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Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.
Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.
Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.
Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.
Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].
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2. Cremer RJ, Perryman PW, Richards DH. Influence of light on the hyperbilirubinaemia of infants. Lancet. 1958;1:1094-7.
3. Stoll BJ, Kliegman RM. Jaundice and hyperbilirubinemia in the newborn. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders Elsevier; 2006. p. 592-8.
4. Al-Alaiyan S. Fiberoptic, conventional and combination phototherapy for treatment of nonhemolytic hyperbilirubinemia in neonates. Ann Saudi Med. 1996;16:633-6.
5. Hansen WR. Jaundice, neonatal. [cited 2007 Oct 18]; Available from: http://www.emedicine.com/
6. Djokomulyanto S, Quah BS, Surini Y, Noraida R, Ismail NZN, Hansen TWR, et al. Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains. Arch Dis Child Fetal Neonatal 2006;91:439-442.
7. Stokowsky LA, Short MR, Witt CL. Fundamentals of phototherapy for neonatal jaundice. Advances in neonatal care 2006;6:303-312.
8. Dennery AP, Seidman DM, Stevenson KD. Neonatal hyperbilirubinemia. N Engl J Med. 2001;8:581-90.
9. Vreman HJ, Wong RJ, Stevenson DK, Route RK, Reader SD, Fejer MM, et al. Light emitting diodes: A novel light source for phototherapy. Pediatric Research. 1998;44:804-9.
10. Seidman DS, Moise J. A new blue light emitting phototherapy device: a prospective randomized controlled study. J Pediatr. 2000;136:771-4.
11. Tan KL, Lim GC, Boey KW. Efficiency of ‘‘high-intensity’’ blue light and ‘‘standard’’ daylight phototherapy for non-haemolytic hyperbilirubinaemia. Acta Paediatr. 1992;81:870-4.
12. Kang JH, Shankaran S. Double phototherapy with high irradiance compared with single phototherapy in neonates with hyperbilirubinaemia. Am J Perinat. 1995;12:178-80.
13. Hobbie R, Roth B. Atoms and light. [cited 2007 Nov 4]. Available from: http://www.springerlink.com/
14. Boonyarittipong P, Kriangburapa W, Booranavanich K. Effectiveness of double surface intensive phototherapy versus single surface intensive phototherapy for neonatal hyperbilirubinemia. J Med Assoc Thai. 2008;91:50-5.
15. Garg A.K, Prasad R.S, Al- Hifzi I. A controlled trial of high-intensity double-surface phototherapy on fluid bed versus conventional phototherapy in neonatal jaundice. Pediatrics. 1995;95:914-6.
16. Tan KL. Decreased response to phototherapy for neonatal jaundice in breastfed infants. Arch Pediatr Adolesc Med.1998;152:1187-90.
17. Grunhagen DJ, De Boer MGJ, Beaufort AJ. Transepidermal water loss during halogen spotlight phototherapy in preterm infants. Pediatric Res. 2002;51:402-5.
18. Hansen TWR. Phototherapy for neonatal jaundice-therapy effects on more than one level?. Semin Perinatol. 2010;34:231-4.
19. Shinwell ES, Sciaky Y, Karplus M. Effect of position changing on bilirubin levels during phototherapy. J of Perinatol. 2002;22:226-9.
20. Gulcan H, Tiker F, Kilicdag H. Effect of feeding type on the efficacy of phototherapy. Indian Pediatr.2007;44:32-6.