Abstract | BACKGROUND: In neonatal jaundice, phototherapy converts bilirubin to more polar photoisomers which can be excreted without conjugation. We measured changes in the concentration of bilirubin Z,E-photoisomer during the first 4 h of intensive phototherapy using single fluorescent lights as a reference, compared to double fluorescent lights, and a single unit of photodiodes. METHODS: Neonates (N = 42; birth weight: 1,200-4,690 g; gestational age: 28-42 wk) were studied during phototherapy. Infants were randomized to: (i) single, or (ii) double fluorescent phototherapy; or (iii) single unit photodiodes. Irradiance was measured. Serum bilirubin (by cooximetry) and Z,E bilirubin (by high-pressure liquid chromatography) were measured at 0,15, 30, 60, 120, and 240 min after the start of phototherapy. Data were analyzed with a linear mixed model. RESULTS: There was a highly significant increase of Z,E- bilirubin over time (P < 0.0001), starting at 15 min. Photoisomers reached ~25% of total bilirubin concentration after 4 h. However, there were no significant differences between the three randomized groups in spite of significantly higher irradiance using double fluorescent lights vs. single fluorescent or photodiodes. CONCLUSION: Formation of bilirubin photoisomers is rapid, and occurs early during intensive phototherapy for neonatal jaundice. The rate and level of photoisomerization was not influenced by irradiance and light source.
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Authors | Khalaf Mreihil, Poul Madsen, Britt Nakstad, Jūratė Šaltytė Benth, Finn Ebbesen, Thor Willy Ruud Hansen |
Journal | Pediatric research
(Pediatr Res)
Vol. 78
Issue 1
Pg. 56-62
(Jul 2015)
ISSN: 1530-0447 [Electronic] United States |
PMID | 25794186
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Bilirubin
(blood, chemistry)
- Birth Weight
- Chromatography, High Pressure Liquid
- Equipment Design
- Gestational Age
- Humans
- Infant, Newborn
- Jaundice, Neonatal
(blood, therapy)
- Light
- Linear Models
- Phototherapy
(instrumentation, methods)
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