Light Emitting Diode (LED) Phototherapy versus Conventional Phototherapy in Neonatal Hyperbilirubinemia: A Single Blinded Randomized Control Trial from Coastal India.

Sreesravya Gutta,Muralikeshava Sarpangala,Janardhan Shenoy,Sowmini P Kamath,Mukund Srinivasan,B Shantharam Baliga,Prasanna Mithra

doi:10.1155/2019/6274719

Abstract

Neonatal hyperbilirubinemia is a common problem with potentiality to cause irreversible brain damage. Reduction of serum bilirubin level is essential to minimize such damage. Compact fluorescent tubes, halogen bulbs, fiber optic blankets, and LEDs are commonly used light sources for phototherapy with varying efficacies. This study aimed at evaluating the effect of LED versus conventional phototherapy on (a) rate of reduction in total serum bilirubin levels, (b) effect on urinary lumirubin excretion, and (c) comparing side effects of phototherapies among neonates with hyperbilirubinemia. In this randomized control trial, 166 neonates ≥ 35 weeks of age requiring phototherapy were recruited and further divided into 2 groups [LED (83) and conventional (83)] by using computer generated random numbers. Serial total serum bilirubin levels and random urinary lumirubin levels were collected and side effects of phototherapy were noted. Rate of fall in total serum bilirubin levels (TSB, μmol/L/hour) and random urinary lumirubin levels were computed. Data were collected using a pretested proforma. Analysis was done with Statistical Package for Social Sciences (SPSS) version 11.5. Independent sample “t” test and Chi-square tests were used with p value of <0.05 being significant. Significant difference was documented in mean rate of decrease of TSB (μmol/L/hour) in LED group (5.3 ± 2.91) when compared to conventional group (3.76 ± 2.39) (p <0.001). A significant increase in mean random urinary lumirubin levels (arbitrary units) was observed in LED group (129.01 ± 33.18) when compared to conventional group (114.44 ± 44.84) (p = 0.021). Side effects were minimal and comparable in both groups. This study concludes the rates of decrease in total serum bilirubin levels and increase in urinary lumirubin levels were significant with LED when compared with conventional phototherapy, implying LED to be more efficacious.

Highlights

Neonatal jaundice, a condition that requires etiological evaluation and prompt treatment, is one of the most common issues of neonates
The neonate skin is exposed to a light source of specific wavelength which aids in decreasing bilirubin levels
Neonates (n=166), who were aged more than 35 weeks of gestation, were included in the study, out of whom 83 each received Light Emitting Diode (LED) phototherapy (LED group) and conventional phototherapy

Summary

Introduction

A condition that requires etiological evaluation and prompt treatment, is one of the most common issues of neonates. Incidence of neonatal jaundice in India varies from 54.6% to 77% [1]. In most of the neonates, it is just a benign transient phenomenon known as physiological jaundice. Sometimes it can result in irreversible bilirubin encephalopathy if not recognized [2], which becomes the concern factor for a developing brain. Out of various treatment modalities available for neonatal jaundice, phototherapy is widely used. The neonate skin is exposed to a light source of specific wavelength which aids in decreasing bilirubin levels. It has reduced the number of exchange transfusions and bilirubin induced neurologic dysfunction (BIND) [3]

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