Analysis of therapeutic effect of intermittent and continuous phototherapy on neonatal hemolytic jaundice

Abstract

Clinical efficacy and adverse reaction rates of ABO hemolytic jaundice in patients with continuous and intermittent blue light irradiation were compared, to provide reference for clinical treatment of neonatal ABO hemolytic jaundice. A retrospective analysis of 307 patients with neonatal hemolytic jaundice admitted to Qilu Hospital of Shandong University (Qingdao) from January 2010 to December 2017 was undertaken. A total of 165 cases of children with continuous blue light irradiation and 142 cases of intermittent blue light irradiation were analyzed. Also the serum bilirubin levels, phototherapy time and frequency, treatment efficiency and adverse reaction rates were compared between the groups. The phototherapy time of children in the continuous phototherapy group was significantly higher from the intermittent phototherapy group, and the difference was statistically significant (t=26.800, P<0.001). Before treatment, there was no significant difference in serum bilirubin levels between continuous and intermittent phototherapy groups (P>0.050). Serum bilirubin levels of patients in continuous and intermittent phototherapy groups were lower than both previous and before treatment period, and differences were statistically significant (P<0.001). The overall effective rate of the continuous phototherapy group was higher than that of the intermittent phototherapy group (P>0.050). The adverse reaction rates after treatment in the continuous phototherapy group was significantly higher than the intermittent phototherapy group (P<0.050). After the symptomatic treatment in children, the adverse reactions ceased. The therapeutic effect of intermittent blue light irradiation on neonatal ABO hemolytic jaundice was consistent with the continuous blue light irradiation treatment, and the intermittent blue light irradiation treatment has a low adverse reaction rate, and is worth promotion in clinical practice.

Challenges of phototherapy for neonatal hyperbilirubinemia (Review)

“…Phototherapy is widely used, and blue light therapy is currently employed to treat neonatal jaundice in the majority of countries, including China. Blue light is employed mainly because bilirubin absorbs light, particularly on the blue part of the spectrum, near the main wavelength peak of 460 nm ( 40 , 41 ); in addition, compared with green and ultraviolet (UV) light, bilirubin molecules absorb blue light more readily ( 3 ). Furthermore, although UV light accounts for a small proportion (~0.3%) of the traditional blue-green phototherapy, when the skin is exposed to UV light, the pro-inflammatory pathway of the skin's immune system is activated, which increases the production of inflammatory factors and triggers an autoimmune response.…”

“…Neonatal jaundice is present in >50% of full-term newborns and it is more serious in late-preterm infants ( 1 , 2 ). Neonatal jaundice may be classed as physiological or pathological ( 3 , 4 ) and is principally caused by an increase in serum bilirubin during the neonatal period, which causes yellow discoloration of the skin, mucous membranes and sclerae ( 5 ). Neonatal hyperbilirubinemia is caused by an increase in blood bilirubin levels above the normal range.…”

Efficacy of Intermittent Phototherapy versus Continuous Phototherapy for Treatment of Neonatal Hyperbilirubinaemia: A Systematic Review and Meta‐analysis

“…Abbreviations: LOS, lengths of hospital stay; LOT, lengths of treatment; M, mean; SD, standard deviation, *M(SD). Sachdeva et al, 2015) and one retrospective (Zhou et al, 2019) study are summarized in Table 3.…”

“…Three studies, including a total of 429 enrolled neonates (SP, 1984;Sachdeva et al, 2015;Zhou et al, 2019), compared the phototherapy duration of intermittent phototherapy and continuous phototherapy.…”

Improving the Bilirubin Management Program in the Newborn Nursery: Background, Aims, and Protocol

“…Standard phototherapy is used when the TSB is between the 95th and 99th percentiles and the neonate does not have hemolytic jaundice as measured by ETCOc. Standard phototherapy is cycled, with3 h on and then 3 h off [22][23][24], coinciding with the vital sign measurements taken every 3 h, which are standard for our nursery neonates receiving phototherapy. During the 3-h off period, the neonate's phototherapy eye mask is removed and the mother is encouraged to breastfeed.…”