Effectiveness of double-surface intensive phototherapy versus single-surface intensive phototherapy for neonatal hyperbilirubinemia.

ABSTRACT

OBJECTIVE: To compare the efficacy and adverse effects of double-surface intensive phototherapy (DsIPT) and single-surface intensive phototherapy (SsIPT) in term newborn infants with hyperbilirubinemia. DESIGN: Prospective randomized controlled trial. MATERIAL AND METHOD: Healthy full-term infants with nonhemolytic hyperbilirubinemia (total serum bilirubin between 13.0 to 19.9 mg/dl) were allocated randomly to two modes of phototherapy. Group 1 infants received single-surface intensive phototherapy. Group 2 infants received double-surface intensive phototherapy Serum bilirubin, body weight, body temperature and number of defecation were measured at 24 and 48 hours after phototherapy. RESULTS: Sixty infants were studied, 30 in each group. Baseline characteristics were similar in both groups. The initial mean serum bilirubin had no statistically significant difference between SsIPT and the DsIPT groups. After 24 and 48 hours of phototherapy, mean serum bilirubin in the group receiving SsIPT declined 3.5 +/- 1.7 and 6.5 +/- 2.3 mg/dl, while in the DsIPT group, the mean serum bilirubin declined 5.4 +/- 2.0 and 8.4 +/- 2.1 mg/dl respectively. The mean body temperature after 24 hours of phototherapy in the DsIPT group was higher than SsIPT group significantly. The number of defecation in the SsIPT group increased significantly after 24 and 48 hours of phototherapy, but the body weight change in both groups was not statistically significant. CONCLUSION: DsIPT was significantly more effective in reducing serum bilirubin than SsIPT in the term jaundiced infants after 24 and 48 hours of treatment. The adverse effect of DsIPT found in the present study was the increased of body temperature after 24 hours of phototherapy.