Phototherapy for neonatal jaundice at distances of 20 cm vs 40 cm
Keywords:
neonatal jaundice, phototherapy, distance, bilirubin
Abstract
Background Neonatal jaundice is one of the most common problems in newborns. Phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. Phototherapy may be more effective if the light source is placed closer to the neonate.Objective To compare the effectiveness of phototherapy with a 20 cm distance between the light source and the neonate vs a 40 cm distance for decreasing serum bilirubin concentration
Methods An open, randomized, controlled trial was conducted at H. Adam Malik and Pirngadi Hospitals in Medan from August 2009 to March 2010. Subjects were divided into two groups. One group (n=30) received phototherapy at a distance of 20 cm between the light source and the neonate, while the other group (n=30) received phototherapy at a distance of 40 cm. The inclusion criteria in the study were newborns presenting with neonatal jaundice in their first week of life. Serum bilirubin levels were measured at baseline, as well as after 12 hours and 24 hours of phototherapy.
Results The mean total bilirubin levels of the 20 cm and 40 cm groups at baseline were 18.8 (SD 1.73) mg/dL and 17.7 (SD 1.46) mg/dL, respectively, not significantly different. After 24 hours of phototherapy, the mean decreases in total serum bilirubin levels of the 20 cm and 40 cm groups were significantly different with 7.6 (SD 1.01) mg/dL and 2.0 (SD 0.83) mg/dL, respectively, (P<0.05).
Conclusion Phototherapy with a 20 cm distance between the light source and the neonate is more effective than a 40 cm distance for decreasing bilirubin levels at 24 hours in newborns with hyperbilirubinemia.
References
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11. Djokomulyanto S, Quah BS, Surini Y, Noraida R, Ismail NZ, Hansen TWR, et al. Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains. Arch Dis Child Fetal Neonatal Ed. 2006;91:439-42.
12. Wentworth SD. Neonatal phototherapy – today’s lights, lamps and devices. Infant. 2005;1:14-9.
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16. Vreman J, Hendrik J, Ronald JW, Stevenson, Roger KR, Sidney DR, et al. Light-emitting diodes: a novel light source for phototherapy. Wolters Kluwer Pediatrics Research. 1998;44:804-9.
17. Pritchard MA, Beller EM, Norton B. Skin exposure during conventional phototherapy in preterm infants: a randomized controlled trial. J Paediatr Child Health. 2004;40:270-4.
18. Boonyarittipong P. Effectiveness of double-surface intensive phototherapy versus single-surface intensive phototherapy for neonatal hyperbilirubinemia. J Med Assoc Thai. 2008;91:50-5
19. Maisels MJ. Phototherapy-traditional and nontraditional. J Perinatol. 2001;21:93-7.
20. Pishva N, Madani A. Effect of the different light–source distances from the skin surface in conventional phototherapy. IJMS. 2004;29:189-91.
21. Grunhagen DJ, de Boer MGJ, de Beaufort AJ. Transepidermal water loss during halogen spotlight phototherapy in preterm infants. Pediatr Res. 2002;51:402-5.
2. Maisels M. Neonatal hyperbilirubinemia. In: Polin A, Yodes MC, editors. Workbook in practical neonatology. 4th ed. Philadelphia: Saunders; 2007. p. 53-70.
3. Indriyani S, Retayasa IW, Surjono A, Suryantoro P. Percentage birth weight loss and hyperbilirubinemia during the first week of life in term newborns. Paediatr Indones. 2009;49:149-54.
4. Madan A, Macmahon JR, Stevenson DK. Neonatal hiperbilirubinemia. In: Taeusch HW, Ballard RA, Gleason CA, editors. Avery’s disease of the newborn. 8th ed. Philadelphia: Saunders Elsevier; 2005. p. 1226-53.
5. Dewanto NE, Rohsiswatmo R. Management of hyperbilirubinemia in near-term newborns according to American Academy of Pediatrics Guidelines: report of three cases. Paediatr Indones. 2009;49:125-30.
6. Dennery AP, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med. 2001;344:581-90.
7. Hart G, Cameron R. The importance of irradiance and area in neonatal phototherapy. Arch Dis Child Fetal Neonatal Ed. 2005;90:F437-40.
8. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297-316.
9. Al-Alaiyan S. Fiberoptic, conventional and combination phototherapy for treatment of nonhemolytic hyperbilirubinemia in neonates. Ann Saudi Med. 1996;16:633-6.
10. Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med. 2008;358:920-8.
11. Djokomulyanto S, Quah BS, Surini Y, Noraida R, Ismail NZ, Hansen TWR, et al. Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains. Arch Dis Child Fetal Neonatal Ed. 2006;91:439-42.
12. Wentworth SD. Neonatal phototherapy – today’s lights, lamps and devices. Infant. 2005;1:14-9.
13. Seidman DS, Moise J, Ergaz Z, Laor A, Vreman HJ, Stevenson DK, et al. A new blue light-emitting phototherapy device: a prospective randomized controlled study. J Pediatr. 2000;136:771-4.
14. Vreman HJ, Wong RJ, Stevenson DK. Phototherapy: current methods and future directions. Semin Perinatol. 2004;28:326-33.
15. Frank GC, Cooper SC, Merenstein GB. Jaundice. In: Merenstein GB, Gardner SL, editors. Handbook of neonatal intensive care. 5th ed. Philadelphia: Mosby Elsevier; 2002. p. 443-59.
16. Vreman J, Hendrik J, Ronald JW, Stevenson, Roger KR, Sidney DR, et al. Light-emitting diodes: a novel light source for phototherapy. Wolters Kluwer Pediatrics Research. 1998;44:804-9.
17. Pritchard MA, Beller EM, Norton B. Skin exposure during conventional phototherapy in preterm infants: a randomized controlled trial. J Paediatr Child Health. 2004;40:270-4.
18. Boonyarittipong P. Effectiveness of double-surface intensive phototherapy versus single-surface intensive phototherapy for neonatal hyperbilirubinemia. J Med Assoc Thai. 2008;91:50-5
19. Maisels MJ. Phototherapy-traditional and nontraditional. J Perinatol. 2001;21:93-7.
20. Pishva N, Madani A. Effect of the different light–source distances from the skin surface in conventional phototherapy. IJMS. 2004;29:189-91.
21. Grunhagen DJ, de Boer MGJ, de Beaufort AJ. Transepidermal water loss during halogen spotlight phototherapy in preterm infants. Pediatr Res. 2002;51:402-5.
Published
2013-10-30
How to Cite
1.
Pratita W, Supriatmo S, Tjipta G. Phototherapy for neonatal jaundice at distances of 20 cm vs 40 cm. PI [Internet]. 30Oct.2013 [cited 17Apr.2024];53(5):278-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/306
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Received 2016-08-21
Accepted 2016-08-21
Published 2013-10-30
Accepted 2016-08-21
Published 2013-10-30
