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Fototerapia interrumpida simulada en guardería para la ictericia neonatal: un ensayo controlado aleatorizado
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.
European journal of pediatrics
|January 10, 2026
Resumen
La fototerapia interrumpida simulada en guardería durante 10 horas es tan eficaz y segura como la fototerapia continua para el tratamiento de la ictericia neonatal. Este enfoque puede ser una opción factible para el manejo de la hiperbilirrubinemia en recién nacidos de bajo riesgo.
Área de la Ciencia:
- Atención neonatal; Investigación de fototerapia pediátrica; Metabolismo y tratamiento de la bilirrubina
Sus antecedentes:
- La fototerapia intermitente ha demostrado una eficacia comparable a la fototerapia continua para la ictericia neonatal.; Un novedoso diseño de estudio simuló la fototerapia en guardería interrumpiendo el tratamiento después de 10 horas.; La fototerapia en guardería durante 10 horas muestra una factibilidad potencial para el tratamiento de la hiperbilirrubinemia neonatal en lactantes de bajo riesgo.
Objetivo del estudio:
- Comparar la eficacia y seguridad de la fototerapia interrumpida simulada en guardería frente a la fototerapia continua para la ictericia neonatal.; Evaluar el impacto de un régimen de fototerapia interrumpida de 10 horas en los niveles de bilirrubina sérica total en neonatos.; Determinar la significación clínica de los niveles de bilirrubina post-tratamiento en neonatos que reciben fototerapia interrumpida.
Principales métodos:
- Se realizó un ensayo controlado aleatorizado paralelo con asignación uno a uno.; Los neonatos ictéricos de bajo riesgo se asignaron al grupo de fototerapia interrumpida de 10 horas o al grupo de fototerapia continua de 24 horas.; Se midió la bilirrubina sérica total (BST) antes del tratamiento y a las 24 horas posteriores al tratamiento.
Principales resultados:
- La tasa media de caída de la Bili Total en suero por hora no fue significativamente diferente entre los grupos (1,71 vs. 1,9 µmol/L/h, p=0,529).; La Bili Total en suero media post-tratamiento fue mayor en el grupo interrumpido (182 vs. 158 µmol/L, p=0,045), pero esta diferencia no fue clínicamente significativa.; Ningún neonato en ninguno de los grupos requirió la reinstitución o continuación de la fototerapia.
Conclusiones:
- La fototerapia interrumpida de 10 horas, administrada en un entorno de guardería, parece ser eficaz y segura para el tratamiento de la ictericia neonatal.; Este enfoque de fototerapia interrumpida puede ser una alternativa viable y práctica a la fototerapia continua para neonatos de bajo riesgo.; Investigaciones adicionales podrían explorar los resultados a largo plazo y la aplicabilidad más amplia de la fototerapia simulada en guardería.
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