The effects of LED blue light tube phototherapy in the treatment of acute bilirubin encephalopathy

Abstract

Objective To study the clinical efficacy of LED blue light tube phototherapy in severe hyperbilirubinemia with acute bilirubin encephalopathy (ABE). Method Clinical data of newborns admitted to neonatal department of our hospital between Dec. 2013 and Dec. 2016 were retrospectively reviewed. Infants with gestational age≥35 weeks who were diagnosed with severe hyperbilirubinemia and ABE were collected and analyzed. From Dec. 2013 to Nov. 2014, infants treated with common blue light tube were assigned into traditional blue light group (traditional group). From Dec. 2014 to Dec. 2016, infants treated with LED blue light tube were assigned to LED blue light group (LED group). Total serum bilirubin (TSB) levels and bilirubin induced neurological dysfunction (BIND) scores were analyzed between the two groups. Neuron specific enolase (NSE) levels before and after phototherapy were also compared. Follow-up data for three months after discharge were analyzed. Result Fifty-one infants with severe hyperbilirubinemia and ABE were included, with 24 cases in traditional group and 27 cases in LED group. There were no significant differences in TSB levels and BIND scores between the two groups before phototherapy (P>0.05). TSB levels at 4 h, 24 h and 48 h after phototherapy in LED group were significantly lower than traditional group respectively [(331.3±21.8) μmol/L vs. (372.1±25.2) μmol/L, (233.6±20.4) μmol/L vs. (269.4±19.8) μmol/L, (184.5±15.2) μmol/L vs. (226.3±22.7) μmol/L, P 0.05). BIND scores at 4 h after phototherapy in LED group were significantly lower than traditional group [(4.0±0.6) vs. (4.7±0.8), P 0.05). In both groups, serum NSE levels after phototherapy were lower than before phototherapy. Serum NSE level after phototherapy in the LED group was significantly lower than the traditional group (P 0.05). Conclusion TSB levels and brain injury indicators should be closely monitored and evaluated in infants with severe hyperbilirubinemia and ABE. Active LED blue light phototherapy can rapidly reduce TSB levels, effectively control the progress of ABE, and reduce the ratio of exchange transfusion. Adverse reactions of LED blue light phototherapy are not observed in this study. Key words: Phototherapy; Hyperbilirubinemia, neonatal; Brain injuries; Acute bilirubin encephalopathy