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Published on: December 31, 2015
Efficacy of phototherapy devices and outcomes among extremely low birth weight infants: multi-center observational
B H Morris1, J E Tyson, D K Stevenson
1Department of Neonatology, Trinity Mother Frances Health System, Tyler, TX 75703, USA. brenda_2759@msn.com
Insights
Light-emitting diodes (LEDs) and Spotlights demonstrated superior efficacy in reducing total serum bilirubin in extremely premature infants. Further research is needed to evaluate the long-term outcomes associated with different phototherapy devices.
Area of Science:
- Neonatal care
- Phototherapy research
- Infant bilirubin management
Background:
- Jaundice is common in premature infants.
- Phototherapy is a standard treatment for neonatal jaundice.
- Evaluating phototherapy device efficacy is crucial for optimizing infant outcomes.
Purpose of the Study:
- To assess the effectiveness of different phototherapy (PT) devices.
- To determine the outcomes of extremely premature infants treated with various PT devices.
Main Methods:
- A substudy of a large clinical trial involving 1404 extremely premature infants.
- Infants received treatment with a single type of PT device within 24 hours of birth.
- Evaluated absolute and relative decrease in total serum bilirubin (TSB) and long-term outcomes at discharge and 18-22 months corrected age.
Main Results:
- Light-emitting diodes (LEDs) showed the largest initial absolute decrease in TSB (-2.2 mg/dL, -22%).
- Spotlights also demonstrated significant TSB reduction (-1.7 mg/dL, -19%).
- Traditional "Banks" and "Blankets" phototherapy devices showed lesser TSB reduction.
Conclusions:
- LED phototherapy devices were most effective in the initial reduction of TSB.
- LEDs and Spotlights showed comparable performance in other measured aspects.
- Rigorous evaluation of long-term effects of different phototherapy devices in extremely premature infants is warranted.
Objective:
Evaluate the efficacy of phototherapy (PT) devices and the outcomes of extremely premature infants treated with those devices.
Study Design:
This substudy of the National Institute of Child Health and Human Development Neonatal Research Network PT trial included 1404 infants treated with a single type of PT device during the first 24±12 h of treatment. The absolute (primary outcome) and relative decrease in total serum bilirubin (TSB) and other measures were evaluated. For infants treated with one PT type during the 2-week intervention period (n=1223), adjusted outcomes at discharge and 18 to 22 months corrected age were determined.
Result:
In the first 24 h, the adjusted absolute (mean (±s.d.)) and relative (%) decrease in TSB (mg dl(-1)) were: light-emitting diodes (LEDs) -2.2 (±3), -22%; Spotlights -1.7 (±2), -19%; Banks -1.3 (±3), -8%; Blankets -0.8 (±3), -1%; (P<0.0002). Some findings at 18 to 22 months differed between groups.
Conclusion:
LEDs achieved the greatest initial absolute reduction in TSB but were similar to Spots in the other performance measures. Long-term effects of PT devices in extremely premature infants deserve rigorous evaluation.
