Page 447 - 16Neonatal Jaundice_compressed
P. 447

Neonatal jaundice


 Bibliographic   Study Type &   Number of   Intervention & Comparison   Dichotomous outcomes   Continuous Outcomes   Comments
 Information   Evidence Level   Patients/Characteristics   (E:C)   (Mean:SD: N)
 Author:   Methodology:   N:   Group 1:   Exchange Transfusions   Mean decrease in TsB (4 hours):
 Boo N   RCT   54   Phototherapy + Enteral feeds alone   Group 1: 5/27   Group 1: -37 ± 44 micromol/litre
             Group 2: 8/27
 Year:   Blinding:   Inclusion:   Group 2:      Group 2: -43 ± 37 micromol/litre
 2002   Not reported   TsB > 300 micromol/litre   Phototherapy + 50 % Enteral feeds + 50 %  Mortality
       with conjugated bilirubin   Intravenous feeds   Group 1: 0/27
 Country:   Randomisation:   <15% of TsB      Group 2: 0/27
 Malaysia   Stratified      All babies received a daily maintenance
    randomisation (type   Exclusion:   fluid level of 90 mL/kg on day 2, 1290
 175
 ID:     of feed, hydration   Sick babies,   mL/kg on day 3 and 150 mL/kg from day
 status, and TsB   Major congenital   4 onwards.
 levels) using sealed   malformations,   They were also given an additional 10% of
 envelopes   Conjugated   their respective total daily fluid
    hyperbilirubinaemia,   requirement to compensate for the fluid
 Evidence level:   prolonged jaundice   loss.
 1 +
        Enteral feeds group
 Demographics:   Formula-fed babies were given 8 divided
 Gender (M/F): 28/26   feeds at 3 hour intervals. Breastfed babies
 Mean GA: 39.4 ± 0.9 weeks   were breastfed on demand. In addition
 they were given half of the calculated
 Mean BW: 3075 ± 429 gms  volume of formula feeds given to the
 Age at entry to study:   formula-fed babies.
 139 ± 47 hours     Enteral + Intravenous group
 Mean TSB:   Formula-fed babies were given half of
 377 ± 66 micromol/litre   their 24hour fluid requirement at eight
 divided feeds at 3hour intervals. The
 remaining half of their daily fluid
 requirement was given as continuous
 intravenous1/5 normal saline and 5%
 dextrose infusion via a peripheral vein
 over 24 hours. Breastfed babies were
 breastfed on demand. Half of their daily
 fluid requirement was given as continuous
 intravenous1/5 normal saline and 5%
 dextrose infusion via a peripheral vein
 over 24 hours.
 Author: Martinez J   Methodology:   N: 125   Group 1:   ET:   Mean decrease in TsB (48 hours):   Only data from groups 3
    RCT      Continue breastfeeding   Group 1: 0/25   Group 3: -77 ± 41 micromol/litre   and 4 used
 Year: 1993      Inclusion:      Group 2: 0/26
    Blinding:   TSB > 291micromol/litre   Group 2:   Group 3: 0/38   Group 4: -65 ± 34 micromol/litre
 Country: Argentina   Not reported      Discontinue breastfeeding, substitute   Group 4: 0/36
       Exclusion:   formula feeds
 ID:     Randomisation:   Congenital anomalies      Treatment failure:
 133
 Computer-generated  Neonatal complications   Group 3:   Group 1: 6/25
    Birthweight below 10    Discontinue breastfeeding, substitute   Group 2: 5/26
 th
 Evidence level:   formula feeds, add Conventional   Group 3: 1/38

 296
   442   443   444   445   446   447   448   449   450   451   452