Pre-exchange 5% albumin infusion in low birth weight neonates with intensive phototherapy failure--a randomized controlled trial.
OBJECTIVE
To evaluate the role of 5% albumin infusion before exchange transfusion in reducing post-exchange unconjugated serum bilirubin (UCB) levels in low birth weight (LBW) neonates with intensive phototherapy failure.


METHODS
In a placebo-controlled Randomized Controlled Trial, 42 healthy LBW (birth weight between 1000 and 2499 g and gestational age ≥ 32 weeks) neonates were randomly allocated into intervention and control groups. Post-exchange UCB at 6 and 12 h were compared in the two groups along with the duration of post-exchange phototherapy, repeat-exchange requirement, adverse effects of albumin and hospital stay.


RESULTS
The intervention group (n = 21) with mean birth weight 1619 ± 324 g, gestational age 34.5 ± 1.65 weeks, peak UCB 19 ± 3.85 mg dl(-1), was demographically comparable with the control group (n = 21) (1660 ± 320 g, 34 ± 1.6 weeks, 19.4 ± 3.59 mg dl(-1), respectively). Significant reduction in the post-exchange UCB (10.55 ± 1.53 mg dl(-1) at 6 h; 5.86 ± 1.21 mg dl(-1) at 12 h in albumin group; 15.26 ± 1.78 mg dl(-1) at 6 h; 11.69 ± 1.52 mg dl(-1) at 12 h in control group) and phototherapy duration (23.8 ± 3.2 h vs. 40.3 ± 7.2 h) was observed in the intervention group (p < 0.0001). Repeat exchange requirement was reduced by 86% (RR = 0.14; 95%CI: 0.19-1.06). Mean duration of hospital stay was significantly lower (10.1 ± 5.8 days vs. 12.4 ± 6.6 days) (p = 0.021). No albumin transfusion-related complications were observed.
Mitra
Souvik
S
Department of Pediatrics, Medical College, Kolkata, 88, College Street, Kolkata-700 073, India. souvik4sphs@yahoo.com
Samanta
Moumita
M
Sarkar
Mihir
M
De
Arun Kumar
AK
Chatterjee
Sukanta
S
D000418:Albumins / Q000008:administration & dosage*; D001663:Bilirubin / Q000097:blood*; D003131:Combined Modality Therapy; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D008297:Male; D010789:Phototherapy; D017211:Treatment Failure; D016896:Treatment Outcome
D000418:Albumins; D001663:Bilirubin