#076-080 : Phototherapy for neonatal jaundice

#076-080 : Phototherapy for neonatal jaundice

Incubator & Neonatology Review Podcast


Hello Friends 👋

This week we talk about Phototherapy for the management of indirect hyperbilirubinemia. We start off our journey in the UK in 1950's where a series of serendipitous events led to the discovery of light as a potential remedy for neonatal jaundice. We discuss the pathophysiology of indirect hyperbilirubinemia, and the mechanism of action of phototherapy. On Thursday we reviewed a group a papers looking at some interesting questions regarding phototherapy. Is high intensity better? Is intermittent phototherapy equivalent to continuous photo? Does phototherapy increase the risk of childhood cancer? We even talked about whether preterm babies should have their chest shieleded during phototherapy in order to prevent the re-opening of closing PDA.... really interesting stuff.

We are linking to many of the articles mentioned on the show this week.

We are also sharing a presentation covering the content discussed on the podcast to help you teach the material.

Enjoy!


Powerpoint presentation:

https://docs.google.com/presentation/d/1oURQeFHQJsNxZ6LWH0JNKhiyRrI4Gumj/edit?usp=sharing&ouid=102433794540301590359&rtpof=true&sd=true


https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(58)91849-X/fulltext

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(58)91849-X/fulltext

https://www.jpeds.com/article/S0022-3476(83)80370-9/pdf

https://publications.aap.org/neoreviews/article-abstract/4/2/e27/87010/Historical-PerspectivesPhototherapy?redirectedFrom=fulltext

Phototherapy for Neonatal Jaundice | NEJM
Clinical Therapeutics from The New England Journal of Medicine — Phototherapy for Neonatal Jaundice

https://publications.aap.org/neoreviews/article/21/11/e749/91878/Neonatal-Indirect-Hyperbilirubinemia

https://publications.aap.org/pediatrics/article/130/2/e352/29930/Dose-Response-Relationship-of-Phototherapy-for

High-intensity phototherapy for the treatment of severe nonhaemolytic neonatal hyperbilirubinemia - PubMed
High-intensity phototherapy significantly reduces TSB in nonhaemolytic severe hyperbilirubinaemia and decreases the need for exchange transfusion.
Intermittent versus continuous phototherapy for the treatment of neonatal non-hemolytic moderate hyperbilirubinemia in infants more than 34 weeks of gestational age: a randomized controlled trial - European Journal of Pediatrics
Intermittent phototherapy with “12 h on and then 12 h off” schedule in comparison with continuous phototherapy for neonatal hyperbilirubinemia may save costs and decrease anxiety of parents. In this non-inferiority-randomized controlled trial, healthy late preterm (>34 weeks) and term neonates with…

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2765039

https://publications.aap.org/pediatrics/article/148/5/e2021051033/181342/Update-on-Phototherapy-and-Childhood-Cancer-in-a

Patent ductus arteriosus in extremely preterm infants receiving phototherapy: does shielding the chest make a difference? A randomized, controlled trial - PubMed
Chest shielding did not alter the incidence or severity of PDA in our population of extremely preterm infants.
Use of reflective materials during phototherapy for newborn infants with unconjugated hyperbilirubinaemia - Van Rostenberghe, H - 2020 | Cochrane Library
Chest shielding for prevention of a haemodynamically significant patent ductus arteriosus in preterm infants receiving phototherapy - Bhola, K - 2015 | Cochrane Library