Montealegre Adriana, Charpak Nathalie, Parra Adriana, Devia Claudia, Coca Isabel, Bertolotto Ana María
Hospital Universitario San Ignacio, Bogotá, Colombia; Pontificia Universidad Javeriana, Bogotá, Colombia; Fundación Canguro, Bogotá, Colombia.
Pontificia Universidad Javeriana, Bogotá, Colombia; Fundación Canguro, Bogotá, Colombia; Programa Madre Canguro Integral, Hospital Universitario San Ignacio, Bogotá, Colombia.
An Pediatr (Engl Ed). 2020 Feb;92(2):79-87. doi: 10.1016/j.anpedi.2019.02.008. Epub 2019 Apr 9.
Neonatal jaundice is common, especially in premature infants. Compliance with treatment protocols and standard serum bilirubin curves forces the clinician to separate the child from the mother after birth for short phototherapy. The objective of this study is to evaluate the effectiveness and safety of two innovative devices for phototherapy including a LED light mesh: one sleeping bag and one blanket compared to conventional hospital or ambulatory phototherapy.
Two randomised clinical trials were conducted: one with newborns >2,000g at birth in the Neonatal Care Unit and the other with premature infants followed-up in an outpatient clinic (PMC). The gold standard for bilirubin measurement was serum bilirubin, and ambulatory controls were performed with the Bilicheck®. Parents and health personnel completed a questionnaire on comfort and perceptions.
In the study using the bag, a linear regression was performed for the decrease in bilirubin in mg/dL/h, controlling by early jaundice (<36h) and the device type. The results were similar between the 2 devices. For the blanket trial in the PMC, the decrease in bilirubin levels with the new device was significantly greater with no differences in temperatures, duration of phototherapy, re-admission, mortality, or side effects for both trials. Parents and staff satisfaction with the two devices was identical for the 2 trials.
These 2 small studies add a 'grain of sand' to humanisation of newborn care, avoiding the mother-and-child separation for both the intra-hospital high-risk hyperbilirubinaemia, as well as for the lower-risk hyperbilirubinaemia in an outpatient clinic.
新生儿黄疸很常见，尤其是在早产儿中。遵循治疗方案和标准血清胆红素曲线要求临床医生在婴儿出生后将其与母亲分开进行短时光疗。本研究的目的是评估两种创新光疗设备（一种睡袋和一种毯子）与传统医院或门诊光疗相比的有效性和安全性，其中一种创新光疗设备是发光二极管光网。
进行了两项随机临床试验：一项在新生儿重症监护病房对出生时体重>2000g的新生儿进行，另一项在门诊诊所对早产儿进行随访（门诊医疗中心）。胆红素测量的金标准是血清胆红素，门诊对照使用Bilicheck®进行。家长和医护人员完成了一份关于舒适度和感受的问卷。
在使用睡袋的研究中，对以mg/dL/h为单位的胆红素下降进行了线性回归分析，控制因素为早期黄疸（<36小时）和设备类型。两种设备的结果相似。在门诊医疗中心进行的毯子试验中，新设备使胆红素水平下降幅度明显更大，两项试验在温度、光疗持续时间、再次入院、死亡率或副作用方面均无差异。两项试验中家长和工作人员对这两种设备的满意度相同。
这两项小型研究为新生儿护理的人性化增添了“一粒沙”，避免了因医院内高危高胆红素血症以及门诊低风险高胆红素血症而导致的母婴分离。
