours of phototherapy, a significant reduction was observed in total bilirubin (p<0.001), direct bilirubin (p<0.001), and indirect bilirubin (p<0.001). After 48 hours of phototherapy, decrease in the proportion of neonates with normal levels was observed for sodium (82.3%, p=0.736), chloride (77.6%, p=0.776), calcium (80.7%, p=0.475), potassium (81.8%, p=0.302), and magnesium (87.5%, p=0.195). The proportion of hypocalcemia increased from 14.6% to 18.8%, hypokalemia from 10.9% to 15.6%, and hypomagnesemia from 8.9% to 12.5%. Conclusion: This study highlights the effectiveness of phototherapy, and its potential to cause electrolyte disturbances. While the reductions in serum sodium, chloride, calcium, potassium, and magnesium levels were statistically significant, their clinical relevance remains uncertain.