Double surface light emitting diode phototherapy versus double surface compact florescent light phototherapy in neonatal non-haemolytic hyperbilirubinemia: a randomized controlled trial
Keywords:Compact fluorescent tube, Jaundice, Light emitting diode, Neonate, Phototherapy
Background: The aim of the study was to evaluate whether light-emitting diode (LED) phototherapy is as efficacious as compact fluorescent tube (CFT) phototherapy for the treatment of non-hemolytic jaundice in healthy term and late preterm neonates.
Methods: Study design was open label randomized controlled trial conducted at tertiary care NICU. Healthy term and late preterm neonates with non-haemolytic jaundice included in the present study. Intervention was double-surface LED or CFT phototherapy. Primary outcome variable was duration of phototherapy.
Results: A total of 60 neonates were randomized to receive LED (n=30) or CFT (n=30) phototherapy. The baseline demographic and biochemical variables were similar in the two groups. The median duration of phototherapy (Mean±SD) in the two groups was comparable (26.7±7.0) h vs (24.8±6.05) h, P=0.0.241). The rate of fall of serum total bilirubin (STB) during phototherapy in initial 6 hours was significantly more LED group (n=30), 3.43±0.65 versus (n=30) 2.22±0.55 with P-value of <0.001.
Conclusions: LED and CFT phototherapy units were equally efficacious in the management of non-haemolytic hyperbilirubinemia in healthy term and late-preterm neonates. Side effects were rare, comparable in the two groups and included only rash.
Kumar RK. Neonatal jaundice: an update for family physicians. Aust Fam physician. 1999;28(7):679-82.
Lucia MP, Camilla RG, Martin, Cloherty JP. Neonatal Hyperbilirubinemia. In: Cloherty JP, Eichenwald EC, Stark AR, eds. Manual of neonatal care. 11th Ed. Lipincott,Williams and Wilkins: 304-339.
Narang A, Gathwala D, Kumar P. Neonatal jaundice an analysis of 551 cases. Indian Pediatr. 1997;34;429-32.
National Neonatal- perinatal database, report 2002-03. NNPDnetwork 2005: p-29. Available at https://www.newbornwhocc.org/pdf/nnpd_report_2002-03.PDF. Accessed on 30 september 2012
Vreman HJ, Wong RJ, Stevenson DK. Phototherapy: current methods and future directions. Semin Perinatol. 2004;28(5):326-33.
Tan KL. Phototherapy for neonatal jaundice. Clin Perinatol. 1991;18(3):423-39.
Madan A, James RM, Stevenson DK. Neonatal Hyperbilirubinemia. In: Avery’s Diseases of Newborn. Taeusch, Ballard, Gleason eds. 8th ed. Philadelphia: Saunders; 2005: 1226-1266.
Kumar P, Murki S, Malik GK, Chawla D, Deorari AK, Karthi N, et al. Light-emitting diodes versus compact fluorescent tubes for phototherapy in neonatal jaundice: a multicentre randomized controlled trial. Indian Pediatr. 2010;47(2):131-7.
Maisels MJ. Jaundice In: Avery GB, Fletcher MA, Macdonald MG, ed. Neonatology: Pathophysiology and management of newborn. Philadelphia: JBL Lipincott; 1999: 765-819.
Ennever JF, Sobel M, Mcdonagh AF, Speck WT. Phototherapy for neonatal jaundice: in vitro comparison of light source. Pediatr Res. 1984;18(7):667-70.
Kang JH, Shankaran S. Double phototherapy with high irradiance compared with single phototherapy in neonates with Hyperbilirubinemia. Am J Perinatol. 1995;12(3):178-80.
Sarici SU, Alpay F, Unay B, Ozcan O, Golcay E. Double versus single phototherapy in term neonates with significant hyperbiliruninemia. J Trop Pediatr. 2000;46(1): 36-9.
Nuntnarumit P, Naka C. Comparison of the effectiveness between adapted double phototherapy versus conventional single phototherapy. J Med Assoc Thai. 2002;85(4):S1159-66
Boonyarittipong P, Kriangburapa W, Booranavanich K. Effectiveness of double surface intensive phototherapy versus single surface phototherapy for neonatal Hyperbilirubinemia. J Med Assoc Thai. 2008;91(1):50-5.
Maisels MJ, Kring EA, De Ridder J. Randomized controlled trial of light emitting diode phototherapy. J Perinatol. 2007;27(9):565-67.