Effect of Light-emitting Diode Phototherapy on Serum Electrolyte Levels in Neonates with Unconjugated Hyperbilirubinemia: A Prospective Single-center Study

Background: Neonatal unconjugated hyperbilirubinemia (NUH) is one of the common morbidities found in the 1st week of life. Phototherapy has been found to be the safest of all the known treatments for neonatal jaundice. Light-emitting diode phototherapy does, however, have some side effects, just like any other therapeutic approach. Objectives: We aimed to study the effect of light-emitting diode phototherapy and their duration on the serum electrolyte (serum sodium, potassium, chloride, and calcium) levels in neonates with unconjugated hyperbilirubinemia (UH) and to study the effect of phototherapy modes on them. Materials and Methods: All stable icteric neonates, gestational age >35 weeks, who received phototherapy for UH were included in the study. A double-surface light-emitting diode phototherapy system (spectrum 430-470 nm) was used. These neonates were subjected to different phototherapy modes: normal and intensive. Total serum bilirubin and serum electrolytes were measured at the start and the end of phototherapy. Paired t-test, independent t-test, and Chi-square test were used for the comparisons. Results: A total of 100 neonates were admitted for phototherapy. The male: female ratio was 1.08:1. The mean birth weight, mean gestational age, mean age, and mean duration of phototherapy of jaundiced neonates were 2.50 +/- 0.603 kg, 36.8 +/- 2.04 weeks, 2.56 +/- 1.05 days, and 29.34 +/- 6.51 h, respectively. The mean Na, K, Cl, and Ca levels before phototherapy were 140.10 +/- 14.88 meq/L, 4.51 +/- 0.55 meq/L, 105.65 +/- 6.53 meq/L, and 8.90 +/- 0.55 mg/dl and after phototherapy were 139.62 +/- 5.38 meq/L, 4.36 +/- 0.48 meq/L, 103.89 +/- 6.85 meq/L, and 8.33 +/- 0.72 mg/dl, respectively (P < 0.001). The duration of phototherapy was found to correlate with serum Ca levels significantly negative (P < 0.05). Conclusion: This study shows that serum electrolyte levels were significantly decreased during light-emitting diode phototherapy. These levels were affected more by the duration of phototherapy than by its mode. Phototherapy-induced dyselectrolytemia is a significant concern, as electrolyte abnormalities result in severe short-term and long-term adverse effects.