Continuous vs Intermittent Phototherapy in the Management of Non-Haemolytic Neonatal Hyperbilirubinemia - A Randomised Non - Inferiority Study

  • Mallanagouda M Patil Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India
  • Gowthami G S Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India
  • Hidaytullah R Bijapure Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India https://orcid.org/0000-0001-5808-1657
  • Anil Kumar Sajjan Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India
  • S S Kalyanshettar BLDE Deemed To Be University, Department of Paediatrics, BLDE DU Shri B M Patil Medical College Hospital and Research Centre, Vijayapur, Karnataka, India 586103
  • S V Patil Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India
Keywords: Continuous phototherapy, Intermittent phototherapy, Neonatal hyperbulirubinemia, Total Serum Bilirubin

Abstract

Introduction: Phototherapy is used to manage neonatal hyperbilirubinemia in early life. We aimed to compare between intermittent and continuous phototherapy in reducing TSB, rate of fall of bilirubin, duration of phototherapy and duration of hospitalisation in neonates with non-haemolytic hyperbilirubinemia.

Methods: Total 190 neonates who were > 34 weeks and birth weight ≥ 2000 gm were included. They were randomised into group A (continuous phototherapy) and group B (intermittent phototherapy). Group A received phototherapy for three hours and 45 minutes off and group B received phototherapy for three hours and then three hours off. TSB levels estimation were done in both groups and compared after each 12 hours, 24 hours, and 48 hours of commencing phototherapy.

Results: The mean TSB at presentation was 15.64 ± 2.19 mg/dl for continuous and 15.03 ± 1.07 mg/dl for intermittent group. Mean TSB at 12, 24, 48 hours were 13.26 ± 2.4 mg/dl, 10.8 ± 1.72 mg/dl, 10.16 ± 0.95 mg/dl respectively for continuous and 12.6 ± 1.65 mg/dl, 10.04 ±1.8 mg/dl, 9.1 ± 0.66 mg/dl respectively for intermittent group (p < 0.05). The mean rate of fall in serum bilirubin was 0.22 ± 0.12 mg/dl/hr for group A and 0.21 ± 0.08 mg/dl/hr for group B (p = 0.45). There was not much difference in mean duration of hospitalisation in both groups (p = 0.547).

Conclusions: Intermittent phototherapy is a non-inferior option to continuous phototherapy, in the management of non-haemolytic hyperbilirubinemia with additional advantages of less interrupted mother infant bonding and decreased irradiance.

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Author Biographies

Gowthami G S, Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India

Gowthami GS, JR Paediatrics

 gouthami.gs1990@gmail.com (contributed in study intervention)

Hidaytullah R Bijapure, Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India

Hidaytullah R Bijapure MD (Assistant Professor)

hr.bijapure@bldedu.ac.in (contributed in literature review)

Anil Kumar Sajjan, Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India

Sajjan Anilkumar. MD  (Assistant professor)

anilkumar.sajjan@bldedu.ac.in (contributed in clinical management of case)

S S Kalyanshettar, BLDE Deemed To Be University, Department of Paediatrics, BLDE DU Shri B M Patil Medical College Hospital and Research Centre, Vijayapur, Karnataka, India 586103

Kalyanshettar SS. MD (Professor and HOD)  

s.kalyanshettar@bldedu.ac.in (contributed in study data collection and interpretation)

S V Patil, Department of Paediatrics, Bijapur Lingayat District Educational Association (Deemed To Be University), Vijayapur, India

SV Patil.  MD  (Professor)

sv.patil@bldedu.ac.in (contributed in study conception, planning,)

Published
2020-12-15
How to Cite
Patil, M., S, G., Bijapure, H., Sajjan, A., Kalyanshettar, S., & Patil, S. (2020). Continuous vs Intermittent Phototherapy in the Management of Non-Haemolytic Neonatal Hyperbilirubinemia - A Randomised Non - Inferiority Study. Journal of Nepal Paediatric Society, 40(3), 185-189. https://doi.org/10.3126/jnps.v40i3.29535
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Original Articles