Three Hundred Sixty Degree Phototherapy Versus Conventional Phototherapy in Neonatal Indirect Hyperbilirubinemia

Abstract

Background
 Phototherapy is the mainstay of treatment of hyperbilirubinemia. The efficacy of phototherapy depended on the light spectrum (wavelength), intensity of and type of the light and surface area of the infant exposed to phototherapy and distance of the light from the baby. A measure of the efficacy of phototherapy is the rate of decline in total serum bilirubin per hour and the dramatic reduction in the number of exchange transfusions being performed.
 Objectives
 To determine the efficacy of increasing surface area of phototherapy (360◦) compared with conventional single surface fluorescent phototherapy.
 Patients and Methods
 A prospective study was done for 214 neonates, who were admitted to neonatal care unit at Raprin teaching hospital in a period of 6 months from the first of January till the thirty of July 2013. Neonates were presented with significant indirect hyperbilirubinemia that needed phototherapy, less than two weeks of age were included in this study. According to the level of total serum bilirubin and availability of highly intensive phototherapy the cases were divided in to two groups.
 Results
 The mean starting TSB in group I was 15.03±2.53 mg/dl while in group II 19.65±3.34 mg/dl and the percentage of decline after 12 hour in group I was 19.17±13.08%, while in group II was 39.37±10.31% , and it was statistically significant (p<0.001). The decline rate after 12 hour ,regarding group I was 0.23 ± 0.21 mg/dl/hr, while in group II was 0.50 ± 0.33 mg/dl/hr which was statistically significant (p<0.001). There was a significant decline in the number of exchange transfusion in 2013 when the highly intensive 360 degree phototherapy started to be used.
 Conclusion
 Increasing surface area of exposure increase the rate of reducing of the serum bilirubin, and decreases rate of exchange transfusion as well.