PHOTOTHERAPY FOR NEONATAL NONHEMOLYTIC HYPERBILIRUBINEMIA - ANALYSIS OF REBOUND AND INDICATIONS FOR DISCONTINUING THERAPY

Phototherapy, an effective treatment for neonatal indirect hyperbiliru binemia, has guidelines for its initiation but none for its discontinu ation. In our study, phototherapy was begun at a mean age of 90 hours in 28 full-term and 30 preterm infants with indirect nonhemolytic hype rbilirubinemia. After three days, phototherapy was halted at a mean bi lirubin concentration of 13.0 +/- 0.7 mg/dL in term and 10.7 +/- 1.2 m g/dL in preterm infants, levels higher than those used by other invest igators. Bilirubin rebound then occurred at a mean of 12.5 hours to a level of 0.86 +/- 1.0 mg/dL in term and at a mean of 14.1 hours to a l evel of 0.83 +/- 0.56 mg/dL in preterm infants. No complications were observed nor was there a need for reinstitution of phototherapy. Based on these data, discontinuation of phototherapy at higher bilirubin co ncentrations and earlier home discharge than previously described appe ar harmless for both term and preterm neonates.