Role of Continuous Nasogastric Feeds in the Management of Severe Hyperbilirubinemia

Jisha Mathew, Kishore Kumar R

Abstract

Aim: To evaluate the role of continuous nasogastric feeds along with intensive phototherapy in the treatment of neonates with severe hyperbilirubinemia

Materials and Methods: A retrospective observational study was conducted by reviewing medical records of 243 neonates admitted to Cloudnine Hospital (Bengaluru, Karnataka, India). Term neonates admitted to the NICU with total serum bilirubin (TSB) of ≥ 18 mg/dL (308 μmol/L) and preterm neonates admitted with a TSB value of ≥ 15 mg/dL (257 μmol/L) within the first 72 to 96 hours of life were included in the study.

Results: Of the 243 neonates included, 57% were early term, 23.5% were term, and 19.5% were late preterm neonates. All the admitted neonates received continuous nasogastric feeds and intensive phototherapy. Further, 44% of the preterm and 23% of the term neonates had the admission TSB in the exchange zone; however, none required exchange transfusion. The median drop in TSB in the first 4 hours was 1.02 (0.22–2.78) mg/dL/h in preterm and 0.82 (0.05–2.7) mg/dL/h in term neonates (P = .67), with the aforementioned treatment. The average drop in the bilirubin level was 0.89 mg/dL/h.

Conclusion: Continuous nasogastric feeds along with intensive phototherapy could decrease the need for exchange transfusion. This treatment strategy can also be easily adopted in low-resource settings to reduce the need for IV access and referral to higher centers.