Effectiveness of phototherapy in neonatal hyperbilirubinemia

Abstract

Introduction: newborn jaundice is the yellowish skin pigmentation caused by an increase in the blood bilirubin level. The most utilized treatments have been phototherapy and phototherapy plus phenobarbital.

Objective: to identify the best evidence on the effective use of phototherapy as a treatment for newborn hyperbilirubinemia.

Methods: a search was conducted on articles published from 2007 to 2014 using the keywords: hyperbilirubinemia, newborn, halogen phototherapy, and leds phototherapy, and included in the Cochrane Library, in REDALyC, Scielo, Medline, CINAHL, and CUIDEN databases. Twenty eight articles related to the effectiveness of phototherapy were identified and analyzed.

Results: compared to halogen and optical fiber phototherapy, the leds light phototherapy is more efficient for the control of bilirubin (average difference −0.43, CI 95%: −1.91, at 1.05 hrs.). White sheets around the radiant heat cradle increase the effectiveness of phototherapy. With regard to protection of the genitals, the literature mentions that if the bilirubin levels are very high, the diaper must be removed but only while using leds phototherapy. Eye protection must be used with any phototherapy device. It is also mentioned that face masks or similar-material covers are not protective enough while giving these treatments.

Conclusions: the leds phototherapy is the most effective treatment. White sheets augment the effectiveness of the phototherapy. The newborn diaper can be removed when the bilirubin level increases.