- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03684499
Fluid in Neonatal Hyperbilirubinemia
Role of Fluid Supplementation in Neonatal Unconjugated Hyperbilirubinemia
Hyperbilirubinemia is a common neonatal problem. bilirubin is potentially toxic to central nervous system and can cause serious permanent complication called kernicterus, in which brain stem nuclei and basal ganglia are damaged,resulting in cerebral palsy.In Hyperbiliubinemia,rapid reduction of serum bilirubin level is of utmost importance.
Two commonly used mode of therapy are phototherapy and exchange transfusion. Phototherapy has some side effects such as diarrhea, skin rash, dehydration, overheating, mother-baby bonding disruption.On the other hand, complication of exchange transfusion include infections, emboli,anemia,apnea and hypocalcemia.
while IV fluid supplementationis postulated to decrease bilirubin concentration directly through a reduction of haemoconcentration, increasing enteral feed volume is proposed to decrease bilirubin concentration through reduced enterohepatic circulation via an increased gut peristalsis.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Bilirubin encephalopathy or kernicterus Unconjugated bilirubin is lipid soluble and therefore can cross the blood brain barrier .There it can deposit in areas of the brain, with a predilection for deposition in the basal ganglia, auditory pathways, and oculomotor nucleus. This deposition and accompanying damage result in the classical symptoms associated with kernicterus. Hypoxia, acidosis, prematurity, and genetic predispositions all increase the risk for kernicterus.In well term babies risk for kernicterus increases after bilirubin levels cross (20 mg/dL) and it is very high above (30 mg/dL). In preterm babies the threshold for damage from bilirubin could be as low as(20mg/dl). The risk increases with increasing serum levels of unconjugated bilirubin.
Acute bilirubin encephalopathy presents as lethargy, high pitched cry, poor feeding, abnormal tone, opisthotonus, upgaze palsy and seizures. Aggressive treatment at this stage can reduce the damage caused. Chronic bilirubin encephalopathy leads to conditions like choreoathetoid cerebral palsy, high frequency hearing loss, dental dysplasias and oculomotor palsies.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Azza ahmed, professor
- Phone Number: 01006863277
- Email: azza.eisa@gmail.com
Study Contact Backup
- Name: Mohamed Gamil, lecturer
- Phone Number: 01024741834
- Email: mohamed.gmail@gmail.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
1 -Ful term ,Body weight (≥2.5kg). 2- total serum bilirubin range(≥18mg/dl to≤25mg/dl). 3-Non -haemolytic type of jaundice. 4-Ratio of conjugated bilirubin :unconjugated bilirubin is 1:5
Exclusion Criteria:
1 - Body weight ≤2.5kg. 2- Evidence of haemolysis. 3- Obvious features of dehydration. 4- Major congenital malformation . 5- Baby received already IV fluid for any reason. 6- Septicemia . 7-GIT functional or organic obstruction .
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: study group (1)
The subjects will be divided into two equal groups Study group and control group by randomization.
The study group will be given IV fluid supplementation with 0.5% normal saline in dextrose 5%for period of 24hours .
The volume of supplementation included a presumed deficit of 50 ml/kg (equivalent to mild dehydration), half of daily maintenance fluid for 24 hours in accordance to standard norms and extra 20 ml/kg per day as a phototherapy allowance.
In addition, they will continue breastfeeding.
The control group will be continued on breast feeding , before the randomization procedure.
All the infants will get phototherapy by standard method.
Phototherapy will be discontinued when the bilirubin level will be <15 mg/dl.
|
The subjects will be divided into two equal groups Study group and control group by randomization.
The study group will be given IV fluid supplementation with 0.5% normal saline in dextrose 5%for period of 24hours .
The volume of supplementation included a presumed deficit of 50 ml/kg (equivalent to mild dehydration), half of daily maintenance fluid for 24 hours in accordance to standard norms and extra 20 ml/kg per day as a phototherapy allowance.
In addition, they will continue breastfeeding.
All the infants will get phototherapy by standard method.
Phototherapy will be discontinued when the bilirubin level will be <15 mg/dl.
Other Names:
The subjects will be divided into two equal groups Study group and control group by randomization .
The control group will be continued on breast feeding , before the randomization procedure.
All the infants will get phototherapy by standard method.
Phototherapy will be discontinued when the bilirubin level will be <15 mg/dl.(Bandyopadhyay
et al, 2017)
|
No Intervention: control group( 2)
The subjects will be divided into two equal groups Study group and control group by randomization.
The study group will be given IV fluid supplementation with 0.5% normal saline in dextrose 5%for period of 24hours .
The volume of supplementation included a presumed deficit of 50 ml/kg (equivalent to mild dehydration), half of daily maintenance fluid for 24 hours in accordance to standard norms and extra 20 ml/kg per day as a phototherapy allowance.
In addition, they will continue breastfeeding.
The control group will be continued on breast feeding , before the randomization procedure.
All the infants will get phototherapy by standard method.
Phototherapy will be discontinued when the bilirubin level will be <15 mg/dl.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
decrease of bilirubin level after fluid supplementation
Time Frame: 24 hours
|
bilirubin level will be measured on admission and after 24 hours and
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
phototherapy
Time Frame: 24
|
reduce duration of phototherapy
|
24
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Yasmeen Hasaneen, Assiut University
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- fsnh
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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