Daycare-simulated interrupted phototherapy for neonatal jaundice: a randomized controlled trial

Jia Cheng Ong1,2,3, Farohah Che Mat Zain1,2, Yee Cheng Kueh4

  • 1Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, 16150, Malaysia.

PubMed

Insights

Daycare-simulated interrupted phototherapy for 10 hours is as effective and safe as continuous phototherapy for treating neonatal jaundice. This approach may be a feasible option for managing hyperbilirubinemia in low-risk newborns.

Area of Science:

  • Neonatal care
  • Pediatric phototherapy research
  • Bilirubin metabolism and treatment

Background:

  • Intermittent phototherapy has demonstrated comparable efficacy to continuous phototherapy for neonatal jaundice.
  • A novel study design simulated daycare phototherapy by interrupting treatment after 10 hours.
  • Daycare phototherapy for 10 hours shows potential feasibility for treating neonatal hyperbilirubinemia in low-risk infants.

Purpose of the Study:

  • To compare the effectiveness and safety of daycare-simulated interrupted phototherapy versus continuous phototherapy for neonatal jaundice.
  • To evaluate the impact of a 10-hour interrupted phototherapy regimen on total serum bilirubin levels in neonates.
  • To determine the clinical significance of post-treatment bilirubin levels in neonates receiving interrupted phototherapy.

Main Methods:

  • A parallel randomized controlled trial with one-to-one allocation was conducted.
  • Low-risk jaundiced neonates were assigned to either a 10-hour interrupted phototherapy group or a 24-hour continuous phototherapy group.
  • Total serum bilirubin (TSB) was measured pre-treatment and at 24 hours post-treatment.

Main Results:

  • The mean rate of TSB fall per hour was not significantly different between the groups (1.71 vs. 1.9 µmol/L/h, p=0.529).
  • The mean post-treatment TSB was higher in the interrupted group (182 vs. 158 µmol/L, p=0.045), but this difference was not clinically significant.
  • No neonates in either group required reinstitution or continuation of phototherapy.

Conclusions:

  • Ten hours of interrupted phototherapy, administered in a daycare setting, appears to be effective and safe for treating neonatal jaundice.
  • This interrupted phototherapy approach may be a viable and practical alternative to continuous phototherapy for low-risk neonates.
  • Further research could explore the long-term outcomes and broader applicability of daycare-simulated phototherapy.

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