Role of Probiotics in Neonates with Hyperbilirubinemia Receiving Phototherapy

2021 ◽  
Vol 15 (11) ◽  
pp. 3112-3115
Author(s):  
Bushra Tariq ◽  
Muhammad Shahman ◽  
Amna Mateen ◽  
Mohammad Taha Kamal ◽  
Anum Nawazish Ali ◽  
...  
Keyword(s):  
Bilirubin Level ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Controlled Trial ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Group I ◽  
Significant Difference ◽  
The Mean

Study Objectives: To compare the mean duration of phototherapy in neonates with hyperbilirubinemia receiving phototherapy with vs. without probiotics. Study Design and Settings: It was a randomized controlled trial carried at Department of Pediatrics, DHQ Hospital Kasur from Jan 2021 to June 2021. Patients and Methods: The present research involved 94 neonates of both genders aged between 2 to 28 days of life diagnosed of neonatal hyperbilirubinemia (serum bilirubin level ≥15mg/dL and direct bilirubin level ≤1.5 mg/dL). These neonates were allocated into two groups randomly. Neonates in Group-I were given probiotics along with conventional treatment of phototherapy whereas neonates in Group-II received conventional phototherapy alone. Study outcome was described in terms of mean duration of phototherapy (phototherapy was stopped when serum bilirubin level was less than 10 mg/dl during the first week and less than 11 mg/dl after the first week) which was recorded and compared between the groups. An informed written consent was taken from parents of every neonate. Results of the Study: The mean age of the neonates was 6.54±4.96 days while the mean gestational age was 37.31±2.04 weeks. There were 55 (58.5%) baby boys and 39 (41.5%) baby girls with a boys to girls ratio of 1.4:1. The mean weight of the neonates was 2.89±0.49 Kg while the mean serum bilirubin level upon admission was 16.73±1.19 mg/dl. The mean duration of phototherapy was significantly shorter in neonates receiving probiotics along with phototherapy as compared to phototherapy alone (3.13±0.92 vs. 3.81±1.12 days; p=0.002). Similar significant difference was observed across various subgroups based on age, gender, gestational age, weight and serum bilirubin level upon admission. Conclusion: Addition of probiotics to conventional practice of phototherapy alone in jaundiced neonates was found to hasten the recovery evident from significant reduction in the mean duration of phototherapy advocating its routine use in future practice. Keywords: Neonatal Hyperbilirubinemia, Phototherapy, Probiotics

Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

2021 ◽  
Vol 17 (2) ◽  
pp. 199-203
Author(s):  
Tehreem Afzal ◽  
Naveed Butt ◽  
Shahzad Munir ◽  
Nazish Zia
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Standard Treatment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Combination Group ◽  
Medical Institute ◽  
Significant Difference ◽  
The Mean ◽  
Time Required

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.  Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

scholarly journals Rebound serum bilirubin levels after single vs. double phototherapy

2014 ◽  
Vol 54 (5) ◽  
pp. 260
Author(s):  
Widyastuti Widyastuti ◽  
Supriatmo Supriatmo ◽  
Guslihan Dasa Tjipta
Keyword(s):  
Randomized Controlled Trial ◽  
Serum Level ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Controlled Trial ◽  
Serum Bilirubin Level ◽  
Exact Test ◽  
Rebound Effects ◽  
Randomized Controlled ◽  
Significant Difference

Background Hyperbilirubinemia is the most common clinicalphenomenon found in newborns. Phototherapy is the standardtreatment for lowering bilirubin levels in neonates. Whileintensive (double) phototherapy produces a more rapid declinein serum bilirubin levels than standard (single) phototherapy,greater rebound effects may occur.Objective To assess bilirubin levels in neonates with hyperbilirubinemiawho underwent single or double phototherapy, includingrebound bilirubin levels after phototherapy termination.Methods An open, randomized, controlled trial was con ductedat H. Adam Malik Hospital and Dr. Pirngadi Hospital, Medan,from August 2009 until January 2010. Subjects with indirecthyperbilirubinemia were divided into two groups. One groupreceived single phototherapy (n = 41) and other receiveddouble photo therapy (n = 40) . Measurements of total plasmabilirubin level were conducted at 12 hours and at 24 hoursof phototherapy, as well as at 24 hours after phot otherapytermination. Rebound bilirubin serum level was defined asan increment of about 1 - 2 mg/dL serum bilirubin afterphototherapy discontinuation.Results The decreases in serum bilirubin levels were significantlygreater in the do uble phototherapy group for observationsat 12 h ours , 24 h ours, and 24 hours after phototherapyt ermination (P = 0.0001). At the 24-hour observation afterterminationofphototherapy, only 1 neonate (2.7%) in the singlephototherapy group compared to 4 neonates (10.8%) in thedouble phototherapy group had serum bilirubin level increasesof 1 - 2 mg/dL. Fisher's exact test did not reveal a significantdifference in rebound serum bilirubin occurrence in the twogroups (P = 0.358).Conclusion Double phototherapy shows significantly greaterdecrease in bilirubin level compared to single phototherapywithin a same period of time. Rebound serum bilirubin levels aftersingle and double phototherapy may occur in some patients withhyperbilirubinemia, as bilirubin production continues. However,260 • Paediatr Irulones, Vol. 54, No. 5, September 2014there is no significant difference in rebound effects between singlevs. double phototherapy.

scholarly journals A study on risk factors associated with neonatal hyperbilirubinemia among newborns at tertiary care level in Kerala, India

2020 ◽  
Vol 7 (6) ◽  
pp. 1415
Author(s):  
Chandramohan Reddy S. ◽  
Sam Varghese
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Clinical History ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Time Interval ◽  
Antenatal Counseling ◽  
Associated Risk Factors

Background: Neonatal hyperbilirubinemia is defined as serum bilirubin levels >7 mg/dl around 85% of all term newborns and most of the premature babies develop clinical jaundice and various associated risk factors are involved in NNH and treatment for this condition depends on gestational age, serum bilirubin levels at different time interval during early life of these newborns and treating them with phototherapy or exchange transfusion. Objective of the study was to establish the relation with the NNH and risk factors among newborns and treatment with the phototherapy if required.Methods: The present prospective study was conducted at Karuna Medical College, Chittur Palakkad from January 2019 to December 2019. A total of 40 samples which are born during the study period were included in the study. All types of gestations (preterm, full term, post term), both genders (male and female), new-borns with risk factors, serum bilirubin (TSB) >7 mg/dl at 48 hrs of life were included in the studyResults: In our study, female samples consists of 55% and male samples were 45% during the study period minimum gestational age was 35 weeks and maximum was 40 weeks. 5% sample with a serum bilirubin level of 9 mg/dl,  with risk factor as a Rh(-ve) incompatibility was treated with phototherapy up to 96 hrs of life.Conclusions: Study conveys various risk factors responsible for NNH and treatment with phototherapy given to the affected new-borns. With good clinical history, risk factors involved in new-borns, antenatal counseling is needed to all pregnant women’s it is necessary to check the serum bilirubin levels and treated with phototherapy to avoid further NNH related complications in the new-borns.

Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 86-89
Author(s):  
Suat Caglayan ◽  
Halil Candemir ◽  
Sadik Aksit ◽  
Savas Kansoy ◽  
Sezin Asik ◽  
...  
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Single Agent ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Treatment Modalities ◽  
Combination Group ◽  
Control Group ◽  
Term Newborns ◽  
Time Required

Objective. To determine the value of oral agar in the treatment of neonatal hyperbilirubinemia and to compare it with two other treatment modalities: phototherapy alone and phototherapy plus oral agar. Methods. Two hundred eight jaundiced full-term newborns were divided into four groups. They were given either phototherapy alone, phototherapy plus oral agar, oral agar alone, or no treatment (control group). The changes in the serum bilirubin values were determined and the results were compared statistically, mainly using analysis of variance. Results. In all three therapy groups, the time required to reduce the bilirubin level to either 15 mg/dL or to 10 mg/dL was significantly shorter than that required by the control group. Although oral agar was found to be as effective as phototherapy, the most significant decrease in bilirubin level was in the combination group. Conclusions. The efficacy of phototherapy in decreasing the serum bilirubin level in neonatal hyperbilirubinemia can be augmented with the use of oral agar. Oral agar can also be used as a single agent for the treatment of neonatal hyperbilirubinemia, since it is as effective as phototherapy.

scholarly journals Comparison of light emitting diode and compact fluorescent lamp phototherapy in treatment of neonatal hyperbilirubinemia

2017 ◽  
Vol 4 (2) ◽  
pp. 341 ◽  
Author(s):  
Maharoof M.K. ◽  
Shamshad Ahmed Khan ◽  
Prakash Robert Saldanha ◽  
Reshad Mohamed
Keyword(s):  
Gestational Age ◽  
Serum Bilirubin ◽  
Light Emitting Diode ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Fluorescent Lamp ◽  
Light Emitting ◽  
The Mean ◽  
Compact Fluorescent Lamp

Background: High levels of total serum bilirubin can cause life threatening complications in neonates requiring management either with phototherapy or exchange blood transfusion. Most commonly used modality of phototherapy is with blue light. There are many bulbs like fluorescent tubes, halogen spotlights etc. Due to disadvantages of the available bulbs, newer method like light-emitting diodes (LEDs) has been investigated as possible alternatives as they produce low heat, has a longer life span with lower energy consumption and rapid reduction of serum bilirubin level. The aim was to compare the efficacy between phototherapy equipped with light emitting diode (LED) to compact fluorescent lamp (CFL) in the treatment of neonatal hyperbilirubinemia among neonates.Methods: A hospital-based intervention study was conducted among 50 neonates born in the hospital during the study period, with gestational age more than equal to 35 weeks, being breastfed and healthy in a private medical college teaching hospital in Dakshina Kannada district from August to September 2016.  Following ethical committee clearance the neonates looking icteric by clinical examination were randomly allocated to receive CFL or LED phototherapy. Baseline, 24 hour total serum bilirubin and rectal temperature was measured.  Results: A total of 50 neonates were randomly allocated into two groups with almost similar characteristics between the two groups with respect to gender, type of delivery and gestational age. The mean bilirubin values (in mg/dl) among neonates in the CFL group and LED group were 14.8 and 15.6 respectively and post 24 hour values were 11.54 and 10.68 respectively. The mean difference in the reduction in the bilirubin values before and after receiving phototherapy between the two groups were significant (p <0.001). The increase in temperature was lesser among LED treatment group.Conclusions: LED therapy is better than the CFL therapy in terms of mean reduction in the total serum bilirubin after a fixed duration of time and lesser raise in temperature among the neonates.  

scholarly journals Effectiveness of single and double phototherapy on indirect hyperbilirubinemia in neonates

2011 ◽  
Vol 51 (6) ◽  
pp. 316 ◽  
Author(s):  
Nanda Susanti Milyana ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Bugis Mardina Lubis ◽  
...  
Keyword(s):  
Neonatal Jaundice ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Controlled Trial ◽  
Spectral Irradiance ◽  
Bilirubin Concentration ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Term Newborns ◽  
The Mean

Background Hyperbilirubinemia is a common problem in full term newborns and phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. Double phototherapy could increase the effectiveness of treatment.Objective To compare the effectiveness of single and double phototherapy and increasing spectral irradiance for decreasing serum bilirubin levels in neonates for indirect hyperbilirubinemia.Methods An open, randomized, controlled trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. Subjects were divided into two groups, those who received single phototherapy (n=30) and those who received double phototherapy (n=30) treatments. We included term newborns with neonatal jaundice in the first week of life. Serum bilirubin and average spectral irradiation levels were measured at baseline and after 12 hours and 24 hours of phototherapy treatment.Results The mean total bilirubin levels of the single and double phototherapy groups at the beginning of therapy were 17.6 mg/dL (SD1.41) and 17.5 mg/dL (SD 1.32), respectively, with no significant difference between values. During the study period the sum of average spectral irradiance by double phototherapy was significantly higher than that of single phototherapy (P < 0.05). A significantly greater decrease in bilirubin levels was observed in the double phototherapy group at 12 hours and 24 hours of phototherapy compared to the single phototherapy group (P = 0.001).Conclusion Double phototherapy is more effective than single phototherapy in reducing bilirubin levels in jaundiced newborns.

Is Cord Blood Bilirubin Level a Reliable Predictor for Developing Significant Hyperbilirubinemia?

2018 ◽  
Vol 36 (03) ◽  
pp. 317-321
Author(s):  
Caner Dogan ◽  
Zeynep Okmen ◽  
Seda Gulec ◽  
Selma Aktas
Keyword(s):  
Cord Blood ◽  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Mode Of Delivery ◽  
Blood Groups ◽  
Serum Bilirubin Level ◽  
Delay In Diagnosis ◽  
Rh Incompatibility ◽  
The Mean

Objective We aimed to investigate whether cord blood bilirubin (CBB) level could be used to identify the newborns at a high risk of developing hyperbilirubinemia. Study Design Total and direct serum bilirubin level were evaluated from umbilical cord blood of newborns. We checked blood groups and Rh status of all mothers and determined blood groups and direct Coombs test (DC) of newborns born to mothers whose blood group was O type or Rh negative to determine the maternal–fetal blood group or Rh incompatibility. Results A total of 418 newborns were included, and phototherapy (PT) was required in 17 newborns. The cutoff value of CBB for predicting the occurrence of significant hyperbilirubinemia requiring PT was 1.67 mg/dL, with a sensitivity of 82% and specificity of 99%. The mean CBB level in babies receiving PT was 2.4 ± 0.9 mg/dL. When blood group, CBB level, DC, gender, and mode of delivery were assigned as possible risk factors, multıvariate analysis showed ABO, Rh incompatibility, and CBB level increased the risk of PT requirement. Conclusion CBB could be useful to determine newborns at a risk of developing hyperbilirubinemia and prevent developing severe complications due to delay in diagnosis.

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

scholarly journals Cord blood bilirubin, albumin, and bilirubin /albumin ratio for predicting subsequent neonatal hyperbilirubinemia

2019 ◽  
Vol 59 (5) ◽  
pp. 244-51
Author(s):  
Jehangir Allam Bhat ◽  
Sajad Ahmad Sheikh ◽  
Roshan Ara
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Early Discharge ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Albumin Ratio ◽  
Level Measurement ◽  
Physiological Values ◽  
Group B

Background Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons, as well as economic constraints. Thus, the recognition, follow-up, and early treatment of jaundice has become more difficult as a result of early discharge from the hospital. Since the dreaded complication of neonatal hyperbilirubinemia is kernicterus, an investigation which can predict the future onset of neonatal pathological jaundice is needed. Objective To investigate the predictability of neonatal hyperbilirubinemia by using cord blood bilirubin, albumin and bilirubin/albumin ratio. Methods This study was conducted on 300 healthy newborns. Umbilical cord blood was used to measure albumin and bilirubin. All infants were regularly followed up to 5th day of life. Neonates were divided into two groups: group A was consisted of neonates who developed jaundice which was in physiological range, while group B was consisted of neonates who developed neonatal hyperbilirubinemia (requiring phototherapy or other modality of treatment). Babies suspected to have bilirubin level which cross physiological limit on any day after birth were subjected to serum bilirubin measurement. Infants whose serum bilirubin level measurement revealed bilirubin levels crossing physiological values were sent to nursery for phototherapy. Results The incidence of neonatal hyperbilirubinemia was 11%. Statistically significant correlations between cord blood bilirubin, albumin, and bilirubin/albumin ratio to the development of neonatal hyperbilirubinemia were observed. On ROC analysis, cut-off points to predict significant hyperbilirubinemia in newborn were cord blood bilirubin >3 mg/dL (sensitivity 60.61%, specificity 97.63%), albumin <2.4 mg/dL (sensitivity 78.79%, specificity 98.13%), cord blood bilirubin/albumin ratio >0.98  (sensitivity 78.79%, specificity 95.51%). Conclusion Cord blood total bilirubin, albumin. and bilirubin/albumin ratio are excellent parameters to predict the occurrence of neonatal hyperbilirubinemia. However, cord blood albumin is better compared to cord blood bilirubin and bilirubin/albumin ratio.

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