DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20184269

Comparison of effectiveness of light emitting diode phototherapy with conventional phototherapy and combination phototherapy of conventional with fiberoptic biliblanket, and light emitting diode phototherapy with fiber optic biliblanket for treatment of neonatal hyperbilirubinemia

Kamal K. Yenamandra, Rajesh Kumar, Ajoy K. Garg, Vivek Kumar, Daljit Singh

Abstract


Background: Hyperbilirubinemia is a common problem in neonates with an incidence of 70-80%. Phototherapy is the preferred method of treatment for neonatal hyperbilirubinemia by virtue of its noninvasive nature and its safety. LED phototherapy, conventional phototherapy and fiber optic phototherapy are the modalities used in management of nonhemolytic hyperbilirubinemia in the first week of life in healthy near term and term neonates. The present study was conducted with the objective to compare effectiveness of double surface light emitting diode phototherapy with conventional double surface phototherapy and combination phototherapy of conventional and fiberoptic biliblanket, and light emitting diode phototherapy with fiber optic biliblanket for treatment of neonatal hyperbilirubinemia.

Methods: Total of 236 neonates with hyperbilirubinemia were prospectively randomized to four groups to receive single surface conventional and fiber optic biliblanket combination phototherapy (n=60; Group-1), double surface LED phototherapy (n=59; Group-2), fiber optic biliblanket and single surface LED phototherapy groups (n=62; Group-3) and double surface conventional phototherapy group (n=55; Group-4). Bilirubin levels were measured at different time intervals and adverse effects were noted if any.

Results: The rate of percentage and overall decrease of bilirubin was best in Group-2 (48.27%; 8.6 mg%) followed by Group-4 (45.49%; 8.1 mg%), Group-3 (41.26%; 7.27 mg%) and Group-1 (39.37%; 6.9 mg%). None of the babies presented side effects in Group-1 and Group-3. Neonates in Group-4 had shown loose stools (n=1), skin rash (n=3) and hyperthermia (n=2). Hyperthernia and skin rash was found in each case in Group-2.

Conclusions: Rate of decrease of bilirubin was best in double surface LED phototherapy followed by double surface conventional phototherapy, fiber optic biliblanket with single surface LED combination phototherapy and fiber optic biliblanket and single surface conventional phototherapy.


Keywords


Fiber optic biliblanket, Light emitting diode phototherapy, Phototherapy, Neonatal hyperbilirubinemia

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References


Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in Neonates: Types, causes, clinical examinations, preventive measures and treatments: a narrative review article. Iran J Public Health. 2016;45(5):558-68.

Stokowski LA. Fundamentals of Phototherapy for Neonatal Jaundice. Advances in Neonatal Care. 2011;11(5):10-21.

Paludetto R, Mansi G, Raimondi F, Romano A, Crivaro V, Bussi M, D’Ambrosio G. Moderate hyperbilirubinemia induces a transient alteration of neonatal behavior. Pediatrics. 2002;110:50.

Boo NY, Ishak S. Prediction of severe hyperbilirubinaemia using the Bilicheck transcutaneous bilirubinometer. J Paediatr Child Health. 2007;43:297-302.

Nass RD, Frank Y. Cognitive and Behavioral Abnormalities of Pediatric Diseases. 1st ed Oxford University Press; 2010.

Maisels MJ. Jaundice. In: MacDonald MG, Mullett MD, Seshia MMK, eds. Avery’s Neonatology. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2005:768-846.

Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med. 2008;358:920-8.

Vecchi C, Donzelli GP, Migliorini MG, Sbrana G. Green light in phototherapy. Pediatr Res. 1983;17:461-3.

American Academy of Pediatrics. Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more week of gestation. Pediatrics. 2004;114(3):297-316.

Tan KL. The nature of dose-response relationship of phototherapy for neonatal hyperbilirubinemia. J Pediatr. 1977;90:448-52.

Silva I, Luco M, Tapia JL, Pérez ME, Salinas JA, Flores J, et al. Single vs. double phototherapy in the treatment of full-term newborns with nonhemolytic hyperbilirubinemia. J Pediatr (Rio J). 2009;85(5):455-8.

Gale R, Dranitzki A, Dollberg S, Stevenson DK. A randomized, controlled application of the Wallaby Phototherapy System compared with standard phototherapy. J Perinatol. 1990;10:239-42.

Al-Alaiyan S. Fiberoptic, Conventional and Combination phototherapy for treatment of nonhemolytic hyperbilirubinemia in neonates. Ann Saudi Med. 1996;16(6):633-6.

Tan KL. Phototherapy for neonatal jaundice. Clin Perinatol. 1991;18:423-39.

Ventura-Junca P, Gonzalez A. Hiperbilirrubinemia neonatal. In: Tapia JL, Ventura-Junca P, editors. Manual de neonatologia. Santiago: Mediterraneo; 2000:393-413.

Xiong T, Tang J, Mu DZ. Side effects of phototherapy for neonatal hyperbilirubinemia. Zhongguo Dang Dai Er Ke Za Zhi. 2012;14(5):396-400.

Kurt A, Aygun AD, Kurt AN, Godekmerdan A, Akarsu S, Yilmaz E. Use of phototherapy for neonatal hyperbilirubinemia affects cytokine production and lymphocyte subsets. Neonatology. 2009;95:262-6.