EFFECT OF STRONG LIGHT THERAPY WITH COLD LIGHT SOURCE IN TREATMENT OF SEVERE NEONATAL HYPERBILIRUBINEMIA

Abstract

Objective To investigate the clinical effect of strong light therapy with cold light source in the treatment of severe neonatal hyperbilirubinemia. Methods A total of 217 neonates with severe hyperbilirubinemia who were hospitalized in Department of Neonatology in our hospital from June 2016 to January 2022 were enrolled and treated with strong light therapy with cold light source. Serum total bilirubin (STB) was measured after 4-6 h, and if STB decreased or immunohemolytic STB decreased by ≥34-50 μmol/L, strong light therapy with cold light source was continued for 18-24 h, with STB tested once during 8-12 h. When STB decreased to below 342.0 μmol/L, the treatment was changed to standard phototherapy. If STB did not decrease to the target value after 4-6 h of strong light therapy with cold light source or the early manifestation of acute bilirubin encephalopathy was observed, phototherapy was stopped and switched to exchange transfusion immediately. Results Among the 217 neonates, 2 showed no response to strong light therapy with cold light source and were treated with exchange transfusion, and the other 215 neonates achieved a reduction in STB of (40.6±14.9), (61.2±17.7), and (114.7±49.4) μmol/L, respectively, after 4-6 h, 12-14 h, and 20-24 h of strong light therapy with cold light source. The mean duration of strong light therapy with cold light source was (32.3±14.5) h. After treatment for 5-9 d, the neonates were discharged when there was no increase in STB. Hearing screening within 1 week after discharge showed normal results; brainstem auditory evoked potential (BAEP) examination was performed for 96 neonates and showed no abnormality; all neonates had normal MRI results. Of all neonates, 134 were followed up for 1 year, 43 were followed up for 1-6 months, and 38 were lost to follow-up after 1 month. The neonates who were followed up had normal physical growth, motor development, neurobehavioral assessment, BAEP, and MRI results. Conclusion Strong light therapy with cold light source has a marked clinical effect in the treatment of severe neonatal hyperbilirubinemia, and comprehensive treatment such as non-exchange transfusion strong light irradiation with cold light source can be selectively used.

Keywords

• phototherapy|hyperbilirubinemia, neonatal|duration of therapy|treatment outcome