Skip to main content
Top
Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Phototherapy | Research article

Effectiveness of FIBEROPTIC phototherapy compared to conventional phototherapy in treating HYPERBILIRUBINEMIA amongst term neonates: a randomized controlled trial

Authors: Helvi N. Joel, Deborah N. Mchaile, Rune N. Philemon, Ronald M. Mbwasi, Levina Msuya

Published in: BMC Pediatrics | Issue 1/2021

Login to get access

Abstract

Background

Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods.

Methods

This was a randomized controlled trial conducted at the Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) neonates were allocated to receive fiberoptic phototherapy, 13 to blue light conventional phototherapy and 15 to white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and side effects of treatment. The data was analyzed with the independent t-test.

Results

The mean overall bilirubin reduction rate was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower mean overall bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No side effects of treatment were noted in the fiberoptic phototherapy group.

Conclusion

The effectiveness of fiberoptic PT and blue light conventional PT were comparable in terms of bilirubin reduction rate and treatment duration, whereas fiberoptic phototherapy was more effective than white light conventional PT, with a significantly higher bilirubin reduction rate and shorter treatment duration. Fiberoptic phototherapy may mitigate side effects caused by conventional phototherapy.

Trial registration

The Pan African Clinical Trial Registry, PACTR20200472357​0110. Registered 22nd April 2020- Retrospectively registered.
Literature
1.
go back to reference Hülya B, Eren O, Ahmet T. Is the hour-specific bilirubin nomogram suitable for predicting hyperbilirubinemia. Indian J Pediatr. 2008;75(1):447–50.PubMedCrossRef Hülya B, Eren O, Ahmet T. Is the hour-specific bilirubin nomogram suitable for predicting hyperbilirubinemia. Indian J Pediatr. 2008;75(1):447–50.PubMedCrossRef
2.
go back to reference Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015;5:1–21. Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015;5:1–21.
3.
go back to reference Althomali R, Aloqayli R, Alyafi B, Nono A, Alkhalaf S, Aljomailan A, et al. Neonatal jaundice causes and management. Int J Commun Med Public Heal. 2018;5(11):4992–6.CrossRef Althomali R, Aloqayli R, Alyafi B, Nono A, Alkhalaf S, Aljomailan A, et al. Neonatal jaundice causes and management. Int J Commun Med Public Heal. 2018;5(11):4992–6.CrossRef
4.
go back to reference Flaherman VJ, Maisels MJ. Guidelines for Management of Jaundice in the breastfeeding infant 35 weeks or more of gestation. Breastfeed Med. 2017;12(5):250–7.PubMedCrossRef Flaherman VJ, Maisels MJ. Guidelines for Management of Jaundice in the breastfeeding infant 35 weeks or more of gestation. Breastfeed Med. 2017;12(5):250–7.PubMedCrossRef
5.
go back to reference Mreihil K, Benth JŠ, Stensvold HJ, Nakstad B, Hansen TWR, Scheck O, et al. Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants. Acta Paediatr. 2017;11:611–9. Mreihil K, Benth JŠ, Stensvold HJ, Nakstad B, Hansen TWR, Scheck O, et al. Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants. Acta Paediatr. 2017;11:611–9.
7.
go back to reference Vreman HJ, Olusanya BO, Wong RJ, Brearley M, Vaucher YE, Stevenson K. Safety and efficacy of filtered sunlight in treatment of jaundice in African neonates. Paediatrics. 2014;133(6):e1568–74.CrossRef Vreman HJ, Olusanya BO, Wong RJ, Brearley M, Vaucher YE, Stevenson K. Safety and efficacy of filtered sunlight in treatment of jaundice in African neonates. Paediatrics. 2014;133(6):e1568–74.CrossRef
8.
go back to reference Slusher TM, Olusanya BO, Vreman H. Brearly, a M, Vaucher YE, Lund TC, et al. a randomized trial of phototherapy with filtered sunlight in African neonates. N Engl J Med. 2015;373(12):1115–24.PubMedCrossRef Slusher TM, Olusanya BO, Vreman H. Brearly, a M, Vaucher YE, Lund TC, et al. a randomized trial of phototherapy with filtered sunlight in African neonates. N Engl J Med. 2015;373(12):1115–24.PubMedCrossRef
9.
go back to reference Pratita W, Tjipta GD. Phototherapy for neonatal jaundice at distances of 20 cm vs 40 cm. Paediatr Indones. 2013;53(5):278–82.CrossRef Pratita W, Tjipta GD. Phototherapy for neonatal jaundice at distances of 20 cm vs 40 cm. Paediatr Indones. 2013;53(5):278–82.CrossRef
10.
go back to reference Kaam V, Van B, Keulen V, Lutz-Dettinger N, Sauer P. Fibre optic versus conventional phototherapy for hyperbilirubinaemia in preterm infants. Eur J Pediatr. 1998;157(6):132–7.PubMedCrossRef Kaam V, Van B, Keulen V, Lutz-Dettinger N, Sauer P. Fibre optic versus conventional phototherapy for hyperbilirubinaemia in preterm infants. Eur J Pediatr. 1998;157(6):132–7.PubMedCrossRef
11.
go back to reference AL-Alaiyan S. Fiberoptic , Conventional And Combination Phototherapy For Treatment Of Nonhemolytic Hyperbilirubinemia In Neonates Fiberoptic , Conventional And Combination Phototherapy For Treatment Of Nonhemolytic. Ann Saudi Med. 1996;16(6):633–6.PubMedCrossRef AL-Alaiyan S. Fiberoptic , Conventional And Combination Phototherapy For Treatment Of Nonhemolytic Hyperbilirubinemia In Neonates Fiberoptic , Conventional And Combination Phototherapy For Treatment Of Nonhemolytic. Ann Saudi Med. 1996;16(6):633–6.PubMedCrossRef
12.
go back to reference Mills JF, Tudehope D. Fibreoptic phototherapy for neonatal jaundice. N Engl J Med. 2008;358(9):1–9. Mills JF, Tudehope D. Fibreoptic phototherapy for neonatal jaundice. N Engl J Med. 2008;358(9):1–9.
13.
go back to reference Costello SA, Nyikal J, Yu VYH, Mccloud P. BiliBlanket phototherapy system versus conventional phototherapy : a randomized controlled trial in preterm infants. J Paediatr Child Health. 1995;31(9):11–3.PubMedCrossRef Costello SA, Nyikal J, Yu VYH, Mccloud P. BiliBlanket phototherapy system versus conventional phototherapy : a randomized controlled trial in preterm infants. J Paediatr Child Health. 1995;31(9):11–3.PubMedCrossRef
14.
go back to reference AAPSH. Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114(1):297–316.CrossRef AAPSH. Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114(1):297–316.CrossRef
15.
go back to reference Schuman AJ, Karush G, Ph D. Phototherapy for neonatal Hyperbilirubinemia. Clin Pediatr. 1992;6:345–52.CrossRef Schuman AJ, Karush G, Ph D. Phototherapy for neonatal Hyperbilirubinemia. Clin Pediatr. 1992;6:345–52.CrossRef
16.
go back to reference Tan K. Comparison of the efficacy of fiberoptic and conventional phototherapy for neonatal hyperbilirubinemia. J Pediatr. 1994;125(4):607–12.PubMedCrossRef Tan K. Comparison of the efficacy of fiberoptic and conventional phototherapy for neonatal hyperbilirubinemia. J Pediatr. 1994;125(4):607–12.PubMedCrossRef
17.
go back to reference Al-alaiyan S. Fiberoptic , Conventional and Combination Phototherapy for Treatment of Nonhemolytic Hyperbilirubinemia in Neonates. Ann Saudi Med. 1996;16(6):633–6.PubMedCrossRef Al-alaiyan S. Fiberoptic , Conventional and Combination Phototherapy for Treatment of Nonhemolytic Hyperbilirubinemia in Neonates. Ann Saudi Med. 1996;16(6):633–6.PubMedCrossRef
18.
go back to reference Sarici SÜ, Alpay F, Ünay B, Özcan O, Gökçay E. Comparison of the efficacy of conventional special blue light phototherapy and fiberoptic phototherapy in the management of neonatal hyperbilirubinaemia. Acta Paediatr Int J Paediatr. 1999;88(11):1249–53.CrossRef Sarici SÜ, Alpay F, Ünay B, Özcan O, Gökçay E. Comparison of the efficacy of conventional special blue light phototherapy and fiberoptic phototherapy in the management of neonatal hyperbilirubinaemia. Acta Paediatr Int J Paediatr. 1999;88(11):1249–53.CrossRef
19.
go back to reference Holtrop PC, Madison K, Maisels J. A clinical trial of Fiberoptic phototherapy vs conventional phototherapy. Am J Dis Child. 1992;146(2):235–7.PubMed Holtrop PC, Madison K, Maisels J. A clinical trial of Fiberoptic phototherapy vs conventional phototherapy. Am J Dis Child. 1992;146(2):235–7.PubMed
20.
go back to reference Gutta S, Shenoy J, Kamath SP, Mithra P, Baliga BS, Sarpangala M, et al. Light emitting diode ( LED ) phototherapy versus conventional phototherapy in neonatal Hyperbilirubinemia: a single blinded randomized control trial from coastal India. Biomed Res Int 2019;2019(4):1–7. Gutta S, Shenoy J, Kamath SP, Mithra P, Baliga BS, Sarpangala M, et al. Light emitting diode ( LED ) phototherapy versus conventional phototherapy in neonatal Hyperbilirubinemia: a single blinded randomized control trial from coastal India. Biomed Res Int 2019;2019(4):1–7.
Metadata
Title
Effectiveness of FIBEROPTIC phototherapy compared to conventional phototherapy in treating HYPERBILIRUBINEMIA amongst term neonates: a randomized controlled trial
Authors
Helvi N. Joel
Deborah N. Mchaile
Rune N. Philemon
Ronald M. Mbwasi
Levina Msuya
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Phototherapy
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-020-02458-2

Other articles of this Issue 1/2021

BMC Pediatrics 1/2021 Go to the issue