The effects of shielding the hepatic area on the clinical response to phototherapy
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Phototherapy effectively reduces serum bilirubin in infants. Shielding the liver area during treatment did not change bilirubin levels, suggesting phototherapy acts on the skin.
Area of Science:
- Neonatal Medicine
- Pediatric Phototherapy Research
Background:
- Neonatal jaundice is a common condition requiring treatment.
- Phototherapy is a standard treatment for hyperbilirubinemia in newborns.
- The precise mechanism and primary site of action for phototherapy are not fully elucidated.
Purpose of the Study:
- To investigate the impact of shielding the liver area on phototherapy efficacy.
- To determine if the liver is a primary site for phototherapy's action in reducing bilirubin levels.
Main Methods:
- A comparative study involving 26 infants with neonatal jaundice.
- Two groups were formed: one with an opaque patch over the liver area during phototherapy, and a control group without shielding.
- Serum bilirubin levels, duration of phototherapy, and bilirubin decrement rates were monitored and compared between groups.
Main Results:
- No statistically significant differences were observed between the patched and control groups.
- Key metrics including peak bilirubin concentration and rates of bilirubin decline showed no variation.
- The duration of phototherapy required was similar for both infants with and without liver shielding.
Conclusions:
- Shielding the hepatic area does not impede the effectiveness of phototherapy in treating neonatal jaundice.
- These findings suggest that the skin, rather than the liver, is the primary site where phototherapy exerts its bilirubin-lowering effects.
- Phototherapy's mechanism of action likely involves dermal photo-oxidation of bilirubin.
Abstract:
The changes in serum bilirubin concentration in response to phototherapy were studied in 26 infants with and without an opaque patch on the liver area. Fifteen infants in the patched group were treated at a mean age of 50.7 h, and 11 control infants at 49.1 h. No significant differences were demonstrated between the two groups in duration of phototherapy, peak bilirubin concentration and rates of bilirubin decrement. Shielding the hepatic area during illumination does not alter the clinical response to phototherapy which suggests that the main site of action of phototherapy is in the skin.