A Randomized Controlled Trial Comparing the Duration of Phototherapy Following NICE and AAP Guidelines in Neonatal Hyperbilirubinemia

ABSTRACT

Aims and Objectives: To compare duration of phototherapy between AAP and NICE guidelines in neonatal hyperbilirubinemia. Methods: In an open labelled study 130 babies with non-haemolytic hyperbilirubinemia were randomised to receive phototherapy following one guidelines between AAP and NICE. In this study we compared AAP 2004 and NICE 2010 guidelines to see whether following any of these two guidelines leads to phototherapy for longer duration. The primary outcome variable was duration of phototherapy and the secondary outcome variable was failure of phototherapy, defined as inability to reduce the TSB level of 2-3 mg/dl from baseline within 6 hours of phototherapy or inability to reduce TSB below exchange level. Results: Median age at onset of phototherapy was 77.55(19.43)hours in AAP group and 73.57(12.93) hours in NICE group, median gestational age was 37weeks in AAP group and 38weeks in NICE group, mean birth weight 2377.92gm in AAP group and 2457.10 gm. in NICE group, mean serum bilirubin at the onset of phototherapy was 18.77(1.570) mg/dl in AAP group and 18.24(1.89)g/dl in the NICE group. Average spectral irradiance was 55.8(µw/cm2/nm) in the study. Median duration of phototherapy in NICE as well as AAP group was 18 hours. There was no treatment failure in either group. Neurological examination was done at 40 weeks and 3 moths of corrected age. No abnormal neurological examination or BERA finding was reported in any of the babies. Conclusion: There is no difference in duration of phototherapy in any of the guidelines.