DOUBLE PHOTOTHERAPY WITH HIGH IRRADIANCE COMPARED WITH SINGLE PHOTOTHERAPY IN NEONATES WITH HYPERBILIRUBINEMIA

The purpose of this study is to compare the effectiveness of double ph ototherapy versus single conventional phototherapy in decreasing serum bilirubin levels in jaundiced neonates. Forty-two preterm infants who were less than 37 weeks' gestational age and less than 2000 g birthwe ight with nonhemolytic jaundice were alternately assigned to double ph ototherapy (n = 19) (Biliblanket, Ohmeda with irradiance of 33 to 35 m u W/cm(2)/nm in addition to single conventional phototherapy with comb ination of three or four special blue and white lamps with irradiance of 7 to 9 mu W/cm(2)/nm) or to single conventional phototherapy (n = 2 3) based on elevated serum bilirubin levels in the first week of life. Phototherapy was initiated at specific bilirubin levels in three weig ht stratifications. The groups were similar in clinical characteristic s at study entry. The decrease in serum bilirubin levels was very sign ificant in the double phototherapy group at 8 hours after the therapy (-29+/-18.8 versus 8.5+/-27 mu mol/L; p<0.001), at 16 hours after the therapy (-49.6+/-15.4 versus 3.4+/-39 mu mol/L; p<0.001), and at 24 ho urs after therapy (-71.8+/-18.8 versus -3.4+/-32.5 mu mol/L; p<0.001) compared with the conventional phototherapy group. The time taken for bilirubin levels to fall below the threshold level was 55+/-41 hours i n the single group and 14+/-6 hours in the double group (p<0.001). Dou ble phototherapy was well tolerated. The Biliblanket when used in conj unction with single conventional phototherapy resulted in a faster dec rease of serum bilirubin. We conclude that the use of double photother apy compared with single conventional phototherapy shortens the durati on of hyperbilirubinemia without complications.