Comparison of the Efficacy of Conventional Phototherapy and Double - surface Phototherapy for Neonatal Hyperbilirubinemia

Abstract

Comparison of the Efficacy of Conventional Phototherapy and Double - surface Phototherapy for Neonatal Hyperbilirubinemia

Payon   Boonyarittipong     MD

Department of Pediatrics, BMA Medical College and Vajra Hospital

Objective: To evaluate the efficacy of conventional phototherapy (CPT) and double-surface phototherapy (fiberoptic pad phototherapy combined with conventional phototherapy = DsPT) in the treatment of neonatal hyperbilirubinemia.

Study design: Prospective analytical study.

Subjects: Fifty infants born in BMA Medical college and Vajira Hospital  between January 2000 and November 2000 were included in the study if:

1.       they were healthy term infants with birth weight 2,500 gm and over;

2.       the gestational age between 37 and 42 weeks;

3.       Apgar score at 1 and 5 minutes more than 6; and

4.       they had hyperbilirubinemia (>13.0 mg/dL) which no evidences of hemolysis.

Methods: CPT was administers in 25 jaundiced infants of the control group (6-7 µw/ cm² / nm from eight daylight fluorescent lamps) versus DsPT (fiberoptic pad phototherapy: 7-10 µw/ cm² / nm: combined with CPT) in 25 jaundiced infants. Serum bilirubin was measured 24 and 48 hours after phototherapy.

Main outcome measures: The decrement and percentage of decrease in total serum bilirubin after treatment 24 and 48 hours.

Results: The initial mean serum bilirubin levels had no statistically significant difference between both CPT and DsPT groups. After 24 and 48 hours of phototherapy, the serum bilirubin in the group receiving DsPT was significantly decreased. In CPT  group, serum bilirubin levels decreased 1.10+0.84 and 2.00+0.99 mg/dL after 24 and 48 hours of phototheraby, while in DsPT group decreased 1.96+1.33 and 3.98+1.80 mg/dL respectively. The body temperature of both groups were not differenced.

Conclusion: DsPT was significantly more effective in reducing biliurbin than CPT in the term infants after 24 and 48 hours of treatment. The mean body temperature after phototherapy of both groups were not differenced.

Key words: non-hemolytic unconjugated hyperbilirubinemia, conventional phototherapy (CPT), double-surface phototherapy (DsPT)

Vajira Med J 2002 ; 46 : 187 - 194