Fiberoptic PT as effective as blue light PT in hyperbilirubinemia in neonates: Study

Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates.

Therefore, Helvi N. Joel and colleagues from the Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, Tanzania conducted the present study to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods.

The authors carried out a randomized controlled trial conducted at the Kilimanjaro Christian Medical Centre (KCMC) with a total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia. Thirteen (13) neonates were allocated to receive fiberoptic phototherapy, 13 to blue light conventional phototherapy and 15 to white light conventional phototherapy.

Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and side effects of treatment. The data was analyzed with the independent t-test.

The results highlighted that –

a. The mean overall bilirubin reduction rate was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124).

b. However, white light conventional phototherapy had a significantly lower mean overall bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001).

c. The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively.

d. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy.

e. No side effects of treatment were noted in the fiberoptic phototherapy group.

Hence, the team concluded that "the effectiveness of fiberoptic PT and blue light conventional PT were comparable in terms of bilirubin reduction rate and treatment duration, whereas fiberoptic phototherapy was more effective than white light conventional PT, with a significantly higher bilirubin reduction rate and shorter treatment duration. Fiberoptic phototherapy may mitigate side effects caused by conventional phototherapy."