Clinical Trial: High Intensity Phototherapy: Double vs. Single

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Intensive Phototherapy, Double vs. Single, in Treatment of Neonatal Hyperbilirubinemia Using LED

Brief Summary: Intensive phototherapy in form of double light is used worldwide in the treatment of severe neonatal hyperbilirubinemia. It has been debated if there is an upper limit on the efficiency of phototherapy. This study investigates whether double phototherapy reduces total serum bilirubin faster than single light during intensive phototherapy, using light emitting diodes, and whether there is an upper limit for the efficacy of phototherapy.

Detailed Summary:

Hyperbilirubinemia occurs in 60 - 80 % of newborns during the first days of life, among others because of immaturity of the enzyme uridin-glukuronosyl-transferase (UGT1A1) in the liver. In seldom cases with very high total serum bilirubin concentration (TsB), bilirubin can cross the blood-brain barrier and the deposition of unconjugated bilirubin in the central nervous system may cause acute bilirubin encephalopathy (ABE). This can progress to chronic bilirubin encephalopathy (CBE), a devastating condition, which unfortunately still occurs, even in industrialised countries.

Hyperbilirubinemia gets severe for 2 - 6 % of infants born at term or late preterm, which means, they need treatment to prevent ABE and the treatment of choice is phototherapy due to its efficacy and safety. Hereby bilirubin in the skin and plasma is converted to photobilirubins; they are water-soluble and can be excreted through the liver without conjugation. They are presumably non-toxic. In most departments, single phototherapy is first choice. To avoid the above-mentioned damaging condition, it is very important to optimize phototherapy.

Former fluorescent tubes were used as light source, but now light emission diodes (LED) are used.

This study investigates whether double phototherapy reduces total serum bilirubin faster than single light during intensive phototherapy, using LED, and whether there is an upper limit for the efficacy of phototherapy.

It is a prospective, randomised controlled study. The infants will be randomized to either 1: Conventional phototherapy with blue LED light from above and a distance from light source to mattress of 30 cm, giving a light irradiance of 66 µW/cm2/nm or 2: Conventional phototherapy combined with a light b
Sponsor: Aalborg Universitetshospital

Current Primary Outcome: Decrease in total serum bilirubin after 12- and 24 hours of phototherapy, measured in percent. [ Time Frame: 12 and 24 Hours og phototherapy ]

Total serum bilirubin will be measured at start of phototherapy, after 12 - and after 24 hours of phototherapy for both Groups. Primary outcome measure is, whether double phototherapy decreases total serum bilirubin faster than single phototherapy after 12- and/or after 24 hours of phototherapy.


Original Primary Outcome: Same as current

Current Secondary Outcome: Whether total serum bilirubin continues to decrease measured in percent after 24 hours of high-intensity phototherapy [ Time Frame: 24 Hours of phototherapy ]

To figure out, whether there is an upper limit for the efficacy of phototherapy, i.e. a plateau above which total serum bilirubin does not decrease any further.


Original Secondary Outcome: Same as current

Information By: Aalborg Universitetshospital

Dates:
Date Received: June 6, 2016
Date Started: June 2014
Date Completion:
Last Updated: June 15, 2016
Last Verified: June 2016