The use of intensive phototherapy using super light-emitting diode (LED) bed technology appears to be effective in treating hyperbilirubinemia in newborns due to hemolytic disease of the fetus and newborn (HDFN) or other causes, potentially reducing the need for exchange transfusions (ECTs), according to a recently published study in Cureus.
High blood bilirubin levels (hyperbilirubinemia) in the newborn is a common complication associated with HDFN. However, it can also be caused by a great variety of conditions, including liver disease. Hyperbilirubinemia leads to a yellow coloration of the skin and eyes, known as jaundice. More importantly, it can lead to permanent neurological complications (kernicterus). Patients with kernicterus appear flaccid and weak and fail to achieve development in the long term.
Standard treatment for hyperbilirubinemia in newborns included phototherapy, which consists of exposure to UV radiation and ETCs. ETC has proven to effectively improve hyperbilirubinemia. However, it is associated with complications such as infection, air embolisms, and blood clots. Furthermore, the administration of many ETCs in the same patient has been linked to a rebound effect.
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“The immediate and marked fall in bilirubin levels during ECT is transient, with a rapid rebound influencing subsequent decisions in managing neonatal severe hyperbilirubinemia,” the authors wrote.
The authors performed a study of 69 newborn patients with hyperbilirubinemia who met the criteria for ETC and were treated with intensive phototherapy instead. The majority of the patients included in the study had hyperbilirubinemia due to HDFN.
All of the patients who had moderate symptoms experienced complete resolution of their symptoms with phototherapy. However, patients who had already developed kernicterus remained with neurological sequelae.
“While the study provides valuable insights into the efficacy of intensive LED phototherapy as an alternative to exchange transfusion (ECT) in managing severe neonatal hyperbilirubinemia, there are several limitations to consider,” they added.
The authors recommend performing larger and more varied studies regarding the subject to draw more confident conclusions regarding the superiority of phototherapy over ETC.
