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Isotonic versus Hypotonic Fluid Supplementation in Term Neonates with Severe Hyperbilirubinemia - A Double Blind, Randomized Controlled Trial.
MedLine Citation:
PMID:  22040311     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  To compare the incidence of hyponatremia in full-term neonates with severe hyperbilirubinemia, receiving intravenous fluid supplementation with 0.2% saline in 5% dextrose versus 0.9% saline in 5% dextrose, to prevent blood exchange transfusion. Methods:  In this double blind randomized controlled trial, full-term appropriate for gestational age newborns (≥37 weeks) with severe non-hemolytic hyperbilirubinemia (serum bilirubin ≥20 mg/dL) were enrolled. Eligible neonates were randomized to receive either 0.2% saline in 5% dextrose (hypotonic fluid group) or 0.9% saline in 5% dextrose (isotonic fluid group) over 8 hrs, in addition to phototherapy. The primary outcome was proportion of neonates developing hyponatremia (serum Na <135 mmol/L) after 8 hours. Results:  Forty-two neonates were analyzed in each group. Proportion of neonates developing hyponatremia after 8 hours was higher in hypotonic fluid group as compared to isotonic fluid group (48.8% vs. 10.5%, p<0.001). However, a larger proportion in isotonic fluid group developed hypernatremia (39.5% vs. 12.2%, p<0.001). The rate of blood exchange transfusion was similar in both groups. Conclusion:  In full-term neonates with severe hyperbilirubinemia, administration of hypotonic fluid to prevent blood exchange transfusion was associated with a higher incidence of hyponatremia while isotonic fluid was associated with an increased incidence of hypernatremia.
Authors:
Karthik Balasubramanian; Praveen Kumar; Shiv Sajan Saini; Savita Verma Attri; Sourabh Dutta
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-31
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  -     ISSN:  1651-2227     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Acta Paediatrica © 2011 Foundation Acta Paediatrica.
Affiliation:
Neonatal unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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