A Controlled Trial of High-Intensity Double-Surface Phototherapy on a Fluid Bed Versus Conventional Phototherapy in Neonatal Jaundice

Abstract

Objective. To evaluate a simple, relatively inexpensive method using the fluid bed to provide high-intensity double-surface (HIDS) phototherapy and to confirm that the method described is more effective than conventional phototherapy (CPT) in the treatment of neonatal hyperbilirubinemia. Design. Prospective controlled study. Method. HIDS phototherapy (26 to 30 µW/cm2 per nanometer) on the fluid bed (n = 22) versus conventional (7 to 10 µW/cm2 per nanometer) phototherapy (n = 28) was used to treat neonates weighing more than 1500 g with hyperbilirubinemia. Results. After 24 hours of therapy, the bilirubin in the group receiving HIDS phototherapy was significantly lower. The mean rate of fall of bilirubin was 5.34 µmol/L per hour in the group receiving HIDS phototherapy versus 0.7 µmol/L per hour in the group receiving CPT. HIDS phototherapy on a fluid bed was well tolerated. Conclusion. HIDS phototherapy on the fluid bed is significantly more effective in reducing bilirubin than CPT. It can be easily and economically provided using equipment currently available in most neonatal units.

Single surface phototherapy with reflecting curtains versus double surface phototherapy in unconjugated neonatal hyperbilirubinemia in a tertiary care NICU

“…The rate of reduction after 12 hours in a study by Ari Kurniasih et.al noted this to be 0.3 mg/dL / h Vs 0.008mg/dl/hr. 14 Both studies had used single surface phototherapy without curtains but we used double surface phototherapy without curtains so this must be the reason the rate of reduction was seen slightly more in DSP than SSPRC in our study .However total reduction of bilirubin at end of phototherapy was 2.11mg/dl in SSPRC and 2.02mg/dl in DSP which is slightly more reduction in SSPRC group but statistically not significant indicating both are of equal efficacy. This further strengthens the suggestion that the efficacy of both treatment modalities may be quite similar and that the intensities of the light provided with the curtains were very similar to those provided by double phototherapy units.…”

“…9 Changes in skin such as rashes, darker skin color and burns may occur if neonates are over-exposed to fluorescent light. 14 We also observed skin rashes in 7 Vs 10 cases in SSPRC and DSP respectively with no statistical significance [p<0.432]. Another complication noted was change in stool frequency in both groups.…”

An evaluation of the characteristics and performance of neonatal phototherapy equipment

“…by lighting from above and below the baby: so called 'double' phototherapy. The efficacy of 'double' phototherapy has been demonstrated (Tan et al 1992, Garg et al 1995, Tan 1997), but the benefits of 'double' phototherapy have to be weighed against the increasing complexity of nursing in a confined space.…”