59 Prevention of Hyperbilirubinemia of Prematurity by Phototherapy

Lucey, Jerold F.; Ferreiro, Mario; Hewitt, Jean

doi:10.1203/00006450-196705000-00066

Cited by 50 publications

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“…Thrombocytopenia was defined as platelet count < 150,000/ mm 3 . Mild, moderate and severe thrombocytopenia were defined as platelet counts between 100,000-150,000/mm 3 ; 50,000-100,000/mm 3 ; < 50,000/mm 3 , respectively.…”

Section: Introductionmentioning

confidence: 99%

“…It reduces or blunts the rise of unconjugated bilirubin levels regardless of maturity, presence or absence of haemolysis. 3,4 Phototherapy though safe, is not free of side effects. Neonates receiving phototherapy have increased insensible water loss, redistribution of blood flow, watery diarrhoea, irritability, rise in temperature, retinal damage, bronze baby syndrome, gonadal toxicity, impaired maternal-infant interaction, hypocalcaemia, riboflavin deficiency, DNA strand breakage, chromosomal mutations damage, and in few studies even thrombocytopenia.…”

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confidence: 99%

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Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates

Khera

Gupta

2011

Medical Journal Armed Forces India

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is observed in first week of life in approximately 60% full-term and 80% pre-term neonates. 1,2 The various modalities of treatment for neonatal jaundice include phototherapy, exchange transfusion, and drugs like phenobarbitone, intravenous immunoglobulin, metalloporphyrin, etc. Amongst them, phototherapy has emerged as the most widely used form for the treatment of unconjugated hyperbilirubinaemia. It reduces or blunts the rise of unconjugated bilirubin levels regardless of maturity, presence or absence of haemolysis. 3,4 Phototherapy though safe, is not free of side effects. Neonates receiving phototherapy have increased insensible water loss, redistribution of blood flow, watery diarrhoea, irritability, rise in temperature, retinal damage, bronze baby syndrome, gonadal toxicity, impaired maternal-infant interaction, hypocalcaemia, riboflavin deficiency, DNA strand breakage, chromosomal mutations damage, and in few studies even thrombocytopenia. 1,2,5,7 Thrombocytopenia as a side effect of phototherapy that has not been described in the standard textbooks although many authors did try to look into this particular side effect. Maurer et al 5,6 and Pishwa et al 7 observed in their studies that neonates exposed to phototherapy had decreased platelet counts and increased platelet turnover.This study was done with an aim to find the incidence of thrombocytopenia in neonates with indirect hyperbilirubinaemia receiving phototherapy. MATERIALS AND METHODThis was a prospective study done at a tertiary care hospital between July 2007 and July 2009; in consecutively enrolled cohort of apparently healthy neonates, who developed indirect hyperbilirubinaemia and required phototherapy irrespective of gestational age and birth weight. The indication of phototherapy was based on the guidelines of American Academy of Pediatrics 2004. 8 The neonates having a base line platelet count of more than 150,000/mm 3 before starting phototherapy were included in the study. Neonates having features suggestive of haemolysis, direct hyperbilirubinaemia, sepsis, anti-platelet drugs given to baby or mother, haemangioma, and other congenital anomalies were excluded. Neonates who developed features suggestive of sepsis during phototherapy were also excluded.Neonates who fulfilled the inclusion criteria were admitted to the hospital. After a detailed history, clinical examination and baseline investigations all babies were put on continuous phototherapy. Platelet counts were performed at admission, 24 hours, Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonatesMaj Sanjeev Khera*, Col Rakesh Gupta † ABSTRACT BACKGROUND

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Section: Introductionmentioning

confidence: 99%

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Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates

Khera

Gupta

2011

Medical Journal Armed Forces India

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“…3 Phototherapy finally arrived in the United States when Lucey et al 3 published their findings in 1968. Why did it take 10 years for this safe and effective therapy to come to the New World?…”

Section: Introductionmentioning

confidence: 99%

“…(See Figures 1 and 2 for the impact phototherapy might have had.) Lucey et al 3 exposed premature infants to a light chamber consisting of ten 20-W daylight bulbs and showed that they could effectively prevent hyperbilirubinemia. Subsequently, Lucey 4 combined his data with two other studies of prophylactic phototherapy in low birth weight newborns.…”

Section: Introductionmentioning

confidence: 99%

Phototherapy — Traditional and Nontraditional

2001

J Perinatol

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“…São ainda comentadas as características de diferentes equipamentos de fototerapia que podem interferir na mensuração da irradiância dos mesmos. (2): 67-74: fototerapia, radiometria, equipamento.…”

Section: Introductionunclassified

Proposta de padronização para aferição de equipamentos de fototerapia

Facchini¹

2001

J. Pediatr. (Rio J.)

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Objective: to propose a method to evaluate and maintain the efficiency of equipment commonly used in Brazil in order to obtain uniform results in phototherapy treatments in different services.Material and methods: the radiometer/photometer used to measure spectral irradiance is locally manufactured and fulfills basic requirements. Measure standardization seeks to be applicable and reproducible to phototherapy devices employed in Brazil. The material necessary for measurements can be easily assembled by the neonatology staff, except for the radiometer. We searched Medline for papers relevant to this review published throughout the last 10 years.Results: irradiance in phototherapy issues should be referred to as "medium spectral irradiance". We describe how to obtain medium spectral irradiance using fluorescent and halogen phototherapies.Comments: the components of a radiometer/photometer are described. This knowledge is fundamental to understanding sensibility variations and to justifying differences in irradiance when ranges of radiometer recording are a little different. The standardization of this device will certainly simplify the comparison between results in different services.We also analyzed characteristics of different equipment used in phototherapy that might interfere with their irradiance.J Pediatr (Rio J) 2001; 77 (2): 67-74: phototherapy, radiometry, equipment. ResumoObjetivo: propor método de avaliação e manutenção da eficiên-cia dos equipamentos mais comumente usados em nosso meio, de maneira a uniformizar os resultados obtidos em tratamentos fototerápicos por diferentes serviços.Material e métodos: o radiômetro/fotômetro utilizado na medida da irradiância espectral é de fabricação nacional e atende aos requisitos básicos indispensáveis. As padronizações de medida procuram ser facilmente aplicáveis e reprodutíveis aos aparelhos de fototerapia em uso no país. O material necessário às aferições, excetuando-se o radiômetro, pode ser facilmente confeccionado em qualquer serviço de neonatologia. Procuramos nos trabalhos publicados nos últimos 10 anos no Medline os pertinentes a esta revisão.Resultado: propõe-se que a irradiância relatada nos trabalhos de fototerapia seja fornecida como Irradiância Espectral Média e descreve-se como obtê-la, tanto em fototerapias com fontes fluorescentes como halógenas.Comentários: são descritos os componentes dos radiômetros/ fotômetros, cuja compreensão é importante para que possamos perceber variações na sensibilidade e diferenças significativas na irradância quando as faixas de leitura dos radiômetros são um pouco diferentes. A adoção de um tipo de equipamento padrão facilitaria muito a comparação de resultados obtidos por diferentes serviços. São ainda comentadas as características de diferentes equipamentos de fototerapia que podem interferir na mensuração da irradiância dos mesmos.J Pediatr (Rio J) 2001; 77 (2): 67-74: fototerapia, radiometria, equipamento. Proposta de padronização para aferição de equipamentos de fototerapia Standardizing the calibration...

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59 Prevention of Hyperbilirubinemia of Prematurity by Phototherapy

Cited by 50 publications

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Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates

Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates

Phototherapy — Traditional and Nontraditional

Proposta de padronização para aferição de equipamentos de fototerapia

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