title: A randomized controlled trial of fluid supplementation in term neonates with severe hyperbilirubinemia.
abstract: OBJECTIVE
  To evaluate the effectiveness of fluid supplementation in decreasing the rate of exchange transfusion and the duration of phototherapy in term neonates with severe nonhemolytic hyperbilirubinemia.
  
  
  METHODS
  This was a randomized controlled trial conducted in a tertiary care referral unit in northern India. Seventy-four term neonates with severe nonhemolytic hyperbilirubinemia (total serum bilirubin > 18 mg/dL [308 micromol/L] to < 25 mg/dL [427 micromol/L]). The subjects were randomized to an "extra fluids" group (intravenous fluid supplementation for 8 hours and oral supplementation for the duration of phototherapy; n = 37) or a control group (n = 37).
  
  
  RESULTS
  At inclusion, 54 infants (73%) had high serum osmolality, including 28 (75%) in the extra fluids group and 26 (70%) in the control group. The proportion of infants who underwent exchange transfusion was lower in the extra fluids group than in the control group: 6 (16%) versus 20 (54%)(P = .001; relative risk = 0.30; 95% confidence interval = 0.14 to 0.66). The duration of phototherapy was also shorter in the extra fluids group: 52 +/- 18 hours versus 73 +/- 31 hours (P = .004).
  
  
  CONCLUSIONS
  Fluid supplementation in term neonates presenting with severe hyperbilirubinemia decreased the rate of exchange transfusion and duration of phototherapy.
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Shailender
authors.initials: S
authors.lastname: Mehta
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Anil
authors.initials: A
authors.lastname: Narang
mesh_terms: D000704:Analysis of Variance; D003131:Combined Modality Therapy; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy*; D007194:India; D007231:Infant, Newborn; D008297:Male; D009994:Osmolar Concentration; D010789:Phototherapy; D044967:Serum / Q000502:physiology; D016896:Treatment Outcome