ORIGINAL ARTICLE

Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains

S Djokomuljanto¹, B S Quah¹, Y Surini¹, R Noraida¹, N Z N Ismail¹, T W R Hansen² and H Van Rostenberghe¹

¹ Department of Paediatrics, Universiti Sains Malaysia, Kelantan, Malaysia
² Department of Paediatrics, Rikshospitalet-Radiumhospitalet HF, University of Oslo, Oslo, Norway

Correspondence to:
Correspondence to:
H Van Rostenberghe
Department of Paediatrics, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia;hansvr{at}kb.usm.my

Objective: To determine whether the addition of low-cost reflecting curtains to a standard phototherapy unit could increase effectiveness of phototherapy for neonatal jaundice.

Design: Randomised controlled clinical trial.

Setting: Level-one nursery of the Hospital Universiti Sains Malaysia, Kelantan, Malayasia.

Patients: Term newborns with uncomplicated neonatal jaundice presenting in the first week of life.

Interventions: Phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n = 50) was compared with single phototherapy without curtains (control group, n = 47).

Main outcome measures: The primary outcome was the mean difference in total serum bilirubin measured at baseline and after 4 h of phototherapy. The secondary outcome was the duration of phototherapy.

Results: The mean (standard deviation) decrease in total serum bilirubin levels after 4 h of phototherapy was significantly (p<0.001) higher in the study group (27.62 (25.24) µmol/l) than in the control group (4.04 (24.27) µmol/l). Cox proportional hazards regression analysis indicated that the median duration of phototherapy was significantly shorter in the study group (12 h) than in the control group (34 h; ² change 45.2; p<0.001; hazards ratio 0.20; 95% confidence interval 0.12 to 0.32). No difference in adverse events was noted in terms of hyperthermia or hypothermia, weight loss, rash, loose stools or feeding intolerance.

Conclusion: Hanging white curtains around phototherapy units significantly increases efficacy of phototherapy in the treatment of neonatal jaundice without evidence of increased adverse effects.

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This article has been cited by other articles:

• Maisels, M. J., McDonagh, A. F. (2008). Phototherapy for Neonatal Jaundice. NEJM 358: 920-928 [Full Text]  
• (2007). Other articles noted. Evid. Based Med. 12: 31-32 [Full Text]