Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants

被引:47
作者
Mreihil, Khalaf [1 ,2 ]
Benth, Jurate Saltyte [2 ,3 ]
Stensvold, Hans Jorgen [2 ,4 ]
Nakstad, Britt [1 ,2 ]
Hansen, Thor Willy Ruud [2 ,4 ]
机构
[1] Akershus Univ Hosp, Dept Pediat & Adolescent Med, Sykehusveien 25, N-1478 Lorenskog, Norway
[2] Univ Oslo, Inst Clin Med, Fac Med, Oslo, Norway
[3] Akershus Univ Hosp, Res Ctr, HOKH, Lorenskog, Norway
[4] Oslo Univ Hosp, Div Paediat & Adolescent Med, Oslo, Norway
关键词
Clinical guidelines; Hyperbilirubinaemia; Neonatal intensive care unit; Neonatal jaundice; Phototherapy; LOW-BIRTH-WEIGHT; RANDOMIZED-CONTROLLED-TRIAL; VS. CONSERVATIVE PHOTOTHERAPY; RHESUS HEMOLYTIC-DISEASE; LIGHT-EMITTING-DIODES; EXCHANGE TRANSFUSIONS; DIABETIC MOTHERS; HYPERBILIRUBINEMIA; EFFICACY; MANAGEMENT;
D O I
10.1111/apa.14141
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Aim: Limited information is available about how guidelines on phototherapy for neonatal jaundice are applied in practice and toxicity is a concern. We studied the use of phototherapy in relation to birthweight and gestational age (GA) in Norwegian neonatal intensive care units (NICUs). Methods: The study population was all 5382 infants admitted to the 21 NICUs in Norway between September 1, 2013 and August 31, 2014. Data were recorded daily in the Norwegian Neonatal Network database and anonymised data on patient characteristics, diagnoses, duration, the ages at the start and discontinuation of phototherapy were analysed. Results: More than a quarter (26.6%) of all infants admitted to Norwegian NICUs during the study period received phototherapy. The use of phototherapy was inversely related to GA and birthweight. More than 80% of the preterm infants under 28 weeks of GA received phototherapy. The duration was significantly longer in the lowest birthweight and GA groups and decreased with increasing birthweight and GA. Conclusion: Phototherapy is proved to be a strong candidate for the most common therapeutic modality in NICU infants. However, in the light of reported toxicity in the smallest, most vulnerable infants, we recommend increased emphasis on quality control.
引用
收藏
页码:611 / 619
页数:9
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