Discontinuation Of Phototherapy Research Articles

Validity of transcutaneous bilirubin measurements during and after phototherapy in term and late preterm infants.

The application of in-house, photo-opaque patches enhanced the correlation and agreement between TcBC and TSB during and after discontinuation of phototherapy. This may prove particularly useful in resource-limited settings where commercial devices are unavailable. • Transcutaneous bilirubin measurement has been widely used as a screening method for neonatal hyperbilirubinemia. • The accuracy of transcutaneous bilirubin measurements during and after phototherapy in infants with hyperbilirubinemia has been debated. • Our study demonstrated that utilizing carefully designed photo-opaque patches enhanced the accuracy of transcutaneous bilirubin measurement during and after phototherapy. • Effective in-house alternatives are crucial in resource-limited settings where commercial opaque patches are not always accessible or affordable.

Accuracy of transcutaneous bilirubinometry in term infants after phototherapy: a prospective observational study

Objective To test the accuracy of transcutaneous bilirubinometry (TcB) in neonates 12 h after discontinuing phototherapy. Study design In a prospective study of 91 neonates at ≥35 weeks of gestation, paired measurements of total serum bilirubin (TSB) and TcB were obtained 12 h after discontinuation of phototherapy. TcB measurements were obtained on the uncovered skin of the sternum and the covered skin of the lower abdomen. Bland–Altman plots were used to evaluate agreement between TSB and TcB. Results TcB was found to systematically underestimate TSB on both covered and uncovered skin. The smallest but statistically significant difference between TSB and TcB was found on the covered lower abdomen (–1.03, p < .0001) compared with the uncovered skin of the sternum (–1.44, p < .0001). The correlation between TSB and TcB was excellent on both covered (r = 0.86, p < .001) and uncovered skin (r = 0.90, p < .001). Bland and Altman plots showed poor agreement between TcB and TSB. Conclusions This study demonstrated excellent correlation between TcB and TSB 12 h after phototherapy but poor TcB–TSB agreement. TcB cannot be reliably used in neonates exposed to phototherapy.

33507 Parking fees: A significant financial burden for phototherapy patients

Phototherapy treatment for dermatologic conditions often requires 2 or 3 treatment sessions weekly at designated facilities. Nonmedical costs, such as parking fees, are associated with discontinuation of phototherapy. This cross-sectional study assesses the association between parking fees, cost of living, and transit access at phototherapy sites across the United States. Phototherapy sites affiliated with dermatology residency programs were identified. The following information for each site was ascertained: address, transit score, cost of living score, online public transit information, parking rates, and validation. Mean, median, and range of each score and Pearson correlations for binary variables were calculated. Of 343 phototherapy sites, 314 (91.5%) responded to information requests. Of participating sites, 69 (22.0%) did not offer phototherapy services. Parking fee information was obtained from 239 (70.0%) sites. 177 (74.1%) offered free or validated parking, and 78 (32.6%) displayed public transportation information on their website. Daily parking costs were positively correlated with cost of living (r2 = 0.102, P < .001) and transit scores (r2 = 0.055, P < .001). The average daily cost of parking was $3.29, amounting to $513.24 for patients completing 3 phototherapy sessions weekly per year. Parking fees represent a significant financial barrier to patients undergoing phototherapy treatment, especially if multiple times per week. Cities with a higher cost of living have less affordable parking, compounding financial barriers. With increased usage of phototherapy services among Medicare beneficiaries, it is important for clinicians to be aware of additional financial barriers, such as parking fees, that further contribute to health disparities in the population.

Risk Factors and Predictors of Rebound Hyperbilirubinemia in a Term and Late-Preterm Infant with Hemolysis.

This study aimed to assess the incidence and predictors of rebound in term and late-preterm infants with hemolytic hyperbilirubinemia postphototherapy. A 4-year retrospective data analysis of neonates with hemolytic indirect hyperbilirubinemia admitted to the neonatal intensive care unit (NICU) of Medina Maternity and Children's Hospital was conducted. Bilirubin rebound was defined as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of postphototherapy. Of 386 identified neonates; 44 (11%) experienced rebound. Neonates in the rebound group demonstrated significantly higher levels of peak TSB, TSB at discontinuation of phototherapy, and lower value of relative TSB (difference between TSB at phototherapy termination and the American Academy of Pediatrics [AAP] threshold for phototherapy at concurrent age) compared with nonrebound group (p-value: <0.001, <0.001, and 0.007, respectively). Lower value of relative TSB at stoppage of phototherapy was the single independent predictor for rebound hyperbilirubinemia by mutivariate regression (p < 0.001). A cut-off value for relative TSB at stoppage of phototherapy of 190 µmol/L had 98% sensitivity and 32% specificity to predict rebound hyperbilirubinemia. Relative TSB at phototherapy termination is the best predictor for postphototherapy rebound hyperbilirubinemia in neonates with hemolytic etiology. · 11% of neonates showed postphototherapy rebound.. · The relative TSB at stoppage of phototherapy is the best predictor for rebound hyperbilirubinemia.. · The first cohort to assess rebound in neonates with hemolysis..

Intra-amniotic Infection

Intra-amniotic Infection

Neonatal Rebound Hyperbilirubinaemia after Intensive Phototherapy in Correlation with Mother Blood Group and Neonatal Weight

Neonatal jaundice is one of the most common diagnoses in the neonatal period; it is estimated to occur in 60% of term newborns in the first week of life. In rare instances, the Total Serum Bilirubin (TSB) reaches levels that can cause kernicterus, a condition characterized by bilirubin staining of neurons and neuronal necrosis involving primarily the basal ganglia of the brain and manifested in athetoid cerebral palsy, hearing loss, dental dysplasia, and paralysis of upward gaze, We conducted a prospective study to detect the serum rebound bilirubin among term And preterm newborns diagnosed with neonatal hyperbilirubinaemia who were admitted to the NICU of Al-Galaa Teaching Hospital and NICU of Pediatrics department of Banha University Hospital, requiring double surface, and intensive phototherapy treatment. This was a prospective study to detect the serum rebound bilirubin among100 term & preterm newborns diagnosed with neonatal hyperbilirubinemia who were admitted to the NICU of Banha University Hospital and AL-Galaa Teaching hospital, requiring double intensive phototherapy treatment. This study is from April 2015 to December 2018, Total Serum Bilirubin 4 -48 hours after discontinuation of phototherapy, significant bilirubin rebound is considered with increased by 2.04 mg/dL after stopping phototherapy and needing readmission. There were no significant differences between neonates with rebound hyperbilirubinemia and those without as regard birth weight (P value = 0.745), There was no significant difference between discharge level (4-48hour post intensive photo) (10.0) and after intensive phototherapy level (9.72), we concluded that It is not necessary to keep infants in the hospital to check for rebound because of rare instance of serum billirubin rebound but clinical follow-up 24 to 48 hours later is important furthermore follow up for a risk factor group is a must and keep infant in the hospital should be taken into consideration.

Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants.

Limited information is available about how guidelines on phototherapy for neonatal jaundice are applied in practice and toxicity is a concern. We studied the use of phototherapy in relation to birthweight and gestational age (GA) in Norwegian neonatal intensive care units (NICUs). The study population was all 5382 infants admitted to the 21 NICUs in Norway between September 1, 2013 and August 31, 2014. Data were recorded daily in the Norwegian Neonatal Network database and anonymised data on patient characteristics, diagnoses, duration, the ages at the start and discontinuation of phototherapy were analysed. More than a quarter (26.6%) of all infants admitted to Norwegian NICUs during the study period received phototherapy. The use of phototherapy was inversely related to GA and birthweight. More than 80% of the preterm infants under 28 weeks of GA received phototherapy. The duration was significantly longer in the lowest birthweight and GA groups and decreased with increasing birthweight and GA. Phototherapy is proved to be a strong candidate for the most common therapeutic modality in NICU infants. However, in the light of reported toxicity in the smallest, most vulnerable infants, we recommend increased emphasis on quality control.

Effect of Phototherapy on the Reliability of Transcutaneous Bilirubin Devices in Term and Near-Term Infants: A Systematic Review and Meta-Analysis

Background: Transcutaneous bilirubin (TcB) devices are commonly used for screening of hyperbilirubinemia in term and near-term infants not exposed to phototherapy. However, the accuracy of TcB devices in infants exposed to phototherapy is unclear. Objectives: To conduct a systematic review of studies comparing TcB devices with total serum bilirubin (TSB) in infants receiving phototherapy or in the postphototherapy phase. Methods: MEDLINE, EMBASE, Cochrane Library, CINAHL and Scopus databases (from inception to May 8, 2014) were searched. Additional citations were identified from the bibliography of selected articles and from the abstracts of conference proceedings. The studies were included if they compared TcB results with TSB in term and near-term infants during phototherapy or after discontinuation of phototherapy. Two reviewers independently assessed studies for inclusion, and discrepancies were resolved with consensus. Risk of bias was assessed using the QUADAS-2 tool. Results: Fourteen studies were identified. The pooled estimates of correlation coefficients (r) during phototherapy were: covered sites 0.71 (95% CI 0.64-0.77, 11 studies), uncovered sites 0.65 (95% CI 0.55-0.74), 8 studies), forehead 0.70 (95% CI 0.64-0.75, 12 studies) and sternum 0.64 (95% CI 0.43-0.77, 5 studies). Two studies also provided results as Bland-Altman difference plots (mean TcB-TSB differences -29.2 and 30 µmol/l, respectively). The correlation coefficient improved marginally in the postphototherapy phase (r = 0.72, 95% CI 0.64-0.78, 4 studies). Conclusion: We found a moderate correlation between TcB and TSB during phototherapy with a marginal improvement in the postphototherapy phase. Further research is needed before the use of TcB devices can be recommended for these settings.

Bronze baby: A rare presentation of biliary atresia

Bronze baby syndrome is a dark brown pigmentation of skin occurring sometimes following phototherapy. No specific treatment is required, as the pigmentation spontaneously disappears after the discontinuation of phototherapy. A 12-day-old neonate with dark brown pigmentation of skin was referred as cyanotic heart disease with the mass in the liver for emergency surgical removal. Infant was found to have conjugated hyperbilirubinemia. Workup was performed for the possible causes. Infant was diagnosed to have extra-hepatic biliary atresia. Dark brown pigmentation should not be interpreted as cyanosis. Always rule out the underlying causative liver disease.

The utility of inpatient rebound bilirubin levels in infants readmitted after birth hospitalization for hyperbilirubinemia.

There are few data evaluating the role of inpatient rebound bilirubin levels in the management of infants readmitted after their birth hospitalization for indirect hyperbilirubinemia. The goal of the present study was to evaluate the clinical utility of inpatient rebound bilirubin levels within this patient population. A retrospective cohort study was conducted of 226 infants readmitted after their birth hospitalization for indirect hyperbilirubinemia. Data from 130 infants with rebound bilirubin levels drawn at a mean of 6.1±2.4 hours after discontinuation of phototherapy were compared with data from 96 infants without rebound bilirubin levels. The primary outcome was readmission to the hospital, and secondary outcomes included length of stay and discharge time. A subgroup analysis compared characteristics of children who required repeat phototherapy versus those who did not. Overall, 5 of 130 patients from the rebound group were readmitted compared with 4 of 96 patients from the no-rebound group (P=.98). Length of stay was significantly longer for patients with rebound bilirubin levels (27.7 vs 23.2 hours; P=.001). Patients with bilirubin levels lowered to ≤14 mg/dL were less likely to receive repeat phototherapy than those with levels>14 mg/dL (2 of 129 vs 12 of 97; P=.001). Early inpatient rebound bilirubin levels do not successfully predict which patients will require hospital readmission for repeat phototherapy. Children with bilirubin levels lowered to ≤14 mg/dL with phototherapy are unlikely to receive repeat phototherapy.

75: Effect of Phototherapy on the Reliability of Transcutaneous Devices in Infants &gt;35 Weeks of Gestational Age: A Systematic Review

American Academy of Pediatrics (AAP) recommends the use of TcB devices for the diagnosis of significant hyperbilirubinemia in infants >35 weeks of gestational age and for making decisions for initiation of phototherapy. However, the accuracy of TcB devices in infants receiving phototherapy is unclear. To conduct systematic review of diagnostic accuracy studies comparing TcB devices with total serum bilirubin (TSB) estimation in near-term and term neonates receiving phototherapy or post-phototherapy phase Search Strategy MEDLINE, EMBASE, Cochrane library, CINAHL, Scopus databases (all from the date of inception to August 2013) were searched. Additional citations were identified from the bibliography of selected articles and from abstracts of the conference proceedings. Study Selection and Data Extraction The studies were included if they compared TcB results with TSB in term and near-term infants during phototherapy or after discontinuation of phototherapy in neonatal period. Two reviewers independently assessed studies for inclusion and discrepancies were resolved with consensus. Data were extracted by one reviewer and checked for accuracy by the second reviewer. Quality assessment of included studies was performed using QUADAS-2 tool. Seventy-three studies were selected for full text review of which 12 were eligible for inclusion (seven studies awaiting decision). Studies varied in terms of site of TcB estimation (forehead [12], sternum [6], back [2]); TcB devices used (Bilicheck [2], Minolta air shields [4], JM101 [6]); method of estimation of TSB (Direct Spectrophotometry [5], Diazo method [8], both [2], not specified [1]). All studies provided results of comparison of TcB with TSB as co-relation coefficients (r=0.67 [95% CI 0.61 to 0.72]), with five studies providing data separately for TcB measurements from a covered area (r=0.71 [95% CI 0.65 to 0.77]) and two studies providing results for post phototherapy phase (r=0.75 [95% CI 0.66 to 0.82]) data One study provided data for Bland-Altman difference plots and showed TcB underestimated TSB by a mean difference of29.2 mmol/L. Our results show that TcB devices were not as reliable for estimation of serum bilirubin in infants receiving phototherapy as compared to pre-phototherapy phase. However, majority of studies were conducted using older TcB devices that are currently not in practice. Also, there is insufficient data for recommending the use of TcB devices in post phototherapy phase.

A COMPARISON OF SIGNIFICANT BILIRUBIN REBOUND AFTER DISCONTINUATION OF PHOTOTHERAPY IN TWO GROUPS OF NEONATES IN VALIASR HOSPITAL: A RANDOMIZED CLINICAL TRIAL

Introduction:The aim of this study is to compare significant post-phototherapy bilirubin rebound in two groups of neonates, with two levels of bilirubin, at discontinuation of phototherapy. Materials and Methods:One hundred and fifteen neonates ≥35 weeks of gestationl age (GA), admitted due to hyperbilirubinemia in the Neonatal Ward of Valiasr Hospital, were randomly divided into two groups: group A and group B. In group A, phototherapy was discontinued when bilirubin level reached 11 mg/dl, or the 40th percentile of the Bhutani nomogram, while in group B, it took place at bilirubin level of 13 mg/dl or the 75th percentile. After 24 hr, total serum bilirubin was measured. Significant post-phototherapy rebound was defined as bilirubin increase of more than 2 mg/dl or the 95th percentile. Results: A total of 13 (11.3%) neonates out of 115 participants developed significant rebound, 9 of which (69%) were in group A , and the rest (21%) were in group B, which was not considered a significant difference (p=0.13). Comparison of the two groups showed no significant difference concerning the correlation between rebound and the infant’s age, in hr of starting phototherapy. However, the number of neonates in group B, who received phototherapy before 48 hr of age, was too small to draw reliable conclusions. Logistic regression analysis showed that intravenous serum therapy was the only risk factor significantly associated with rebound (p=0.005). Conclusion: According to this study, it is shown that discontinuation of phototherapy in hyperbilirubinemia, at lower bilirubin levels, would not prevent rebound. Moreover, no association was found between the known risk factors and rebound.

Effect of narrowband ultraviolet B phototherapy on melanocytic naevi

Melanocytic naevi have been observed to undergo morphological changes following exposure to narrowband ultraviolet (NB-UV)B radiation. To analyse changes in naevi exposed to NB-UVB in a large cohort of patients. Subjects referred for phototherapy had macroscopic and dermoscopic images taken of prominent melanocytic naevi at the following time points: immediately prior to NB-UVB treatment, after 10 exposures, after 30 exposures or at the end of treatment if earlier, and 3 months after discontinuing treatment. Four dermatologists, by consensus, examined each naevus for specific clinical and dermoscopic features at each time point. The size (area) of each naevus was determined by plenimetry. Complete sets of images were taken for 36 out of 51 patients. The most common global dermoscopic patterns in the 440 naevi examined were reticular (50%) and globular (32%). Following NB-UVB exposure, blurring or merging of lines was observed in 45% of reticular naevi. An increase in colour intensity and in the number of dots or globules was observed in 63% of globular naevi, and 167 naevi (40%) underwent a change in size. Of these, 91/167 (54%) decreased in size, with a median area reduction of 8% (0·9-42%); while 76/167 (46%) increased in size, with a median area increase of 9% (1-76%). Around half of naevi exposed to a course of NB-UVB treatment undergo size or morphological changes. Naevi that enlarged tended to revert to pretreatment size 3 months after discontinuation of phototherapy.

Idiopathic guttate hypomelanosis‐like lesions in patients with mycosis fungoides: a new adverse effect of phototherapy

Idiopathic guttate hypomelanosis (IGH) is a common pigmentary disorder, the aetiology and pathogenesis of which are largely unknown. The appearance of IGH-like lesions during phototherapy has been reported previously in only one patient. To describe the clinical and histological features of phototherapy-induced IGH-like lesions, their relation to ultraviolet dosimetry and the course of this eruption in patients with mycosis fungoides (MF). The files of all patients with MF who underwent phototherapy in our centre from 1992 to 2008 were searched to identify those in whom IGH-like lesions appeared during treatment. Results Among 87 patients with early-stage MF who underwent phototherapy, seven acquired IGH-like lesions during monotherapy with narrow-band ultraviolet B (NB-UVB; four patients) or psoralen and ultraviolet A (PUVA; three patients). All but one had a light complexion. The lesions appeared in areas exposed to ultraviolet light, and not exclusively on the skin previously involved by the disease. The mean number of exposures until appearance of the lesions was 92 for NB-UVB and 137 for PUVA. Biopsy study showed a decreased number of melanocytes. Phototherapy was discontinued in four patients, of whom three showed a partial or complete disappearance of the IGH-lesions. The other three patients are still receiving phototherapy, with no change in their IGH-like lesions. Phototherapy may induce an eruption bearing similar clinical and histopathological features to IGH. The eruption is rare, appears to emerge only after prolonged therapy and seems to be reversible upon discontinuation of phototherapy. IGH-like eruption should be added to the list of side-effects of phototherapy.

Index Of Suspicion In The Nursery

A 2.9-kg female infant is born at 35 weeks' gestation to a 33-year-old G4P3 woman via cesarean section due to chronic hypertension complicated by superimposed preeclampsia. The mother's blood type is A-negative; the antibody screen is positive for anti-D, anti-C, and anti-G antibodies; she has no prior history of sensitization; and her serologies are negative. The Apgar scores are 7 and 9 at 1 and 5 minutes, respectively. At birth, the infant appears pale and exhibits tachycardia, moderate hepatosplenomegaly, tachypnea, and mild respiratory distress requiring supplemental oxygen. Complete blood count and blood cultures are obtained, and ampicillin and gentamicin are started. The admission hematocrit is 21% (0.21), with a reticulocyte count of 64%. An umbilical venous catheter is placed for intravenous (IV) access. The infant receives a transfusion of packed red blood cells for significant anemia associated with tachycardia. Prophylactic phototherapy is started because of Rh sensitization. The cord blood bilirubin measures 11.4 mg/dL (195 mcmol/L). The infant's blood type is A-negative, and the antibody screen is positive for anti-D and anti-C antibodies, with a positive direct Coombs test. The red blood cell phenotype reveals the presence of “C” antigen. This is a very uncommon antigen in an Rh-negative infant, but the antigen had stimulated the anti-C antibodies that traversed the placenta and caused severe hemolysis of the newborn. At 7 hours of age, the infant's bilirubin is 16 mg/dL (273.6 mcmol/L). She is given two doses of intravenous immune globulin, and phototherapy is intensified. After 24 hours of intensive phototherapy, the infant develops a large reddish-purple discoloration on her abdomen that resembles a severe burn (Fig. 1). The well-demarcated, erythematous, purpuric rash is present over the areas closely exposed to the phototherapy lights and does not blanch with diascopy. No vesiculobullous eruptions, edema, or tenderness is noted. The unexposed …

Post-phototherapy neonatal bilirubin rebound: a potential cause of significant hyperbilirubinaemia

Aim: To determine the incidence of post-phototherapy neonatal plasma total bilirubin (PTB) rebound. Methods: A prospective clinical survey was performed on 226 term and near-term neonates treated with phototherapy in...

Recent Developments in the Management of Neonatal Hyperbilirubinemia

After completing this article, readers should be able to: 1. Describe the morbidity associated with exchange transfusion used to treat neonatal hyperbilirubinemia. 2. Explain how phototherapy affects bilirubin. 3. Describe potential toxicities of phototherapy. 4. Explain the role of carboxyhemoglobin in hemolysis. 5. Delineate the guidelines for administering intravenous immunoglobulin to healthy ABO-incompatible Coombs-positive neonates. 6. Describe the action of protoporphyrins on bilirubin. Recent clinical trends toward early discharge coupled with a new, more relaxed, “kinder, gentler approach” to the treatment of newborn hyperbilirubinemia have thrust concerns about bilirubin-related toxicity once again to the forefront of neonatologists’ consciousness. In recent years we even have witnessed a resurgence of kernicterus, which had been rendered almost nonexistent in the 1970s and 1980s. Although exchange transfusion is the oldest and most effective method of treating hyperbilirubinemia, mortality associated with this therapy has been reported to be between 0.3% and 1.2% in healthy infants and as high as 10% to 25% in sicker preterm infants. Furthermore, potential morbidity related to exchange transfusion remains significant and includes anemia, apnea, bradycardia, hypothermia, sepsis, necrotizing enterocolitis, thromboembolic phenomena, graft versus host disease, transient metabolic abnormalities, and thrombocytopenia. Accordingly, it behooves us to re-evaluate other therapeutic modalities for hyperbilirubinemia that may be equally efficacious but less invasive. Ever since the 1950s, when Sister Ward of Rochford General Hospital in Essex noted that a jaundiced baby’s skin had “faded” in natural sunlight, physicians have been searching for artificial light sources that might be used safely to treat neonatal hyperbilirubinemia. Phototherapy, which has become the standard of care, has had such a dramatic impact that a recent editorial raised the concern that exchange transfusions are becoming extinct and lamented the fact that future generations of house officers may not receive adequate training in this procedure. Under the effects of phototherapy light with maximal irradiance in the …

Glucose-6-Phosphate Dehydrogenase Deficiency: A Worldwide Potential Cause of Severe Neonatal Hyperbilirubinemia

After completing this article, readers should be able to: 1. Explain methods of preventing the hyperbilirubinemia caused by glucose-6-phosphate dehydrogenase (G6PD) deficiency. 2. Compare and contrast the correlation between hemolysis and serum bilirubin levels in healthy infants and those who are G6PD-deficient. 3. Describe the role of deficient bilirubin conjugation in the pathogenesis of G6PD deficiency-associated neonatal hyperbilirubinemia. 4. Define the risk for neonatal hyperbilirubinemia in female G6PD-deficient heterozygotes, G6PD-deficient homozygotes, and hemizygote males. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a commonly occurring X-linked genetic enzyme defect, is notorious for its association with acute hemolytic crises occurring in response to a frequently identifiable trigger (favism). Another potentially devastating danger of this condition is severe neonatal hyperbilirubinemia with its accompanying bilirubin encephalopathy, kernicterus, and death. Far from being a condition limited to historical time epochs and developing countries, G6PD deficiency-associated kernicterus still is seen in modern times. Indeed, among 80 infants from 21 states in the United States documented in a pilot Kernicterus Registry between 1984 and 1998, 18 (22.5%) were reported to have G6PD deficiency. Furthermore, Maisels recently listed G6PD deficiency among the 10 factors that are associated most commonly with an increased risk of nonhemolytic jaundice. Because of the association with favism, G6PD-associated hyperbilirubinemia traditionally has been regarded as hemolytic in origin. However, recent research has shown that although acute hemolysis does play a role, its contribution in many cases may be smaller than previously thought. The emphasis now has been placed on decreased bilirubin conjugation, with promoter polymorphism for the gene for the bilirubin conjugating enzyme, UDP glucuronoslytransferase 1A1 (UGT1A1), being a major factor in production of the icterus. In this review we highlight key aspects of the pathogenesis of this type of hyperbilirubinemia, explain the relevance of the condition, and describe a particularly problematic group that has a recently recognized high incidence of …

Cardiac output and ductal reopening during phototherapy in preterm infants

Left ventricular output (LVO), left pulmonary artery blood flow (LPA) and patency of the ductus arteriosus (PDA) were studied with 2D/pulsed Doppler ultrasound before, during and after phototherapy treatment in 27 preterm infants (gestational age ≤ 32 wk), who were exposed for a minimum of 12 h to phototherapy for non‐haemolytic hyperbilirubinemia. In 14 infants (52%) the ductus arteriosus reopened during phototherapy, but ductal patency was not of haemodynamic importance. LVO initially decreased in preterm infants in whom the ductus did not reopen. From 12 h until discontinuation of phototherapy, LVO and LPA were higher than before phototherapy in all infants. After withdrawal of phototherapy, LVO and LPA returned to pre‐phototherapy values. □Cardiac output, patent ductus arteriosus, phototherapy, preterm

Cardiac output and ductal reopening during phototherapy in preterm infants.

Left ventricular output (LVO), left pulmonary artery blood flow (LPA) and patency of the ductus arteriosus (PDA) were studied with 2D/pulsed Doppler ultrasound before, during and after phototherapy treatment in 27 preterm infants (gestational age < or =32 wk), who were exposed for a minimum of 12 h to phototherapy for non-haemolytic hyperbilirubinemia. In 14 infants (52%) the ductus arteriosus reopened during phototherapy, but ductal patency was not of haemodynamic importance. LVO initially decreased in preterm infants in whom the ductus did not reopen. From 12 h until discontinuation of phototherapy, LVO and LPA were higher than before phototherapy in all infants. After withdrawal of phototherapy, LVO and LPA returned to pre-phototherapy values.