Related Experiment Video
Updated: Sep 27, 2026
Development of an Innovative LED-based Illumination Device for In Vitro Application of Photodynamic Therapy with Rose Bengal
Published on: September 12, 2025
Comparison of the effectiveness between the adapted-double phototherapy versus conventional-single phototherapy
Pracha Nuntnarumit1, Chonlathit Naka
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Insights
Adapted-double phototherapy (DP) using affordable fluorescent lamps is a safe and effective method for reducing newborn jaundice. This intensified phototherapy offers a cost-effective alternative to conventional methods.
Area of Science:
- Neonatal Medicine
- Pediatric Phototherapy
Background:
- Neonatal jaundice is common, with severe hyperbilirubinemia posing a neurotoxic risk (bilirubin encephalopathy).
- Conventional phototherapy is effective, but its efficacy depends on light source, intensity, and skin exposure.
- Double phototherapy using fiber-optic blankets is more effective but expensive; adapted-double phototherapy offers a cheaper alternative.
Purpose of the Study:
- To compare the efficacy and safety of adapted-double phototherapy (DP) using daylight fluorescent lamps against conventional phototherapy (CP).
- To evaluate DP as a potentially more cost-effective intensified phototherapy option for neonatal hyperbilirubinemia.
Main Methods:
- A prospective randomized controlled trial was conducted.
- Term infants requiring phototherapy were randomized into adapted DP (n=24) or CP (n=27) groups.
- Adapted DP used daylight fluorescent lamps positioned above and below the crib to achieve 9-10 microw/cm2/nm irradiance.
Main Results:
- The bilirubin reduction rate was significantly greater in the DP group compared to the CP group (0.22 vs 0.14 mg/dl/h on day 1; p=0.02).
- Phototherapy duration was shorter in the DP group (34.9 vs 43.7 hours; p=0.039).
- No significant differences in side effects were observed between the two groups.
Conclusions:
- Adapted-double phototherapy using daylight fluorescent lamps is safe and more effective than conventional phototherapy for reducing bilirubin levels in term infants.
- This method provides a cost-effective and easily applicable alternative for intensified phototherapy.
Background:
Jaundice is very common in neonates during the first few days of life. Severe hyperbilirubinemia is potentially neurotoxic, resulting in bilirubin encephalopathy. Phototherapy has been used widespread and proven to be effective in lowering serum bilirubin. The efficacy of phototherapy depends on the type of light-source, the intensity of light and the area of skin exposed. Double phototherapy with a fiber-optic blanket has been reported to be more effective in reducing bilirubin than conventional phototherapy. However, a fiber-optic blanket or bili-bed is very expensive, thus the authors designed the adapted-double phototherapy by using ordinary fluorescent lamps that are much cheaper and more easily available.
Objective:
To compare the efficacy and safety of adapted-double phototherapy (DP) using daylight fluorescent lamps to conventional phototherapy (CP) in healthy term infants with hyperbilirubinemia.
Design:
Prospective randomized controlled trial study.
Method:
Term infants who met phototherapy criteria were randomized into two groups of phototherapy; the adapted DP placing daylight fluorescent lamps 38 cm above and 32 cm below the crib to produce 9-10 microw/cm2/nm (n = 24) versus CP of similar irradiance (n = 27).
Result:
There were no significant differences between the two groups with respect to birth weight, gestational age, hematocrit at enrollment and cause of hyperbilirubinemia. Infants in the DP group had higher bilirubin levels and were slightly older at the time of enrollment than those in the CP group. The bilirubin reduction rate after therapy was significantly greater in the DP compared to CP; 0.22 +/- 0.12 mg/dl/h vs 0.14 +/- 0.1 mg/dl/h on day 1 of therapy (p = 0.02) and 0.16 +/- 0.11 mg/ dl/h vs 0.1 +/- 0.05 mg/dl/h on day 2 (p = 0.06). Duration of phototherapy was shorter in DP; 34.9 +/- 12.6 h vs 43.7 +/- 17.5 h in CP group (p = 0.039). No differences in side effects were found between two groups.
Conclusion:
The adapted-DP using daylight fluorescent lamps in this study has proven to be safe and more effective in reducing bilirubin than CP. It could be an alternative model for intensified phototherapy as it produces a reasonable cost-effectiveness and is easy to apply.
