Cylindrical intensive vs. double surface LED phototherapy for neonatal hyperbilirubinemia

  • Rini Sulviatni Medical Staff Group of Child Health, Syamsudin SH Hospital, Sukabumi, West Java, Indonesia.
  • Khonsa Hartsu Syuhada General practioners
  • Hanny Krissanti Medical Staff Group of Child Health, Syamsudin SH Hospital, Sukabumi, West Java, Indonesia.
  • Denny Purnama Medical Staff Group of Child Health, Syamsudin SH Hospital, Sukabumi, West Java, Indonesia.
Keywords: neonatal hiperbilirubinemia, double surface LED phototherapy, cylincrical intensive phototherapy, phototherapy

Abstract

Background High bilirubin levels may lead to complications such as bilirubin encephalopathy or even death. Therefore, neonatal hyperbilirubinemia patients require appropriate treatment in the form of phototherapy or exchange transfusion. With the advancement of technology, various types of phototherapy, such as the cylindrical intensive phototherapy (bilisphere) and double LED, are now available.

Objective To compare cylindrical intensive phototherapy to double surface LED phototherapy in neonatal hyperbilirubinemia.

Methods This cohort study was conducted in neonates with hyperbilirubinemia at at Syamsudin SH Hospital, Sukabumi, West Java, who were treated with either cylindrical intensive phototherapy or double surface LED phototherapy. The variables observed were subjects’ characteristics, bilirubin levels pre- and post-therapy, duration of phototherapy, length of stay, and total treatment cost. The data were analyzed using univariate and bivariate analyses.

Results Of 47 neonates, the mean bilirubin levels were 19.36 mg/dL pre-therapy and 12.26 mg/dL post-therapy. Subjects’ overall mean duration of phototherapy was 24 hours, mean length of stay was 1 day, and mean cost of treatment was IDR 813,175. There was no significant difference in the bilirubin decrease between the cylindrical intensive phototherapy and double LED groups. However, there were significant differences between the cylindrical intensive phototherapy and double LED groups in duration of phototherapy (10.75 vs. 75.17 hours, respectively (P<0.000), mean length of stay (1 vs. 3.13 days, respectively (P<0.000), and total cost of treatment (IDR 598,918 vs. IDR 1,036,747, respectively P<0.000).

Conclusion While the decrease in bilirubin was not significantly different in neonatal hyperbilirubinemia patients who underwent cylindrical intensive phototherapy compared to double LED therapy, cylindrical intensive phototherapy relates to significant shorter phototherapy duration, length of stay, and total treatment cost. Hence, cylindrical intensive phototherapy phototherapy is considered to be more time-efficient and cost-efficient than double LED phototherapy.

References

1. American Academy Of Pediatric. Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatric. 2004;114:297-316. doi:10.1542/peds.114.1.297.
2. Santosa Q, Mukhson M, Muntafiah A. Evaluasi Penggunaan Fototerapi Konvensional dalam Tata laksana Hiperbilirubinemia Neonatal: Efektif, tetapi Tidak Efisien. Sari Pediatr. 2020;21:377-85. DOI: 10.14238/sp21.6.2020.377-85.
3. Azlin E. Efektivitas Fototerapi Ganda dan Fototerapi Tunggal dengan Tirai Pemantul Sinar pada Neonatus yang Mengalami Jaundice. Sari Pediatr. 2016;13:111-6. DOI: 10.14238/sp13.2.2011.111-6.
4. AkÅŸahin M. Multifunctional Phototherapy Device Design. Published online 2019:65-71. DOI: 10.26650/electrica.2019.18022.
5. Vreman HJ, Wong RJ, Stevenson DK. Phototherapy: Current methods and future directions. Semin Perinatol. 2004;28:326-33. DOI: 10.1053/j.semperi.2004.09.003.
6. Kosim MS, Soetandio R, Sakundarno M. Dampak Lama Fototerapi Terhadap Penurunan Kadar Bilirubin Total pada Hiperbilirubinemia Neonatal. Sari Pediatr. 2008;10:201-6. DOI: 10.14238/sp10.3.2008.201-6.
7. Stokowski LA. Fundamentals of Phototherapy for Neonatal Jaundice. 2011;11:10-21. DOI: 10.1097/ANC.0b013e31822ee62c.
8. Novos medical system. Bilisphere 360 LED. Published online 2021. [cited 2021 January 9]. Available from: https://pdf.medicalexpo.com/pdf/novos/bilisphere-360/69556-115865.html.
9. Mediprema. Phototherapy device?: Cradle 360. Published online 2021:1-23. [cited 2021 January 9]. Available from: https://www.udh.med.sa/advices/1926-User_Manual.pdf
10. Edris AAF, Ghany EAGA, Razek ARAA, Zahran AM. The role of intensive phototherapy in decreasing the need for exchange transfusion in neonatal jaundice. J Pak Med Assoc. 2014;64:5-8.
11. Mokhtar WA, Sherief LM, Elsayed H, Shehab MM, Gebaly SME, Khalil AMM, et al. Conventional intensive versus LED intensive phototherapy oxidative stress burden in neonatal hyperbilirubinaemia of haemolytic origin. Paediatr Int Child Health. 2019;40:30-4. DOI: 10.1080/20469047.2019.1586185.
12. Abd-Ellatif MAK, Abd-Ellatif DAK. The use of intensive phototherapy in severe neonatal hyperbilirubinemia. J Egypt Soc Parasitol. 2012;42:483-94. DOI: 10.12816/0006334.
13. Marzoog AS, Mohammed HN, Habib KD. Effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion in treating neonatal jaundice at Fatima Al-Zahra Hospital for maternity and children in Baghdad. AL-Kindy Coll Med J. 2020;16:25-9. DOI: 10.47723/kcmj.v16i2.262.
14. Mathindas S, Wilar R, Wahani A. Hiperbilirubinemia pada neonatuS. J Biomedik. 2013;5. DOI: 10.35790/jbm.5.1.2013.2599.
15. Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015;2015:319. PMID: 25998618.
16. Xie B, da Silva O, Zaric G. Cost-effectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario. Paediatr Child Health. 2012;17:11-6. DOI: 10.1093/pch/17.1.11.
17. Suresh GK, Clark RE. Cost-effectiveness of strategies that are intended to prevent kernicterus in newborn infants. Pediatrics. 2004;114:917-24. DOI: 10.1542/peds.2004-0899.
Published
2021-08-16
How to Cite
1.
Sulviatni R, Syuhada K, Krissanti H, Purnama D. Cylindrical intensive vs. double surface LED phototherapy for neonatal hyperbilirubinemia. PI [Internet]. 16Aug.2021 [cited 26Apr.2024];61(4):205-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2601
Section
Neonatology
Received 2021-02-04
Accepted 2021-08-16
Published 2021-08-16