Intensive 360° (Capsule) versus conventional phototherapy in neonatal jaundice

Abstract

Background: Neonatal jaundice is a common condition affecting a high percentage of neonates. In severe cases, if left untreated, it could lead to damaging neurologic complications. Capsule phototherapy is an innovative model of phototherapy that could be faster and more effective than conventional phototherapy. However, to date, only a few studies have compared its effect with conventional phototherapy. Methods: This article is a retrospective, non-randomised and observational study conducted in the neonatal unit at Hatta Hospital, Dubai. All infants above 35-week gestation who presented with neonatal jaundice above the threshold for intensive phototherapy were included in the study. Babies were exposed to conventional intensive phototherapy if the bilirubin level crossed the intensive phototherapy level and to capsule phototherapy once the bilirubin level reached 2.5 mg/dL below the exchange transfusion level. The rate of bilirubin decline and the time needed to reach below the intensive phototherapy level was compared between babies under either model of phototherapy. Results: The efficacy difference was significant, as the mean serum bilirubin decreased 1.29 ± 0.45 mg/dL/h and 0.31 ± 0.13 mg/dL/h in capsule and intensive phototherapy, respectively. The difference was about 0.98 ± 0.23 mg/dL/h, with a P = 0.0001. The duration of treatment in capsule phototherapy was much shorter at 6.45 ± 2.3 h in comparison to 22 ± 10.8 h in intensive phototherapy (difference of 15.5 ± 6.8 h, P = 0.0001). Conclusion: Capsule phototherapy resulted in a faster decline of serum bilirubin level, and therefore, a shorter treatment duration than intensive phototherapy. However, more robust clinical trials with a higher number of subjects are required before suggesting capsule phototherapy, as the standard treatment for severe neonatal jaundice.