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- Title
Comparison of the Effect of Phenobarbital and Phototherapy to Phototherapy in the Treatment of Non-Hemolytic Hyperbilirubinemia in Neonates Admitted to the NICU of Mashhad Hospitals: A Clinical Trial.
- Authors
Farhat, Ahmad Shah; Mohammadzadeh, Ashraf; Lotfi, Saed Reza; Khodashenas, Ezzat
- Abstract
Introduction: Neonatal jaundice is a significant problem that occurs in 80% of premature infants and 30-60% of term infants in the first week of life. About 6-10% of these cases develop severe hyperbilirubinemia in need of treatment (bilirubin level above 90% of age per hour ), and 5-36% of healthy full-term neonates who are discharged from the hospital are readmitted due to moderate to severe hyperbilirubin. Treatments for jaundice include phototherapy and blood exchange transfusions. Percutaneous phototherapy by photoisomerization reduces blood bilirubin. However, it is expensive, and due to the necessity of hospitalization and the eyes being covered, it disrupts the relationship between the mother and the child. Furthermore, the power of phototherapy to reduce bilirubin levels above 20 is not so high. Methods: The infants at the neonatal intensive care units (NICUs) of Imam Reza (AS) and Samen Al-Aimeh hospitals, Mashhad, Iran, were selected for this study after receiving approval from the Research Council of Mashhad University of Medical Sciences, informing the infants' parents, and obtaining their informed consent. Phenobarbital complications were explained to the parents of infants weighing more than 2.5 kg before admission, and adjustments were made based on gestational age. Infants were randomly assigned to either the phenobarbital (case) or the placebo (control) group. Routine laboratory tests for jaundice were performed for all infants. After that, phototherapy and medications were administered. Bilirubin levels were checked every 6, 12, 24, and 48 h after medication, and at discharge. The collected data were analyzed using SPSS software (version 16). The results are considered with 80% power, a 95% confidence interval, and a 5% significance level. Results: This study was performed on 80 jaundiced infants who were referred to Imam Reza (AS) and Samen Al-Aimeh hospitals, Mashhad, Iran, for treatment and were transferred to the NICU. According to the results, 45% of infants in the study group and 52.2% of the total number of them were male, but the difference was not significantly significant (P>0.05). There was also no significant difference in infants' gestational age, weight, or the age of hospitalization. The mean and standard deviation of bilirubin levels before and after the intervention were not significantly different between the two groups after 6, 12, 24, and 48 h and at discharge time. Despite the significant difference, the length of hospital stay could not be studied due to the absence of exact hospitalization and discharge hours, as well as measurement errors. Conclusion: This double-blind clinical trial study aimed to determine the effect of a single dose of 20 mg/kg of phenobarbital on healthy full-term infants who were breastfed and had symptomatic bilirubin levels in need of phototherapy. Overall, 80 full-term neonates with nonhemolytic hyperbilirubinemia were studied in two groups. The treatment in the case group included phototherapy and phenobarbital, while the control group only received phototherapy. The inclusion and exclusion criteria were considered for each infant, and the study was started after parents' informed consent was obtained. Phototherapy with 20 mg/kg phenobarbital was prescribed for the case group, while phototherapy alone was performed for the control group. After that, the bilirubin levels of both groups were checked every 6, 12, 24, and 48 h, and at the time of discharge. Decreased bilirubin was observed every 6, 12, 24, and 48 h, as well as at the time of discharge in the case group. In neonates with jaundice, phototherapy with a single dose of phenobarbital (20 mg) did not reduce bilirubin levels or the length of hospital stay.
- Subjects
MOTHER-child relationship; NEONATAL intensive care units; NEONATAL jaundice; PREMATURE infants; HOSPITAL admission &; discharge; JAUNDICE
- Publication
Reviews in Clinical Medicine, 2024, Vol 11, Issue 2, p13
- ISSN
2345-6256
- Publication type
Article