Comparison of the efficacy of conventional special blue light phototherapyand fiberoptic phototherapy in the management of neonatal hyperbilirubinaemia

The efficacy and usefulness of two types of phototherapy differing in the s ource, wavelength and irradiance of the light, conventional phototherapy co nsisting of special blue light and fiberoptic phototherapy, were compared i n a relatively larger series of term newborns with non-haemolytic and more significant hyperbilirubinaemia than those in previous studies. In total, 1 08 newborns were allocated sequentially to receive either conventional phot otherapy consisting of five special blue lamps or fiberoptic phototherapy. The average spectral irradiance measured at the skin surface level of newbo rns during the study period was significantly greater in the conventional p hototherapy group. The special blue lamp of the conventional phototherapy u nit had an emission spectrum almost identical to the bilirubin absorption s pectrum, whereas the tungsten-halogen lamp of the fiberoptic phototherapy h ad a broad emission through the blue and green wavelengths (mainly in the g reen spectrum). Phototherapy was more effective in the conventional phototh erapy group; the duration of exposure to phototherapy (h) was significantly shorter, and the overall bilirubin decline rate (as mu mol/l/h and %/h) wa s significantly greater in the conventional phototherapy group. According t o the nursing personnel, fiberoptic phototherapy was more comfortable than the conventional phototherapy frame because of the easier accessibility and handling of the infants during phototherapy. They complained of giddiness, nausea, glare, temporary blurring of vision and difficulty in detecting th e skin colour changes of newborns with the blue light of the conventional p hototherapy unit. Conventional phototherapy consisting of special blue fluo rescent lamps with approximately twofold higher irradiance and an emission spectrum almost identical to the bilirubin absorption spectrum is preferabl e to fiberoptic phototherapy in the standard treatment of term newborns wit h non-haemolytic hyperbilirubinaemia.