Comparative Study of Phototherapy for Hyperbilirubinemia

Hyperbilirubinemia is a common problem for term and preterm newborns in intensive care
nurseries around the world. It is a condition in which there is too much bilirubin in the
blood. Bilirubin is a substance that is naturally released when red blood cells break down.
In the early newborn period, multiple factors lead to an abnormally elevated bilirubin level.
Large amounts of bilirubin can circulate to tissues in the brain and may cause seizures or
brain damage. About 6.1% of term newborns and a higher percentage of preterm newborns develop
hyperbilirubinemia that requires treatment. Initiating treatment depends on many factors,
including the cause of the hyperbilirubinemia, the level of serum indirect bilirubin, the
rate of indirect bilirubin rise, and the age of the patient. The goal of treatment is to keep
the level of bilirubin from rising to dangerous levels.

The bilirubin molecule absorbs light. Therefore, treatment of hyperbilirubinemia involves
exposure of the baby's skin to special blue spectrum light. Phototherapy is globally
recognized as the standard of care for treatment of elevated indirect hyperbilirubinemia in
the neonatal period. This light exposure converts water-insoluble indirect bilirubin to a
more easily excreted soluble molecule. Over the last five years, several devices have been
introduced that emit high intensity light in the blue portion of the visible light spectrum.
However, despite frequent use of such therapy, the effectiveness of different phototherapy
devices has not been adequately compared. The objective of this study is to compare the
efficacy of the blue LED fiberoptic phototherapy with the metal halide spot phototherapy
versus blue LED bank light phototherapy versus a combination of tandem therapy on lowering to
total serum bilirubin.