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Δευτέρα 16 Νοεμβρίου 2020

Intermittent cycled phototherapy may control peak serum bilirubin levels and reduce mortality in extremely low birthweight infants

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Study design

Design: Randomised controlled study.

Allocation: Remote randomisation stratified by centre and risk (high-risk group: birth weight ≤ 750g and ventilated at enrolment; low-risk group: birth weight > 750g or not ventilated).

Setting: 6 neonatal intensive care units in the USA.

Patients: 128 extremely low birthweight (ELBW) infants receiving continuous phototherapy were compared with 128 ELBW infants receiving cycled phototherapy ≥15 min/hour.

Primary outc omes

Mean peak total serum bilirubin (TSB) level and total phototherapy hours through to day 14. Predischarge wave V latency brainstem auditory-evoked responses (BAERs), which have been shown to correlate with bilirubin neurotoxicity.

Secondary outcome

Mortality and other indices of major morbidity including severe intraventricular haemorrhage, bronchopulmonary dysplasia, surgical necrotising enterocolitis, patent ductus arteriosus requiring intervention, severe retinopathy of prematurity and late-onset sepsis.

Main results

Cycled phototherapy reduced phototherapy hours compared with continuous. Mean peak TSB levels were higher in the cycled arm, but not significantly so. BAER wave V latency times...

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