Skin exposure during conventional phototherapy in preterm infants: A randomized controlled trial.
OBJECTIVE
To assess the effect of reduced skin exposure in preterm infants receiving overhead phototherapy treatment on total serum bilirubin (TSB).


METHODS
Randomized controlled trial. Preterm infants (>1500 g birthweight and < or = 36 weeks gestation) were randomized to being nursed either partially clothed with only disposable nappies and in posturally supported positions (n = 30) or naked without postural support (n = 29). Primary outcome was mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment (irradiance of 6 microW cm(-2)/nm at a wavelength of 425-475 nm). The incidence of rebound jaundice, number of infants continuing to receive phototherapy treatment at 24 h periods, parental stress, mother-infant interaction and mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment were examined.


RESULTS
Mean TSB percentage change at 24 h of completed treatment for the partially clothed group was 15.4% (+/-18) and for the naked group 19% (+/-15) (mean difference 3.6% 95% CI -5.1, 12.3). No other outcomes were significantly affected by reduced skin exposure to overhead phototherapy treatment.


CONCLUSIONS
Our results show no statistically significant difference in TSB level change using either nursing practice.
Pritchard
M A
MA
Perinatal Research Centre, Royal Brisbane and Women's Hospital, School of Medicine, The University of Queensland, Queensland, Australia. mpritchard@somc.uq.edu.au
Beller
E M
EM
Norton
B
B
D001663:Bilirubin / Q000097:blood*; D003020:Clothing; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010789:Phototherapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D001663:Bilirubin