The following article is part of coverage from the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020). Due to the global COVID-19 pandemic, the Association made the necessary decision to cancel their meeting originally scheduled for March 25-28, 2020, in Long Beach, CA, and rescheduled the event to a virtual meeting held June 4-5, 2020. Readers can click here to catch up on the latest research.
Neonatal hyperbilirubinemia is a common diagnosis among newborns, and phototherapy has been the mainstay of treatment to reduce total serum bilirubin (TSB) levels. A study of infants with hyperbilirubinemia found that dual LED blanket phototherapy is effective in reducing TSB levels, but combination phototherapy with blankets and lights is preferred, according to results presented virtually at the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020).
“Reducing TSB levels quickly is essential to avoid the risk of health complications, including kernicterus,” noted the authors who have introduced dual-blanket phototherapy over the past 5 years “Eliminating unnecessary phototherapy exposure is important as emerging data links phototherapy exposure to seizures and damage to DNA.”
Researchers from Ann & Robert H. Lurie Children’s Hospital of Chicago conducted a chart review of 255 infants with hyperbilirubinemia from June 2012 to September 2019. Infants were included if they were at least 37 weeks gestational age, were 3 to 10 days of age at time of admission, and were otherwise healthy. Phototherapy type, duration, and rate of TSB decline were evaluated. Demographic information for the infants were obtained including if the infant was breastfed or formula fed.
Infants were divided into groups: 1 phototherapy light and 1 phototherapy blanket (n=117); 2 lights and 1 blanket (n=13); mixed method phototherapy (defined as multiple combinations of phototherapy received during the same hospitalization) (n=44), and 2 phototherapy blankets (n=81). The first 3 phototherapy groups had a sharper rate of TSB decline when compared with the fourth (2 blanket) group. All groups received similar phototherapy duration; no significant difference was found for results of TSB reduction. No statistical difference was found in demographic data among the groups.
“Additional research is needed to assist in determining effectiveness of dual phototherapy blanket treatment when compared with 1 phototherapy light and 1 phototherapy blanket,” concluded the researchers.
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Wiegert S, Mai H. The effect of combination phototherapy compared with dual phototherapy blankets on phototherapy duration and total serum bilirubin levels. Presented virtually at: NAPNAP 2020; June 4-5, 2020. Abstract W10.