Effect of Sling Application on Efficacy of Phototherapy in Healthy Term Neonates with Non-hemolytic Jaundice: A Randomized Controlled Trial

Objective: To evaluate the efficacy of white reflecting material (slings) hung from the sides of compact fluorescent lamp (CFL) phototherapy equipment in reducing the duration of phototherapy in healthy term neonates with non-hemolytic jaundice. Design: Randomized controlled trial. Setting: Postnatal ward of a tertiary level neonatal unit. Participants and intervention: Healthy term neonates with non-hemolytic jaundice between 24 hours and 10 days of age were randomly assigned to receive single surface phototherapy with (n=42) or without slings (n=42). Outcome measure: Duration of phototherapy in hours (h) and the requirement of exchange transfusion. Results: Birthweight (2790 352 vs. 2923 330 g), gestation (38 +/- 1.3 vs. 37 +/- 11.0 wk) and initial serum total bilirubin (STB) (16.6 +/- 2.4 vs. 16.1 +/- 2.2 mg/dL) were comparable between the two groups. There was no significant difference in the duration of phototherapy (mean +/- SD) between the Sling (23.3 +/- 12.9 h) and No sling (24.9 +/- 15.4h) groups (P=0.6). The irradiance of phototherapy equipment (microwatt/cm(2), mean SD) was higher in Sling group compared to No sling group (195.8 +/- 24.2 versus 179.7 +/- 27.7, P=0.01). There was a trend towards a higher rate of fall of serum total bilirubin (mg/dL, mean SD) in the Sling group (0.23 +/- 0.49) compared to No sling group (0.03 +/- 0.47) (P=0.06). Conclusion: Though hanging of white reflective sling on sides of CFL phototherapy equipment resulted in marginal increase in irradiance, it did not decrease the duration of phototherapy.