Full-term infants with evidence of severe
hemolysis on the peripheral blood smear, whose serum
bilirubin levels were between 15-21 mg/dl were divided into 2 groups, depending on the availability of the
phototherapy bed. Group 1 infants received double
phototherapy consisting of conventional (single)
phototherapy plus an extra light source from a
phototherapy bed (Medela Billibed, Switzerland). Group 2 infants received only conventional
phototherapy. Maternal and infants'
blood groups and Rh, direct Coomb's test, G6PD screening test and hematocrit were determined on every infant.
Phototherapy was given until the serum
bilirubin level dropped to < or = 13 mg/dl. Exchange transfusion was indicated when the serum
bilirubin level was > or = 21 mg/dl after
phototherapy had been given for 4-6 hours.
RESULTS: There were 110 infants included in this study, 62 and 48 in group 1 and 2 respectively. There was no statistical difference in terms of
birth weight, sex ratio, proportion of breast feeding infants and the initial hematocrit level. However, the initial mean +/- SD of
bilirubin level of group 1 infants was higher than that of group 2, (17.7 +/- 1.6 mg/dl vs 16.2 +/- 0.9 mg/dl, p < 0.001). Causes of
hemolysis could be determined in 74 infants; 27 (24.5%), 39 (35.5%) and 8 (7.3%) infants had ABO incompatibility,
G6PD deficiency and both ABO incompatibility and
G6PD deficiency respectively. Rate of
bilirubin reduction in group 1 infants was significantly faster, (3.3 +/- 2.4 mg/dl/24 h vs 2.1 +/- 1.1 mg/dl/24 h, p < 0.01). Duration of
phototherapy was also shorter in group 1 infants, (45.8 +/- 29.7 hours vs 58.5 +/- 26.0 hours, p < 0.05). Four infants failed to respond to the
phototherapy that was assigned. Two infants in group 2 had to be switched to receive double
phototherapy because of rapid rising of serum
bilirubin. One in each group needed exchange transfusion.
CONCLUSION: