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360° phototherapy versus single-surface LED phototherapy with white curtains in neonatal hyperbilirubinaemia: a
Nik Amalia Nik Najib1,2, Hans Van Rostenberghe1,2,3, Nor Rosidah Ibrahim1,2
1Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Malaysia.
Insights
360° phototherapy significantly reduces bilirubin levels faster than single-surface LED phototherapy in neonates. This advanced method offers a comparable safety profile and quicker treatment for neonatal hyperbilirubinaemia.
Area of Science:
- Neonatal care
- Pediatric phototherapy
- Bilirubin metabolism
Background:
- Neonatal hyperbilirubinaemia is a prevalent global condition with risks like bilirubin encephalopathy.
- Phototherapy is the established treatment for neonatal jaundice due to its availability and efficacy.
- This study evaluates 360° phototherapy against single-surface LED phototherapy for intensive treatment.
Purpose of the Study:
- To compare the efficacy of 360° versus single-surface LED phototherapy in treating neonatal hyperbilirubinaemia.
- To assess the speed of bilirubin reduction and treatment duration.
- To evaluate safety and ease of use for healthcare providers.
Main Methods:
- A randomized controlled trial involving 40 neonates requiring intensive phototherapy.
- Two groups: 360° phototherapy (n=20) and single-surface LED phototherapy with a white curtain (n=20).
- Primary outcome: mean serum bilirubin reduction at 4, 10, and 24 hours; secondary outcomes: side effects and device usability.
Main Results:
- Both methods effectively reduced bilirubin levels (P < 0.001).
- 360° phototherapy demonstrated a significantly greater bilirubin reduction at 4 hours (27 ± 6.13 μmol/L) compared to the control (2.61 ± 6.3 μmol/L).
- 360° phototherapy required a shorter duration (P = 0.005), with 0% needing further treatment at 24h versus 5% in the control group.
Conclusions:
- 360° phototherapy accelerates the achievement of therapeutic goals for neonatal hyperbilirubinaemia.
- The 360° method offers a comparable safety profile to standard phototherapy.
- This technique provides a more rapid and effective treatment option for neonatal jaundice.
Introduction:
Neonatal hyperbilirubinaemia is a common condition encountered globally with potential complications such as bilirubin encephalopathy. Phototherapy remains the standard treatment due to its accessibility and effectiveness. This study compares the efficacy of 360° phototherapy versus single-surface LED phototherapy with a white curtain in managing neonatal hyperbilirubinaemia requiring intensive phototherapy.
Methods:
A randomised controlled trial was conducted at Hospital Pakar Universiti Sains Malaysia from December 2022 to March 2023 involving 40 neonates requiring intensive phototherapy within the first week of life. Participants were randomised into two groups: an intervention group that received 360° phototherapy ( n = 20) and a control group that received single-surface LED phototherapy with a white curtain ( n = 20). The primary outcome was the mean reduction in serum bilirubin at 4 h, 10 h and 24 h of phototherapy, which was analysed using repeated measures analysis of variance and the log-rank test. Secondary outcomes included phototherapy-related side effects and device ease of use among nurses from the neonatal intensive care unit.
Results:
Both phototherapy methods significantly reduced serum bilirubin levels over 24 h ( P < 0.001). The 360° phototherapy group showed greater reduction at 4 h (27 ± 6.13 μmol/L, P < 0.001) than the control group (2.61 ± 6.3 μmol/L, P = 0.616). The log-rank test showed a significant difference in phototherapy duration ( P = 0.005). At 24 h, the proportion that required phototherapy was 0 for the 360° phototherapy group and 0.05 for the control group (χ 2 = 7.6, degrees of freedom = 1, P = 0.005, hazard ratio 2.29, 95% confidence interval 1.17-4.51). Safety profiles were comparable. Most nurses reported no difficulty using the 360° device.
Conclusion:
360° phototherapy achieves therapeutic goals more rapidly with a comparable safety profile.
