Abstract
Jaundice is observed during the first week of life in approximately 60% of term infants and 80% of preterminfants.1 Out of the 60% only 5% term and 20% preterm actually need treatment2 like phototherapy. Theobjective of the study was to calculate rate of fall of total serum bilirubin in jaundiced babies followingcontinuous and intermittent phototherapy. A non-randomized, group matched, prospective, experimentalstudy involving two comparable populations of 91 jaundiced babies receiving intermittent (45 babies - 6hour on and 6 hour off) and continuous phototherapy (46 babies) were studied at the Tribhuvan UniversityTeaching Hospital over a period of six months. The percent fall of total serum bilirubin for each 24-hour onfirst, second, third and fourth day of phototherapy was -9.724% (SD 25.094), 4.717% (SD 17.52), 7.468%(SD 7.811) and 7.349% (SD 4.482) respectively in continuous phototherapy. The corresponding figures forintermittent phototherapy were -13.623% (SD 26.804), 1.131% (SD 19.965), 7.672% (SD 15.365) and 12.864%(SD 8.29). The differences were statistically insignificant on the first, second and third day (p=0.51, p=0.60and p=0.95 respectively). On the fourth day it was higher with the intermittent phototherapy (p=0.04). Thetotal duration of photo exposure was 64.435 hours (SD 22.251) in the continuous phototherapy group ascompared to 35.581 hours (SD 12.855) in the intermittent phototherapy group (p=0.000001). In view of theconcern, which has been raised regarding the possible long-term side effects of phototherapy, intermittentphototherapy offers an attractive therapeutic alternative by reducing the duration of light exposure toabout half without decreasing the efficacy.Key Words: Neonatal jaundice, phototherapy.
Highlights
Jaundice is observed during the first week of life in approximately 60%of term infants and 80% of preterm infants.1 Out of the 60% only 5% term and 20% preterm need treatment,2 in the rest it disappears after a few days, often without any special treatment
During the first 24 hour there was an increase in the TSB in both the continuous and the intermittent phototherapy groups. (-9.274% and 13.623% respectively, p=0.51)
Present study proves the effectiveness of phototherapy in controlling hyperbilirubinaemia in jaundiced babies
Summary
Jaundice is observed during the first week of life in approximately 60%of term infants and 80% of preterm infants. Out of the 60% only 5% term and 20% preterm need treatment, in the rest it disappears after a few days, often without any special treatment. Jaundice is observed during the first week of life in approximately 60%of term infants and 80% of preterm infants.. Out of the 60% only 5% term and 20% preterm need treatment, in the rest it disappears after a few days, often without any special treatment. Hyperbilirubinaemia can reach levels toxic enough to cause permanent brain damage, which can result in varying degree of neurological deficit and in extremely severe cases, even death. The colour usually results from the accumulation in the skin of unconjugated, non-polar, lipid soluble bilirubin pigment (indirect-reacting) formed from haemoglobin by the action of haeme oxygenase, biliverdin reductase, and non-enzymatic reducing agents in the reticuloendothelial cells. With the advent of phototherapy in 1958,3 it has been accepted in neonatal units all over the world. Its noninvasive nature means that all complications attending an invasive procedure
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