Early formation of bilirubin isomers during phototherapy for neonatal jaundice: effects of single vs. double fluorescent lamps vs. photodiodes

Pediatric Research
Khalaf MreihilThor Willy Ruud Hansen

Abstract

In neonatal jaundice, phototherapy converts bilirubin to more polar photoisomers which can be excreted without conjugation. We measured changes in the concentration of bilirubin Z,E-photoisomer during the first 4 h of intensive phototherapy using single fluorescent lights as a reference, compared to double fluorescent lights, and a single unit of photodiodes. Neonates (N = 42; birth weight: 1,200-4,690 g; gestational age: 28-42 wk) were studied during phototherapy. Infants were randomized to: (i) single, or (ii) double fluorescent phototherapy; or (iii) single unit photodiodes. Irradiance was measured. Serum bilirubin (by cooximetry) and Z,E bilirubin (by high-pressure liquid chromatography) were measured at 0,15, 30, 60, 120, and 240 min after the start of phototherapy. Data were analyzed with a linear mixed model. There was a highly significant increase of Z,E-bilirubin over time (P < 0.0001), starting at 15 min. Photoisomers reached ~25% of total bilirubin concentration after 4 h. However, there were no significant differences between the three randomized groups in spite of significantly higher irradiance using double fluorescent lights vs. single fluorescent or photodiodes. Formation of bilirubin photoisomers is rapid, and ...Continue Reading

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Citations

May 29, 2016·Clinics in Perinatology·Angelo A Lamola
Nov 17, 2015·Pediatric Research·Debra T LinfieldDavid K Stevenson
Sep 7, 2017·Pediatric Research·Mette L DonneborgFinn Ebbesen
Nov 3, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·M L DonneborgF Ebbesen
Jun 20, 2018·Journal of Perinatology : Official Journal of the California Perinatal Association·Devashis MukherjeeM Jeffrey Maisels
Jul 4, 2019·Transfusion·Melissa M CushingUNKNOWN AABB Clinical Transfusion Medicine Committee
Aug 20, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Thor Willy Ruud HansenVinod K Bhutani
Apr 17, 2019·Experimental and Therapeutic Medicine·Shiying ZhouYanli Liu

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