In severe and rapidly increasing jaundice, the use of high-intensity phototherapy provides greater effectiveness and a faster decrement in bilirubin levels. The aim of this study is compare the effectiveness of intensive compact fluorescent tube (CFT) and intensive LED phototherapy in higher doses of irradiance.
Method Forty three infants over 35 weeks of gestation with severe severe nonhemolytic hyperbilirubinaemia were enrolled in the prospective study. All infants received multidirectional (circular shaped) high-intensity phototherapy. Of these 20 infants received CFT while 23 infants received LED phototherapy. Bilirubin levels and body temperatures were measured periodically and the rates of bilirubin decrement were calculated.
Results Mean serum bilirubin level of the 43 infants was 20.5±1.5 mg/dl at the beginning of the therapy and mean duration of phototherapy was 20.6±1.1 hours. The rate of mean bilirubin decline was 47.2% and the declination was more prominent in the first four hours. Clinical characteristics, initial bilirubin levels, rates of bilirubin decrement and the phototherapy durations were comparable for LED and CFT groups. Slightly elevated mean body temperature (37.1ºC) was determined in CFT group (p<0.05).
Conclusion Circumferential phototherapy units are effective devices, can provide up to 50% reduction in bilirubin levels within 24 hours in infants with nonhemolytic jaundice. Since it was shown that these devices can provide rapid decrease in bilirubin levels in the first few hours, they are useful in cases with high risk of bilirubin encephalopathy and kern icterus. These units decrease the hospitalization period so can help to maintain breast feeding.