Efficacy of different types of phototherapy devices: A 3-year prospective study from Northern India

Abstract

Objective: To evaluate the efficacy of light-emitting diode (LED) over conventional phototherapy in near-term and term Rh-compatible otherwise healthy neonates in resource-constrained settings. Design: This was a 3-year prospective observational study. Setting: The study was conducted in the neonatal unit of a teaching hospital. Patients: Near-term and term (≥35 weeks of gestation) Rh-compatible, otherwise healthy, newborns were included in the study. Interventions: Single surface LED or conventional phototherapy was performed. Main Outcome Measures: The primary outcome variable was the duration of phototherapy, and the secondary outcome variables were a rate of fall in the total serum bilirubin (TSB) and need for exchange transfusion. Results: A total of 406 patients constituted the study population. Two hundred and thirty patients received LED phototherapy, and 176 patients received conventional phototherapy. The birth weight, gestational age, gender, mean TSB, and other baseline laboratory parameters were similar in both groups. The median duration of phototherapy in the LED group (22.0 h [95% confidence interval: 20.47, 23.53]) was significantly less than that in the conventional phototherapy group (32.0 h [95% confidence interval: 29.8, 34.1]). Similarly, the rate of fall of TSB at 6, 12, and 18 h was significantly higher in LED group than in the conventional group. Fifteen patients (6.5%) received double volume exchange transfusion in LED group and twenty patients (11.4%) in the conventional group. Conclusions: LED phototherapy was found more efficacious than conventional phototherapy in resource-constrained settings, where the majority of jaundiced patients are managed with latter one and because of limited resources irradiance is never checked or checked inappropriately, which can be a source of serious error.