Comparison of The Efficacy of the Fiberoptic Phototherapy and Conventional Phototherapy for Neonatal Hyperbilirubinemia

Min, Hye Jung; Kim, Gwi Sook; Lee, Soo Kyung; Kim, Il Kyung; Sung, Ho; Choi, Chang Hee

Abstract

PURPOSE
We performed this study in order to compare the feasibility and efficacy of the fiberoptic phototherapy with conventional phototherapy and double phototherapy with single phototherapy for the treatment of neonatal hyperbilirubinemia while watching for any possible side effects of the system.
METHODS
During the period of February 1994 till June 1995, randomized controlled study was performed. 130 healthy term infants with non-hemolytic hyperbilirubinemia were enrolled, 45 patients received fiberoptic phototherapy, 40 patients received conventional phototherapy and 45 patients received double phototherapy. Criteria for inclusion in the study were 1) after 37 weeks of gestation 2) negative result of a direct coombs test 3) normal hemoglobin and hematocrit 4) no Rh or ABO incompatibility 5) plasma total bilirubin concentration exceed 10mg/dl during the first 3 days of life.
RESULTS
1) The mean total bilirubin decline level after 24 hours was 0.03 2.03mg/dl and the mean indirect bilirubin decline level after 24 hours was 0.12+/-1.35mg/dl in conventional phototherapy group(p<0.01), but in fiberoptic phototherapy group, the mean total bilirubin level was increased 1.26+/-1.68mg/dl and the mean indirect bilirubin level was increased 1.10+/-1.70mg/dl after 24 hours (p>0.01). 2) The mean total bilirubin decline level after 48 hours was 1.25 2.71mg/dl and the mean indirect bilirubin decline level was 1.17+/-1.52mg/dl in conventional phototherapy group (p<0.01). But in fiberoptic phototherapy group, the mean total bilirubin level was increased 0.97+/-2.81mg/dl and the mean indirect bilirubin level was increased 0.29+/-1.80mg/dl after 48 hours (p>0.01). 3) The mean decline levels of 24 hours-total and indirect bilirubin were 0.01+/-1.23mg/dl and 0.09+/-1.13mg/dl, and the mean decline levels of 48hours-total and indirect bilirubin were 0.92+/-1.85mg/dl and 0.99+/-1.08mg/dl (p<0.01), respectively, in double phototherapy group. But there were no statistically significant differences compared with the mean bilirubin decline levels in single phototheray group. 4) There were no significant differences in side effects such as decreased urine volume (p>0.01) or diarrhea(p>0.01) among three groups.
CONCLUSIONS
We conclude that fiberoptic phototherapy has less efficacy comparable to that of conventional phototherapy and double phototherapy has no significant differences in effectiveness compared with conventional phototherapy. So we hope further studies on the effects of the fiberoptic phototherapy in preterm infants and in after 48 hours will be done.