Dependence of the Efficiency of Phototherapy on Plasma Bilirubin Concentration

Jährig, K; Jährig, D; Meisel, Peter

doi:10.1111/j.1651-2227.1982.tb09417.x

“…A greater fall in bilirubin level has been described in association with a higher level at admission. 10,13 In agreement with such investigations, the present study showed a stronger association between decrease in bilirubin after 24 hours of therapy and bilirubin level at admission in the DP group when compared to the SP group. This finding suggests that at higher levels of bilirubin DP could be more effective than SP.…”

Section: Discussionsupporting

confidence: 80%

Fototerapia simples versus dupla no tratamento de recém-nascidos a termo com hiperbilirrubinemia não-hemolítica

Silva¹,

Luco²,

Tapia³

et al. 2009

J. Pediatr. (Rio J.)

1

0

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Objectives: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns. Methods:Term newborns with hyperbilirubinemia were prospectively randomized to receive double or single phototherapy. Bilirubin levels were measured at admission and at 12-hour intervals, as well as at a follow-up 48 hours after discharge. Results:Thirty-seven patients received single and 40 double phototherapy. The mean decrease in bilirubin level in the first 24 hours of treatment was greater in the double phototherapy group (5.1±2.2 mg/dL vs. 4.3±2.1 mg/dL), but without statistical significance (p = 0.18). Readmission rates were similar and no adverse effects were found in either group.Conclusions: Double-surface was not more effective than single-surface phototherapy in the treatment of nonhemolytic hyperbilirubinemia in term newborns. However, our results suggest that double phototherapy may be more effective in those term newborns with higher bilirubin levels at admission. is the most commonly used method, and, when bilirubin levels are close to the threshold for exchange transfusion, intensive phototherapy is indicated. 6 This can be obtained by increasing the surface area of the newborn exposed to light and the intensity of phototherapy using lateral panels, reflecting objects and fiber-optic blankets. Among them, a second lateral panel, also known as double phototherapy (DP), is frequently used.

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“…Outra consideração diz respeito ao efeito da fototerapia ser também dependente do nível de bilirrubina no momento da internação. Uma maior queda do nível de bilirrubina foi descrita em associação a um maior nível no momento da internação 10,13 . De acordo com essas investigações, o presente estudo apresentou associação mais forte entre a redução da bilirrubina após 24 horas de terapia e os níveis de bilirrubina no momento da internação no grupo que recebeu FD quando comparado ao grupo que recebeu FS.…”

Section: Discussionunclassified

Single vs. double phototherapy in the treatment of full-term newborns with nonhemolytic hyperbilirubinemia

Silva¹,

Luco²,

Tapia³

et al. 2009

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Objectives: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns. Methods:Term newborns with hyperbilirubinemia were prospectively randomized to receive double or single phototherapy. Bilirubin levels were measured at admission and at 12-hour intervals, as well as at a follow-up 48 hours after discharge.Results: Thirty-seven patients received single and 40 double phototherapy. The mean decrease in bilirubin level in the first 24 hours of treatment was greater in the double phototherapy group (5.1±2.2 mg/dL vs. 4.3±2.1 mg/dL), but without statistical significance (p = 0.18). Readmission rates were similar and no adverse effects were found in either group.Conclusions: Double-surface was not more effective than single-surface phototherapy in the treatment of nonhemolytic hyperbilirubinemia in term newborns. However, our results suggest that double phototherapy may be more effective in those term newborns with higher bilirubin levels at admission. J Pediatr (Rio J). 2009;85(5):455-458:Phototherapy, newborns, hyperbilirubinemia, therapy, jaundice. ResumoObjetivo: Comparar a eficácia da fototerapia simples (1 painel) versus dupla (2 painéis) na redução da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. Métodos:Os recém-nascidos a termo foram randomizados prospectivamente para receber fototerapia simples ou dupla. Os níveis de bilirrubina foram medidos no momento da internação e em intervalos de 12 horas, assim como em seguimento 48 horas após a alta.Resultados: Trinta e sete pacientes receberam fototerapia simples, e 40, dupla. A redução média dos níveis de bilirrubina nas primeiras 24 horas de tratamento foi maior no grupo que recebeu fototerapia dupla (5,1±2,2 mg/dL versus 4,3±2,1 mg/dL), porém sem significância estatística (p = 0,18). As taxas de readmissão foram similares e nenhum dos grupos apresentou efeitos adversos. Conclusão:A fototerapia dupla não foi mais eficaz do que a fototerapia simples no tratamento da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. Entretanto, nossos resultados sugerem que a fototerapia dupla possa ser mais eficaz em recém-nascidos a termo com níveis de bilirrubina mais altos no momento da internação. J Pediatr (Rio J)

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“…First, the readmission groups received significantly more irradiance to a greater surface area from underneath the baby (four BB tubes vs the Wallaby), and second, pre-phototherapy TSB levels in the readmission groups were significantly higher than the newborn groups (18.9±2.9 vs 10.7±3.1 mg/dl, P ¼ 0.000). Because the rate of TSB decline under phototherapy is directly related to the pre-phototherapy TSB level, 8 we would expect the decline to be more rapid in the readmitted infants.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of light-emitting diode phototherapy

Maisels

¹

,

Kring

²

,

DeRidder

³

2007

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Objective: We wished to compare the efficacy of light-emitting diode (LED) phototherapy with special blue fluorescent (BB) tube phototherapy in the treatment of neonatal hyperbilirubinemia. Study design:We randomly assigned 66 infantsX35 weeks of gestation to receive phototherapy using an LED device or BB. In addition to phototherapy from above, all infants also received phototherapy from below using four BB tubes or a fiberoptic pad.Result: After 15±5 h of phototherapy, the rate of decline in the total serum bilirubin (TSB) was 0.35±0.25 mg/dl/h in the LED group vs 0.27±0.25 mg/dl/h in the BB group (P ¼ 0.20).Conclusion: LED phototherapy is as effective as BB phototherapy in lowering serum bilirubin levels in term and near-term newborns.

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Dependence of the Efficiency of Phototherapy on Plasma Bilirubin Concentration

Cited by 21 publications

References 12 publications

Fototerapia simples versus dupla no tratamento de recém-nascidos a termo com hiperbilirrubinemia não-hemolítica

Fototerapia simples versus dupla no tratamento de recém-nascidos a termo com hiperbilirrubinemia não-hemolítica

Single vs. double phototherapy in the treatment of full-term newborns with nonhemolytic hyperbilirubinemia

Randomized controlled trial of light-emitting diode phototherapy

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