Effectiveness of FIBEROPTIC phototherapy compared to conventional phototherapy in treating HYPERBILIRUBINEMIA amongst term neonates: a randomized controlled trial

Abstract

Background Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods. Methods This was a randomized controlled trial conducted at the Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) neonates were allocated to receive fiberoptic phototherapy, 13 to blue light conventional phototherapy and 15 to white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and side effects of treatment. The data was analyzed with the independent t-test. Results The mean overall bilirubin reduction rate was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower mean overall bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No side effects of treatment were noted in the fiberoptic phototherapy group. Conclusion The effectiveness of fiberoptic PT and blue light conventional PT were comparable in terms of bilirubin reduction rate and treatment duration, whereas fiberoptic phototherapy was more effective than white light conventional PT, with a significantly higher bilirubin reduction rate and shorter treatment duration. Fiberoptic phototherapy may mitigate side effects caused by conventional phototherapy. Trial registration The Pan African Clinical Trial Registry, PACTR202004723570110. Registered 22nd April 2020- Retrospectively registered.

Light-Emitting Diode (LED) Phototherapy versus Non-LED Phototherapy Devices for Hyperbilirubinemia in Neonates: A Systematic Review and Meta-analysis

“…We evaluated 41 full-text articles to check for eligibility, and, ultimately, 21 were included in this review. 3,15,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The flowchart for evidence search and study selection is shown in ►Fig. 1.…”

“…15,[23][24][25] Fifteen articles compared LED devices with fluorescent lights. 3,[26][27][28][29][31][32][33][34][35][36][37][38]40,41 Two studies compared LED devices with halogen and fluorescent lights. 30,39 Five studies enrolled only full-term neonates 15,23,38,40,41 and 13 studies included infants over 35 or 36 weeks of gestation.…”

Role of ursodeoxycholic acid in neonatal indirect hyperbilirubinemia: a systematic review and meta-analysis of randomized controlled trials

“…Subgroup analysis based on the risk of bias was done in order to lower the heterogeneity between the studies on phototherapy duration outcome. Lowering the phototherapy duration might lower the phototherapy exposure, side effects, hospitalization, and cost [ 32 ]. Phototherapy may have some side effects, but some of these are more common in conventional phototherapy devices, for example by using fluorescent tubes [ 33 ].…”

Eficácia da fototerapia convencional comparada a outros tipos de fototerapia no tratamento de hiperbilirrubinemia neonatal: revisão integrativa

“…No artigo desenvolvido por Joel et al (2021), foi comparado a eficácia da fototerapia com fibra óptica, também chamada de fiberoptic, com maior área iluminada e maior irradiância aos métodos convencionais de fototerapia. Os resultados mostraram que houve diferença estatisticamente significativa na taxa geral de redução de bilirrubina entre a fototerapia convencional de fibra óptica e luz branca, entretanto, não houve diferença estatisticamente significativa quando comparado a taxa geral de redução de bilirrubina entre luz azul de fototerapia convencional e fibra óptica.…”