Effectiveness of Intensive Phototherapy for Neonatal Hyperbilirubinemia

Abstract

Effectiveness of Intensive Phototherapy for Neonatal Hyperbilirubinemia

Payon Boonyarittipong MD

Wiyada Boonlueang MD

Supapan Tantracheewathorn MD

Department of Pediatrics, BMA Medical College and Vajira Hospital

Objective: To evaluate the effectiveness between intensive phototherapy (IPT) and conventional phototherapy (CPT) in the treatment of neonatal hyperbilirubinemia.

Study design: Prospective randomized controlled trial.

Subjects: A total of fifty infants born in BMA Medical College and Vajira Hospital during September 2006 to November 2006 were enrolled. All subjects were healthy term breastfed infants with hyperbilirubinemia (serum bilirubin level: 13-19.9 mg/dl) and no evidence of hemolysis. Their birth weight were ≥ 2,500 grams and Apgar score were more than 6 at 1 and 5 minutes.

Methods: The subjects were randomly allocated into two groups by using random table. CPT, irradiance 12-15  from four daylight fluorescent lamps and two deep blue fluorescent lamps, was administered in 25 jaundiced infants of the control group. IPT, irradiance ≥ 30 from two daylight fluorescent lamps and four deep blue fluorescent lamps, was administered in 25 jaundiced infants of the study group. Serum bilirubin level was measured at 24 and 48 hours after phototherapy.

Main outcome measures: The reduction of total serum bilirubin, body temperatnre, body weight, number of defecation after treatment 24 and 48 hours.

Results: The initial mean serum bilirubin levels were not different between two groups. After phototherapy for 24 and 48 hours, the mean serum bilirubin in study group declined 4.4 ± 2.0 and 7.0  ±1.9 mg/dl. In control group, the mean serum bilirubin declined 2.2 ± 1.6 and 4.0 ± 1.8 mg/dl. The reduction of serum bilirubin in study group was more than control group significantly (p-value < 0.001). The mean body temperature, body weight and numbers of defecation between two groups were not different.

Conclusion: IPT was more effective in reducing serum bilirubin than CPT in the term infant after 24 and 48 hours of treatment significantly.

Vajira Med J 2007 ; 51 : 1 - 8