Effectiveness of 360 intensive phototherapy versus conventional phototherapyfor neonatal hyperbilirubinemia

الملخص EN

Background : Hyperbilirubinemia is a common and, in most cases, benign problem in neonates.

Phototherapy is the mainstay of treatment of Hyperbilirubinemia, the efficacy of phototherapy depended on the light spectrum (wavelength), flux of light, and surface area of the infant exposed to phototherapy.

A measure of the efficacy of phototherapy is the dramatic reduction in the number of exchange transfusions being performed. Objectives : The aim of this study was to evaluate the efficacy of increased surface area of phototherapy (360) compared with conventional single surface fluorescent phototherapy in the management of neonatal hyperbirubinemia, and in decreasing the rate of exchange transfusion. Patients and Method : A total 73 neonates present with significant jaundice 50 % of the maximal total serum bilirubin (TSB) level and need phototherapy were included in the study, they were term and near term.

According to the level of TSB and availability of highly intensive phototherapy the cases divided in to two groups.

First group: 37 newborns who received conventional phototherapy and the second group include 36 newborns who received highly intensive 360 phototherapy. Results : the mean starting TSB in group 1 was 14.5 ± 2.6 while in group 2 20.6 ± 3.74 and it was statistically significant (p < 0.001) and it was also significant for ending TSB (p = 0.004).

The TSB difference in bilirubin was 1.8 ± 1.1 mg / dl for group 1 and 5.5 ± 3.10 mg / dl for group 2 (p < 0.001), and the duration of phototherapy needed in both groups was 8.6 ± 2.2 hr.

for group 1 and 4.1 ± 1.25 hr.

for group 2 (p < 0.001).

The decline rate in group1 was 0.2 mg per hour while in group 2 was 1.3 mg per hour which was statistically significant (p < 0.001), there was a significant decline in the number of exchange transfusion in 2010 (p < 0.026) when the highly intensive 360 degree phototherapy started to be used. Conclusion : increasing surface area of intensive phototherapy to 360 degree was more effective than single-surface conventional phototherapy in reducing bilirubin level in the treatment of Hyperbilirubinemia.

Exchange transfusion rate was much decreased when highly intensive phototherapy was started in the management of neonatal jaundice.