The efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains

Stanislaus Djokomuljanto ¹, Ban-Seng Quah ¹, Surini Yusoff ¹, Noraida Ramli ¹, Nik Zainal Abidin Nik Ismail ¹, Thor Willy Ruud Hansen ² and Hans Van Rostenberghe ^1*

¹ Universiti Sains Malaysia, Malaysia
² University of Oslo, Norway

^* To whom correspondence should be addressed. E-mail: hansvr{at}kb.usm.my.

Accepted 21 July 2006

Abstract

Objective: To determine whether the addition of low-cost reflecting curtains to a standard phototherapy unit could increase effectiveness of phototherapy for neonatal jaundice.

Design: Randomised controlled clinical trial.

Setting: Level one nursery of a tertiary University Hospital in Malaysia.

Patients: Term newborns with uncomplicated neonatal jaundice presenting in the first week of life.

Interventions: Phototherapy with white curtains hanging from the sides of the phototherapy unit (study group) was compared to single phototherapy without curtains (control group).

Main outcome measures: The primary outcome was the mean difference in total serum bilirubin measured at baseline and after four hours of phototherapy. The secondary outcome was the duration of phototherapy.

Results:There were 50 babies in the study group and 47 babies in the control group. The mean decrease in total serum bilirubin levels after 4 hours of phototherapy was significantly (p<0.001) greater in the study group (27.62 µmol/L, SD 25.24) compared to that of the control group (4.04 µmol/L, SD 24.27). Cox proportional hazards regression analysis indicated that the median duration of phototherapy was significantly shorter in the study group (10 hours) than in the control group (34 hours) (chi-square-change = 38.93; p<0.001; hazards ratio: 0.21; 95% confidence interval, 0.13 to 0.35). No difference in adverse events was noted in terms of hyper- or hypothermia, weight loss, skin rash, loose stools, or feeding intolerance.

Conclusion:Hanging white curtains around phototherapy units significantly increases the efficacy in the treatment of neonatal jaundice without evidence of increased adverse effects.

Keywords: developing countries, hyperbilirubinemia, neonatal jaundice, phototherapy, randomised controlled trial

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Maisels, M. J., McDonagh, A. F. (2008). Phototherapy for Neonatal Jaundice. NEJM 358: 920-928 [Full Text]  
• (2007). Other articles noted. Evid. Based Med. 12: 31-32 [Full Text]