期刊
PEDIATRICS
卷 133, 期 6, 页码 E1568-E1574出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2013-3500
关键词
newborn jaundice; hyperbilirubinemia; sunlight; phototherapy; irradiance; UV; IR; low-middle income countries
类别
资金
- Thrasher Research Fund, Salt Lake City, UT
- Clinical and Translational Science Institute grant (from the National Center for Research Resources) [UL1TR000114]
OBJECTIVES: Evaluate safety and efficacy of filtered-sunlight phototherapy (FS-PT). METHODS: Term/late preterm infants <= 14 days old with clinically significant jaundice, assessed by total bilirubin (TB) levels, were recruited from a maternity hospital in Lagos, Nigeria. Sunlight was filtered with commercial window-tinting films that remove most UV and significant levels of infrared light and transmit effective levels of therapeutic blue light. After placing infants under an FS-PT canopy, hourly measurements of axillary temperatures, monitoring for sunburn, dehydration, and irradiances of filtered sunlight were performed. Treatment was deemed safe and efficacious if infants were able to stay in FS-PT for >= 5 hours and rate of rise of TB was <0.2 mg/dL/h for infants <= 72 hours of age or TB decreased for infants >72 hours of age. RESULTS: A total of 227 infants received 258 days of FS-PT. No infant developed sunburn or dehydration. On 85 (33%) of 258 treatment days, infants were removed briefly from FS-PT due to minor temperature-related adverse events. No infant met study exit criteria. FS-PT was efficacious in 92% (181/197) of evaluable treatment days. Mean +/- SD TB change was -0.06 +/- 0.19 mg/dL/h. The mean +/- SD (range) irradiance of FS-PT was 38 +/- 22 (2-115) mu W/cm(2)/nm, measured by the BiliBlanket Meter II. CONCLUSIONS: With appropriate monitoring, filtered sunlight is a novel, practical, and inexpensive method of PT that potentially offers safe and efficacious treatment strategy for management of neonatal jaundice in tropical countries where conventional PT treatment is not available.
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