Comparison between continuous and intermittent phototherapy in the management of neonatal jaundice

  • Muyesser Abdul-Kareem Department of Pediatric Medicine, College of Medicine, HMU, Erbil, Iraq.
Keywords: Neonatal jaundice, indirect hyperbilirubinemia, Phototherapy

Abstract

Background and Objectives: Since 1950s, phototherapy had been the treatment of choice for neonatal jaundice. Continuous phototherapy was the pattern used for many years; however intermittent phototherapy was also used with conflicting and controversial results. This work aim is to assess intermittent phototherapy for the treatment of neonatal jaundice in comparison with continuous phototherapy.

Methods: In a prospective clinical study all newborns with neonatal jaundice admitted to neonatology department of Raperin hospital in Erbil, between August 2009 and February 2010, for phototherapy were included in the study. The patients were randomly divided into 2 groups. In the control group continuous phototherapy defined as two hours on and half an hour off was used while in the study group intermittent phototherapy defined as one hour on and one hour off was used. Mean total serum bilirubin level in both continuous and intermittent phototherapy groups were compared after each12, 24, 36, 48, and 72 hours of commencing phototherapy. The effect of biodemographic characteristics (gender, gestational age, birth weight, age in hours, and bilirubin levels at admission) were also studied.

Results: There was no any significant difference between the two groups regarding mean total serum bilirubin measured at every 12 hours. There was no any significant difference between the 2 groups regarding biodemographic characteristics (p> 0.05).

Conclusion: Intermittent phototherapy is as effective as continuous one in the treatment of indirect hyperbilirubinemia in full term infants and in the absence of hemolytic causes.

References

Cremer RJ, Perryman PW, Richards DH. Influence of light on the hyperbilirubinemia of infants .Lancet 1958; 1:1094-1097.

Van Kaam AH, Van Beek RH , Vergust –van Keuleu JG ,van der Heijden J ,lutz- Dettinger N , Hop W. Fiberoptic versus conventional phototherapy for hyperbilirubinemia in preterm infants. Eur J Peditr. 1998;157: 132-137.

Silva I , Luco M , Tapia J ,Perez ME , Salinas JA , Flores J ,Villaroell. Single vs. double phototherapy in the treatment of full –term newborn with non hemolytic hyperbilirubinemia.J Pediatr. 2009; 85(5): 455- 458.

Niknafs P. , Mortazavi AA , Torabinejad MH , Bijari BB , Niknafs N. Intermittent versus continuous phototherapy for reducing Neonatal hyperbilirubinemia. Iran j Pediatr 2008; 18(3): 251-256.

Ronald RJ , Desandre GH , Sibley E ,et al : Neonatal jaundice and liver diseases, In martin RJ, Fanaroff AA, Walsh MCC(ed), Fanaroff and Martin's Neonatal –Perinatal Madicine: Disesaes of the fetus and infant. 8th ed. Philadelphia, Mosby, 2006; Pp:1419-1463.

Maisels MJ ,McDonagh AF, phototherapy for neonatal jaundice. N Engl J Med. 2008; 358(9): 920-928.

Stanley IP , Chung M , Kulig J. An evidence- based review of important issues concerning neonatal hyperbilirubinemia. Pediatr. 2004; 114(1): 130-153.

Maisels MJ . Jaundice : In Avery GB ,Fletcher MA, macDonald (ed). Neonatology: Pathology and management of the newborn .6th ed. Philadelphia, JB Lippincott 2005; Pp: 768-835.

Maisels MJ . Jaundice in a newborn contempor Pedtiatr 2005; 229(5) : 34-54.

Tan KL . Phototherapy for neonatal jaundice .Clin Perinatal 1991; 18(3): 423-439.

Volg TP , Hegyi T , Hiatt IM .Intermittent phototherapy in the treatment of jaundice in the premature infant. J Pediatr 1978; 92(4): 627-630.

Maurer HM.controlled trail comparing agar, intermittent phototherapy and continuous phototherapy for reducing neonatal hyperbilirubinemia . J Pediatr 1973; 82 (1) : 73 -76.

Lau SP , Fung KP. Serum bilirubin Kinetics in intermittent phototherapy of physiological jaundice .Arch Dis Child 1984; 50 (9): 892-894.

Lazar L ,Litwin A , phototherapy for neonatal non hemolytic hyperbilirubinemia: analysis of and indication for discontinuing therapy .Clin Pediatr 1993; 32: 264-267.

Bhatta BK, Shrestha PS .A comparative study of rate of fall of total serum bilirubin in jaundiced babies following continuous and intermittent phototherapy.Journal of Nepal Medical Association 2003 ; 40 (2) : 260-264.

Published
2018-10-22
How to Cite
Abdul-Kareem, M. (2018). Comparison between continuous and intermittent phototherapy in the management of neonatal jaundice. Zanco Journal of Medical Sciences (Zanco J Med Sci), 15(2), 40-44. Retrieved from https://zjms.hmu.edu.krd/index.php/zjms/article/view/442
Section
Original Articles