Analysis of therapeutic effect of intermittent and continuous phototherapy on neonatal hemolytic jaundice

Zhou,Shiying; Wu,Xiaoyan; Ma,Aihua; Zhang,Min; Liu,Yanli

doi:10.3892/etm.2019.7432

Analysis of therapeutic effect of intermittent and continuous phototherapy on neonatal hemolytic jaundice

Authors:
- Shiying Zhou
- Xiaoyan Wu
- Aihua Ma
- Min Zhang
- Yanli Liu
View Affiliations

Affiliations: Department of Pediatric Internal Medicine, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong 266000, P.R. China, Department of Pediatrics, People's Hospital of Chiping, Liaocheng, Shandong 252000, P.R. China, PIVAS, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China, Department of Stomatology, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China
Published online on: March 22, 2019 https://doi.org/10.3892/etm.2019.7432
Pages: 4007-4012
Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Clinical efficacy and adverse reaction rates of ABO hemolytic jaundice in patients with continuous and intermittent blue light irradiation were compared, to provide reference for clinical treatment of neonatal ABO hemolytic jaundice. A retrospective analysis of 307 patients with neonatal hemolytic jaundice admitted to Qilu Hospital of Shandong University (Qingdao) from January 2010 to December 2017 was undertaken. A total of 165 cases of children with continuous blue light irradiation and 142 cases of intermittent blue light irradiation were analyzed. Also the serum bilirubin levels, phototherapy time and frequency, treatment efficiency and adverse reaction rates were compared between the groups. The phototherapy time of children in the continuous phototherapy group was significantly higher from the intermittent phototherapy group, and the difference was statistically significant (t=26.800, P<0.001). Before treatment, there was no significant difference in serum bilirubin levels between continuous and intermittent phototherapy groups (P>0.050). Serum bilirubin levels of patients in continuous and intermittent phototherapy groups were lower than both previous and before treatment period, and differences were statistically significant (P<0.001). The overall effective rate of the continuous phototherapy group was higher than that of the intermittent phototherapy group (P>0.050). The adverse reaction rates after treatment in the continuous phototherapy group was significantly higher than the intermittent phototherapy group (P<0.050). After the symptomatic treatment in children, the adverse reactions ceased. The therapeutic effect of intermittent blue light irradiation on neonatal ABO hemolytic jaundice was consistent with the continuous blue light irradiation treatment, and the intermittent blue light irradiation treatment has a low adverse reaction rate, and is worth promotion in clinical practice.

View Figures

View References

1	Chang PF, Lin YC, Liu K, Yeh SJ and Ni YH: Identifying term breast-fed infants at risk of significant hyperbilirubinemia. Pediatr Res. 74:408–412. 2013. View Article : Google Scholar : PubMed/NCBI
2	Moncrieff G: Bilirubin in the newborn: Physiology and pathophysiology. Br J Midwifery. 26:362–370. 2018. View Article : Google Scholar
3	Christensen RD, Nussenzveig RH, Yaish HM, Henry E, Eggert LD and Agarwal AM: Causes of hemolysis in neonates with extreme hyperbilirubinemia. J Perinatol. 34:616–619. 2014. View Article : Google Scholar : PubMed/NCBI
4	Bjerre JV, Petersen JR and Ebbesen F: Surveillance of extreme hyperbilirubinaemia in Denmark. A method to identify the newborn infants. Acta Paediatr. 97:1030–1034. 2008. View Article : Google Scholar : PubMed/NCBI
5	Olusanya BO, Teeple S and Kassebaum NJ: The contribution of neonatal jaundice to global child mortality: findings from the GBD 2016 study. Pediatrics. 141:e201714712018. View Article : Google Scholar : PubMed/NCBI
6	Lee BK, Le Ray I, Sun JY, Wikman A, Reilly M and Johansson S: Haemolytic and nonhaemolytic neonatal jaundice have different risk factor profiles. Acta Paediatr. 105:1444–1450. 2016. View Article : Google Scholar : PubMed/NCBI
7	Christensen RD and Yaish HM: Hemolytic disorders causing severe neonatal hyperbilirubinemia. Clin Perinatol. 42:515–527. 2015. View Article : Google Scholar : PubMed/NCBI
8	Agarwal V, Singh V, Goel SP and Gupta B: Maternal and neonatal factors affecting physiological jaundice in western U.P. Indian J Physiol Pharmacol. 51:203–206. 2007.PubMed/NCBI
9	Wei CC, Chang CH, Lin CL, Chang SN, Li TC and Kao CH: Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: A population-based cohort study. J Child Psychol Psychiatry. 56:460–467. 2015. View Article : Google Scholar : PubMed/NCBI
10	Maisels MJ and McDonagh AF: Phototherapy for neonatal jaundice. N Engl J Med. 358:920–928. 2008. View Article : Google Scholar : PubMed/NCBI
11	Itoh S, Okada H, Kuboi T and Kusaka T: Phototherapy for neonatal hyperbilirubinemia. Pediatr Int (Roma). 59:959–966. 2017. View Article : Google Scholar
12	Ebbesen F, Madsen PH, Vandborg PK, Jakobsen LH, Trydal T and Vreman HJ: Bilirubin isomer distribution in jaundiced neonates during phototherapy with LED light centered at 497 nm (turquoise) vs. 459 nm (blue). Pediatr Res. 80:511–515. 2016. View Article : Google Scholar : PubMed/NCBI
13	Mreihil K, Benth JS, Stensvold HJ, Nakstad B and Hansen TWR; Norwegian NICU Phototherapy Study Group; Norwegian neonatal network, : Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants. Acta Paediatr. 107:611–619. 2018. View Article : Google Scholar : PubMed/NCBI
14	Maisels MJ: Phototherapy in the neonatal intensive care unit-quantity and quality. Acta Paediatr. 107:551–553. 2018. View Article : Google Scholar : PubMed/NCBI
15	Bhutani VK and Wong R: Bilirubin-induced neurologic dysfunction (BIND). Semin Fetal Neonatal Med. 20:12015. View Article : Google Scholar : PubMed/NCBI
16	Zecca E, Barone G, De Luca D, Marra R, Tiberi E and Romagnoli C: Skin bilirubin measurement during phototherapy in preterm and term newborn infants. Early Hum Dev. 85:537–540. 2009. View Article : Google Scholar : PubMed/NCBI
17	Kaplan M, Hammerman C, Renbaum P, Klein G and Levy-Lahad E: Gilbert's syndrome and hyperbilirubinaemia in ABO-incompatible neonates. Lancet. 356:652–653. 2000. View Article : Google Scholar : PubMed/NCBI
18	Jiao Y, Jin Y, Meng H and Wen M: An analysis on treatment effect of blue light phototherapy combined with Bifico in treating neonatal hemolytic jaundice. Exp Ther Med. 16:1360–1364. 2018.PubMed/NCBI
19	Mreihil K, Madsen P, Nakstad B, Benth JS, Ebbesen F and Hansen TW: Early formation of bilirubin isomers during phototherapy for neonatal jaundice: effects of single vs. double fluorescent lamps vs. photodiodes. Pediatr Res. 78:56–62. 2015. View Article : Google Scholar : PubMed/NCBI
20	Oláh J, Tóth-Molnár E, Kemény L and Csoma Z: Long-term hazards of neonatal blue-light phototherapy. Br J Dermatol. 169:243–249. 2013. View Article : Google Scholar : PubMed/NCBI
21	Sachdeva M, Murki S, Oleti TP and Kandraju H: Intermittent versus continuous phototherapy for the treatment of neonatal non-hemolytic moderate hyperbilirubinemia in infants more than 34 weeks of gestational age: a randomized controlled trial. Eur J Pediatr. 174:177–181. 2015. View Article : Google Scholar : PubMed/NCBI
22	Lamola AA, Bhutani VK, Wong RJ, Stevenson DK and McDonagh AF: The effect of hematocrit on the efficacy of phototherapy for neonatal jaundice. Pediatr Res. 74:54–60. 2013. View Article : Google Scholar : PubMed/NCBI
23	Maisels MJ, Ramaswamy D and Kring EA: Does phototherapy cause benign skin rashes in newborn infants? Acta Paediatr. 103:e133–e135. 2014. View Article : Google Scholar : PubMed/NCBI
24	Hansen TW: Let there be light - but should there be less? J Perinatol. 32:649–651. 2012. View Article : Google Scholar : PubMed/NCBI
25	Mills JF and Tudehope D: Fibreoptic phototherapy for neonatal jaundice. Cochrane Database Syst Rev. 1:CD0020602001.
26	Stokowski LA: Fundamentals of phototherapy for neonatal jaundice. Adv Neonatal Care. 11 (Suppl 5):S10–S21. 2011. View Article : Google Scholar : PubMed/NCBI