Department of Internal Medicine, Ziauddin University, Karachi, Pakistan.
Department of Pediatrics, Ziauddin University, Karachi, Pakistan.
Eur J Pediatr. 2020 Jun;179(6):865-874. doi: 10.1007/s00431-020-03583-x. Epub 2020 Jan 22.
To assess the efficacy of double phototherapy in managing neonatal jaundice compared to single phototherapy in infants with different birth weight and gestational age. CENTRAL, PubMed, clinicaltrials.gov, and gray literature sources were searched from date of inception of these databases till August 2019. Primary outcome was decline of total serum bilirubin (TSB) per hour. Ten studies were eligible. Our meta-analysis showed significant difference between double phototherapy versus single phototherapy in decline of TSB per hour in preterm infants (standardized mean difference [SMD] = 2.28 [0.79-3.76], p = 0.003) and a significant decrease in TSB levels at 24 h of phototherapy in infants with birth weight ≥ 1500 g (mean difference [MD] = - 61.70 μmol/L, [- 107.96, - 15.43], p = <0.001).Conclusion: Double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.What is Known:• Double phototherapy has shown to be more efficacious than single phototherapy in treating neonatal jaundice.• Double phototherapy efficacy on neonates with different gestational ages and birth weights still remain ambiguous in treating neonatal jaundice.What is New:• The results of this meta-analysis show that double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.
评估双光疗与单光疗在不同出生体重和胎龄婴儿中治疗新生儿黄疸的疗效。从这些数据库的创建日期到 2019 年 8 月,对 CENTRAL、PubMed、clinicaltrials.gov 和灰色文献来源进行了检索。主要结局为每小时总血清胆红素(TSB)下降量。有 10 项研究符合条件。我们的荟萃分析显示,在早产儿中,双光疗与单光疗相比,每小时 TSB 下降量有显著差异(标准化均数差 [SMD] = 2.28 [0.79-3.76],p = 0.003),而在出生体重≥1500g 的婴儿中,光疗 24 小时后 TSB 水平显著降低(均数差 [MD] = -61.70 μmol/L [-107.96,-15.43],p <0.001)。结论:双光疗在治疗不同胎龄和出生体重的婴儿的 TSB 方面是有效的,最主要的发现是早产儿对核黄疸更敏感。已知:• 双光疗在治疗新生儿黄疸方面比单光疗更有效。• 双光疗对不同胎龄和出生体重新生儿的疗效在治疗新生儿黄疸方面仍不明确。新发现:• 这项荟萃分析的结果表明,双光疗在降低不同胎龄和出生体重婴儿的 TSB 方面是有效的,最主要的发现是早产儿对核黄疸更敏感。