Assement Efficacy and Complication of the Distance between Phototherapy Lamps and Neonate’s Body Level on Serum Bilirubin Decrease and Phototherapy Complications in Neonatal Hyperbilirubinemia

Document Type: Original Article

Authors

1 Department of Operative Room and Anesthetics, Iranian Research Center on Healthy Aging. School of paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran

2 Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Nursing and Midwifery School, Sabzevar University of Medical Sciences, Sabzevar, Iran

Abstract

Background: Jaundice is one of the most leading causes of neonate hospitalization (51.8%) during the first four weeks of life, and phototherapy is one of the most common and safest methods for the treatment of jaundice. Different results have been obtained from the studies conducted on the investigation of factors affecting increased phototherapy effect on the reduction of neonatal jaundice. However, there still exist many questions concerning the methods that maximize the effect of phototherapy.
The current research aimed to determine the effect of the distance between phototherapy lamps and neonate's body on the reduction of serum bilirubin and phototherapy complications in the neonates with physiologic jaundice.
Methods: The study was carried out on 60 newborns with jaundice. The neonates in the intervention group were put under phototherapy within a distance of 20 cm, and the ones in the control group underwent phototherapy within a distance of 40 cm. Daily bilirubin was measured at times 0, 12, and 24, and the neonates were examined in terms of serum bilirubin reduction and phototherapy complications.
Results: The obtained results revealed that phototherapy within the distance of 20 cm causes more reduction in the total bilirubin 12 and 24 hours after phototherapy. However, there was no significant difference between bilirubin 48 hours after phototherapy and phototherapy duration and the complications between the two groups.
Conclusion: Based on the results, the method of phototherapy distance reduction could be used as a safe and effective way for the quicker reduction of serum bilirubin level, prevention of hyperbilirubinemia complications and complications of blood transfusion in neonates with physiologic jaundice.

Keywords


1. Aouthmany MM. Phototherapy increases hemoglobin degradation and bilirubin production in preterm neonates. J Perinatol. 1999; 19(4):271-4.
2. Escobar GJ, Greene JD, Hulac P, Kincannon E, Bischoff K, Gardner M, et al. Rehospitalisation after birth hospitalisation: patterns among neonates of all gestations. Arch Dis Child. 2005; 90(2):125-31.
3. Lin CH, Yang HC, Cheng CS, Yen CE. Effects of neonate massage on jaundiced neonates undergoing phototherapy. Ital J Pediatr. 2015; 41(1):94.
4. Ehsanipour F, Khosravi N, Jalali S. The effect of hat on phototherapy-induced hypocalcemia in icteric newborns. Razi J Med Sci. 2008; 15(58):25-9.
5. Zauk AM. Phototherapy: a simple and safe treatment for neonatal jaundice. J Pediatr Neonat Care. 2015; 2(3):8-10.
6. Melton K, Akinbi HT. Neonatal jaundice: strategies to reduce bilirubin-induced complications. Postgrad Med. 1999; 106(6):167-78.
7. Farhat AS, Mohammadzadeh A. Assesment, diagnosis and treatment of pediatrics. 14th ed. Mashhad: Mashhad University of Medical Science; 2007.
8. Eghbalian F, Monsef AR. Comparison of the efficacy and complications between two dimensional phototherapy (cylindrical) and uni dimensional phototherapy (double) in neonatal unconjugated hyperbilirubinemia. J Urmia Univ Med Sci. 2010; 20(4):254-60.
9. Mohammady M, Janani L. Randomization in randomized clinical trials: from theory to practice. J Hayat. 2016; 22(2):102-14.
10. Boonyarittipong P, Kriangburapa W, Booranavanich K. Effectiveness of double-surface intensive phototherapy versus single-surface intensive phototherapy for neonatal hyperbilirubinemia. Med J Med Assoc Thai. 2008; 91(1):50-5.
11. Djokomuljanto S, Quah BS, Surini Y, Noraida R, Ismail N, Hansen TW, et al. Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains. Arch Dis Child Fetal and Neonatal Ed. 2006; 91(6):F439-42.
12. Salehzadeh F, Mirza Rahimi M, Janhangiri S, Habibzadeh S, Amini Sani N, Samshirgara M, et al. Mirror covered tunnel phototherapy increases the efficacy of phototherapy for neonatal jaundice. Iran J Neonatol. 2011; 1(1):20-3.
13. Naderi SA, Safdarian F, Jahanlou AR, Mazloomi D. Comparison of triple and double phototherapy in neonatal hyperbilirubinemia. Hormozgan Med Sci. 2009; 13(1):13-6.
14. Ek-isariyaphorn R, Maneenut R, Kardreunkaew J, Khobkhun W, Saenphrom S. The efficacy of the in-house light-emitting diode phototherapy equipment compare to conventional phototherapy equipment on the treatment of neonatal hyperbilirubinemia. J Med Assoc Thai. 2013; 96(12):1536-41.
15. Babaei H, Alipour AA, Hemmati M, Ghaderi M, Rezaei M. Effect of white plastic cover around the phototherapy unit on hyperbilirubinemia in full term neonates. Iran J Pediatr. 2013; 23(2):143-8.
16. Goodarzi R, Khamesan B, Hamedi Y, Yousefi F, Houshmandi MM. Comparing the effects of continuous and intermittent phototherapy in reducing bilirubin levels of neonates. J Urmia Univ Med Sci. 2013; 24(6):423-9.
17. Behjati S, Ghotbi H. Evaluation of efficacy and complication between three mode of phototherapy. Iran J Pediatr. 2006; 16(2):23-33.