ABSTRACT
BACKGROUND: Special blue tube lights of standard length are used in most neonatal units to deliver phototherapy. Of late, special blue compact fluorescent lamp phototherapy equipments have been introduced in India, which are claimed to be better than standard tube lights. AIM: To compare special blue compact fluorescent lamp (CFL) phototherapy with special blue standard-length tube lights (STL). METHODS: This randomized, controlled trial was conducted in a level III NICU. Neonates, otherwise healthy, of gestation greater than 34 weeks with hyperbilirubinemia requiring phototherapy, were included. Rh iso-immunized babies, those who underwent prior exchange transfusion and whose parents declined to consent were excluded. By stratified block randomization, babies were allocated to receive phototherapy by CFL or STL. CFL and STL were both special blue lights with irradiance maintained above 15 microWatts/nm/cm2. Total serum bilirubin (TSB) was measured 12 hourly till phototherapy was stopped or an exchange transfusion was done. Temperature and clinical and laboratory parameters of dehydration were recorded 12 hourly till 72 hrs. Nursing staff answered an objectivized proforma about the disadvantageous effects on nurses. RESULTS: Fifty babies were enrolled in each group. Baseline characteristics, causes of jaundice, hemolysis, baseline TSB and irradiance were similar in both groups. Mean duration of phototherapy (P = 0.98) was similar in both groups. Kaplan-Meier analysis of phototherapy duration showed no difference in the survival curves of the 2 groups (P = 0.6). Axillary temperature was similar in both groups and no baby was dehydrated. Nursing staff reported no significant differences between CFL and STL visavis glare hurting the eyes, giddiness and headache. CONCLUSIONS: CFL phototherapy has no superiority over STL phototherapy in terms of efficacy and adverse effects on the neonate and effects on nursing staff.
Subject(s)
Female , Fluorescence , Humans , Hyperbilirubinemia, Neonatal/nursing , India , Infant , Infant, Newborn , Intensive Care Units, Neonatal , Intensive Care, Neonatal/methods , Jaundice, Neonatal/nursing , Male , Phototherapy/instrumentation , Treatment OutcomeABSTRACT
A hiperbilirrubinemia neonatal é um evento freqüentemente observado em recém-nascidos a termo e prematuros, resultante do aumento dos níveis séricos de bilirrubina total. Trata-se de um estudo de revisão bibliográfica, que tem como objetivos discurrer sobre a assistência de enfermagem ao recém-nascido (RN) portador de hiperbilirrubinemia e submetido a fototerapia e/ou exsangüíneotransfusão, além de propor intervenções de enfermagem adequadas a estes tratamentos. Quanto à fototerapia, a literatura enfatiza: cuidados com pele e temperatura, além do estímulo da interação do binômio mãe e filho. Na exsangüíneotransfusão ressalta-se: o preparo dos materiais necessários para o procedimento e eventuais complicações, monitorização cardiorrespiratória e de pressão arterial, proporcionar equilíbrio térmico, controle glicêmico durante e após o procedimento, promoção de conforto ao RN. Os resultados encontrados possibilitaram concluir que a assistência de enfermagem aplicada ao RN, quando realizada de forma sistematizada, assegura a qualidade desta assistência, promovendo uma melhor e mais rápida recuperação, além de menor incidência de complicações.