Light-Emitting Diode (LED) Phototherapy versus Non-LED Phototherapy Devices for Hyperbilirubinemia in Neonates: A Systematic Review and Meta-analysis

Abstract

Objective: This review was conducted to evaluate the efficacy of light-emitting diode (LED) phototherapy as compared to the conventional phototherapy in neonates with unconjugated hyperbilirubinemia and their adverse effects. Study Design: We searched the following databases right from their inception till April, 2021: MEDLINE, EMBASE, Cochrane Library, and LILACS. Randomized clinical trials (RCTs) comparing the LED phototherapy with other light sources, which enrolled newborns (term and preterm) with unconjugated hyperbilirubinemia were included. Results: We included 21 articles in this review. The treatment with the LED light therapy had a lower failure rate as compared to the non-LED one (RR 0.60, 95% CI 0.39 to 0.94). The mean duration of phototherapy was significantly shorter in the group with the LED light source as compared to the one with the non-LED light source (mean difference (hours) −8.07, 95% CI −8.45 to −7.68), regardless of the type of non-LED units. However, the rate of bilirubin showed a comparable decline (mean difference (mg/dL/hour) 0.01, 95% CI −0.00, 0.03) in both the light sources, irrespective of irradiance or distance. No studies reported primary outcomes related to the neurotoxicity effects of hyperbilirubinemia in neonates. The LED light devices caused a significantly higher risk of hypothermia. Neonates were at a lower risk of developing hyperthermia and skin rash with the LED light therapy. Conclusion: Our findings provide support for the use of LED light source phototherapy due to its better clinical efficacy, which is evidenced by its shorter duration and lower rate of treatment failure, as compared to the non-LED light sources.

A scattered volume emitter micropixel architecture for ultra efficient light extraction from DUV LEDs

“…Deep ultraviolet (UV) light-emitting diodes (LEDs) covering 100 nm to 400 nm wavelengths (UV-C and UV-B, respectively) have various applications in disinfection 1,2 , sterilization 3,4 , phototherapy 5,6 , plant growth 7,8 , water/ food decontamination 9,10 , and sensing 11,12 . It has great potential to replace harmful mercury-based lamps as the primary UV light source because aluminum gallium nitride (AlGaN)-based emitters are environmentally friendly, cost effective, highly robust, and energy efficient [13][14][15] .…”

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

“…Light other than that between the range of 460 and 490 nm causes unnecessary heat and possibly harmful wavelengths [25]. A light-emitting diode (LED wavelength is 460-490 nm) is a newer type of light source which is energy-efficient, has a longer life, has a low heat output, is effective in lowering bilirubin levels, and is thus recommended for better clinical effectiveness, with a shorter treatment period and a lower rate of treatment failure, compared to non-LED light sources [25][26][27][28]. Phototherapy using optical fibers includes devices such as Bilibed, Bilisoft Cover, Bilipad, or Bilicocoon.…”

Recent Advances in Adjuvant Pharmacotherapy for Neonatal Indirect Hyperbilirubinemia: A Narrative Review

“…The Bhutani nomogram was published by the American Academy of Pediatrics (AAP) and indicated the percentile curve of expected hourly total serum bilirubin (TSB) of newborns in venous blood. Significant hyperbilirubinemia in infants ≥ 35 weeks of gestational age (GA) is defined as a TSB > 95th percentile on the hour-specific Bhutani nomogram after birth (6,7). Severe and extreme neonatal hyperbilirubinemia is defined as TSB > 25 and > 30 mg/dl in this GA, respectively.…”

“…Another type is breast milk jaundice due to abnormality in breast milk that occurs later (10,11). Since indirect bilirubin is fat-soluble and can pass through the brain-blood barrier (BBB), it increases the risk of neurological deficits, such as hearing loss, intellectual development disorders, kernicterus, and even death (6). The etiology of pathological IHB varies depending on the geographical area and genetic structure of infants.…”