Double Phototherapy with High Irradiance Compared with Single Phototherapy in Neonates with Hyperbilirubinemia

 

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ABSTRACT

The purpose of this study is to compare the effectiveness of double phototherapy versus single conventional phototherapy in decreasing serum bilirubin levels in jaundiced neonates. Forty-two preterm infants who were less than 37 weeks' gestational age and less than 2000 g birthweight with nonhemolytic jaundice were alternately assigned to double phototherapy (n = 19) (Biliblanket, Ohmeda with irradiance of 33 to 35 μW/cm²/nm in addition to single conventional phototherapy with combination of three or four special blue and white lamps with irradiance of 7 to 9 μW/cm²/nm) or to single conventional phototherapy (n = 23) based on elevated serum bilirubin levels in the first week of life. Phototherapy was initiated at specific bilirubin levels in three weight stratifications. The groups were similar in clinical characteristics at study entry. The decrease in serum bilirubin levels was very significant in the double phototherapy group at 8 hours after the therapy (-29 ± 18.8 versus 8.5 ± 27 μmol/L; p <0.001), at 16 hours after the therapy (-49.6 ± 15.4 versus 3.4 ± 39 μmol/L; p <0.001), and at 24 hours after therapy (-71.8 ± 18.8 versus -3.4 ± 32.5 μmol/L; p <0.001) compared with the conventional phototherapy group. The time taken for bilirubin levels to fall below the threshold level was 55 ± 41 hours in the single group and 14 ± 6 hours in the double group (p <0.001). Double phototherapy was well tolerated. The Biliblanket when used in conjunction with single conventional phototherapy resulted in a faster decrease of serum bilirubin. We conclude that the use of double phototherapy compared with single conventional phototherapy shortens the duration of hyperbilirubinemia without complications.