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Comparison of Two Phototherapy Methods (Prophylactic vs Therapeutic) for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns

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Author(s): Ramin Iranpour | Majid Mohammadizadeh | Seyedeh-Sarah Nazem-Sadati

Journal: Iranian Journal of Pediatrics
ISSN 2008-2142

Volume: 21;
Issue: 4;
Start page: 425;
Date: 2011;
Original page

Keywords: Phototherapy | Neonatal jaundice | Preterm Neonate | VLBW infant

ABSTRACT
Objective: Preterm and low birth weight (LBW) infants are at greater risk of developing bilirubin-associated brain damage compared with term infants. Certainly, phototherapy, if used appropriately, is capable of controlling the bilirubin levels in LBW infants; but there is not a unique phototherapy treatment strategy in LBW infants. This study was designed to compare the prophylactic phototherapy and late treatment of jaundiced newborns weighing 1000-1500 grams."nMethods: Sixty newborns with birth weight 1000-1500 g were studied. They were divided into two groups: the "Prophylactic" group, in which phototherapy started within six hours after birth and continued for at least 96 hours, and the "Treatment" group, which received phototherapy when indicated according to birth weight and suspended when bilirubin level fell below 50% of bilirubin level for blood exchange. Mean value of daily transcutaneous bilirubin (TCB), duration of phototherapy, the need for blood exchange, and the highest TCB value in both groups were analyzed."nFindings: In the prophylactic group, the highest daily mean rate of TCB was 7.71±1.84 mg/dl, which happened on the third day. In the treatment group, it was 8.74±1.72 mg/dl on the fourth day after birth. The TCB values in prophylactic group were significantly less than those of the treatment group only on the fourth and fifth days after birth (P
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