Views: 1,302 | Downloads:
33
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Comparison of the Effectiveness Between the Adapted-Double Phototherapy Versus Conventional-Single Phototherapy
Nuntnarumit P 
,
Naka C
,
Naka C Background : Jaundice is very common in neonates during the first few days of life. Severe
hyperbilirubinemia is potentially neurotoxic, resulting in bilirubin encephalopathy. Phototherapy has
been used widespread and proven to be effective in lowering serum bilirubin. The efficacy of phototherapy
depends on the type of light-source, the intensity of light and the area of skin exposed.
Double phototherapy with a fiber-optic blanket has been reported to be more effective in reducing
bilirubin than conventional phototherapy. However, a fiber-optic blanket or bili-bed is very expensive,
thus the authors designed the adapted-double phototherapy by using ordinary fluorescent lamps
that are much cheaper and more easily available.
Objective : To compare the efficacy and safety of adapted-double phototherapy (DP) using
daylight fluorescent lamps to conventional phototherapy (CP) in healthy term infants with hyperbilirubinemia.
Design : Prospective randomized controlled trial study.
Method : Term infants who met phototherapy criteria were randomized into two groups of
phototherapy; the adapted DP placing daylight fluorescent lamps 38 em above and 32 em below the
crib to produce 9-10 Jlw/cm2/nm (n=24) versus CP of similar irradiance (n=27).
Result : There were no significant differences between the two groups with respect to birth
weight, gestational age, hematocrit at enrollment and cause of hyperbilirubinemia. Infants in the DP
group had higher bilirubin levels and were slightly older at the time of enrollment than those in the
CP group. The bilirubin reduction rate after therapy was significantly greater in the DP compared to
CP; 0.22 ± 0.12 mg/dl/h vs 0.14 ± 0.1 mg/dl/h on day 1 of therapy (p=0.02) and 0.16 ± 0.11 mg/
dl/h vs 0.1 ± 0.05 mg/dl/h on day 2 (p=0.06). Duration of phototherapy was shorter in DP; 34.9 ±
12.6 h vs 43.7 ± 17.5 h in CP group (p=0.039). No differences in side effects were found between
two groups.
Conclusion : The adapted-DP using daylight fluorescent lamps in this study has proven
to be safe and more effective in reducing bilirubin than CP. It could be an alternative model for
intensified phototherapy as it produces a reasonable cost-effectiveness and is easy to apply.
Key word : Double Phototherapy, Neonatal Jaundice
hyperbilirubinemia is potentially neurotoxic, resulting in bilirubin encephalopathy. Phototherapy has
been used widespread and proven to be effective in lowering serum bilirubin. The efficacy of phototherapy
depends on the type of light-source, the intensity of light and the area of skin exposed.
Double phototherapy with a fiber-optic blanket has been reported to be more effective in reducing
bilirubin than conventional phototherapy. However, a fiber-optic blanket or bili-bed is very expensive,
thus the authors designed the adapted-double phototherapy by using ordinary fluorescent lamps
that are much cheaper and more easily available.
Objective : To compare the efficacy and safety of adapted-double phototherapy (DP) using
daylight fluorescent lamps to conventional phototherapy (CP) in healthy term infants with hyperbilirubinemia.
Design : Prospective randomized controlled trial study.
Method : Term infants who met phototherapy criteria were randomized into two groups of
phototherapy; the adapted DP placing daylight fluorescent lamps 38 em above and 32 em below the
crib to produce 9-10 Jlw/cm2/nm (n=24) versus CP of similar irradiance (n=27).
Result : There were no significant differences between the two groups with respect to birth
weight, gestational age, hematocrit at enrollment and cause of hyperbilirubinemia. Infants in the DP
group had higher bilirubin levels and were slightly older at the time of enrollment than those in the
CP group. The bilirubin reduction rate after therapy was significantly greater in the DP compared to
CP; 0.22 ± 0.12 mg/dl/h vs 0.14 ± 0.1 mg/dl/h on day 1 of therapy (p=0.02) and 0.16 ± 0.11 mg/
dl/h vs 0.1 ± 0.05 mg/dl/h on day 2 (p=0.06). Duration of phototherapy was shorter in DP; 34.9 ±
12.6 h vs 43.7 ± 17.5 h in CP group (p=0.039). No differences in side effects were found between
two groups.
Conclusion : The adapted-DP using daylight fluorescent lamps in this study has proven
to be safe and more effective in reducing bilirubin than CP. It could be an alternative model for
intensified phototherapy as it produces a reasonable cost-effectiveness and is easy to apply.
Key word : Double Phototherapy, Neonatal Jaundice
Download:
PDF