What is the role of phototherapy in the treatment of severe unconjugated neonatal hyperbilirubinemia?

Updated: May 21, 2019
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: BS Anand, MD  more...
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Answer

High-intensity light-emitting diode (LED) beds may be a safe rescue therapy for severe unconjugated neonatal hyperbilirubinemia. [69] In a study of 200 jaundiced neonates at or over 35 weeks' gestation who were phototherapy candidates, the use of a super LED bed achieved significantly higher success rates of intensive phototherapy (87%) compared with conventional intensive phototherapy with triple fluorescent tube units (64%). There was also a significantly greater reduction in bilirubin levels for both hemolytic and nonhemolytic subgroups in the super LED bed treatment group than in similar subgroups that received standard intensive phototherapy. [69]

In a retrospective study over an 11-year period of 147 neonates with severe unconjugated hyperbilirubinemia at risk of requiring exchange transfusion who were being transported for treatment, those who received phototherapy during transport (n=104) were less likely to require exchange transfusion (19.2% vs. 34.9%) than neonates who did not receive phototherapy during transport (n=43). [70] Moreover, although it did not reach statistical significance, the group that received phototherapy during transport also had an increased reduction in serum bilirubin levels from before to after transport compared to the group that did not receive phototherapy during transport.


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