title: When should phototherapy be stopped? A pilot study comparing two targets of serum bilirubin concentration.
abstract: OBJECTIVE
  The objective of this study was to compare the outcome of two groups of jaundiced newborns randomized to one of the two targets of total serum bilirubin (TSB) for phototherapy discontinuation.
  
  
  METHODS
  Infants treated with phototherapy were assigned to two groups: in the 'high-threshold' group, phototherapy was interrupted when TSB decreased to >/=1 mg/dL (17 micromol/L) below the limit requiring phototherapy and in the 'low-threshold' group when TSB decreased to >/=3 mg/dL (51 micromol/L) below the same limit.
  
  
  RESULTS
  Fifty-two infants were enrolled, 25 in the high- and 27 in the low-threshold group. Phototherapy duration was significantly shorter in the high- than in the low-threshold group (22.3 +/- 13 vs. 27.6 +/- 12 h, respectively, p = 0.03). Length of hospital stay was 84+/-30 h in the high- and 94 +/- 24 h in the low-threshold group (p = 0.05). Additional phototherapy was required in 20% of the high- versus 18% of the low-threshold group (p = 0.58). In the presence of haemolysis or G6PD deficiency, 28% of the infants required re-phototherapy and 8.3% when such factors were absent (p = 0.06).
  
  
  CONCLUSIONS
  Phototherapy duration may be shortened by using higher TSB limits for interruption. When hyperbilirubinaemia is accompanied by risk factors, the infants should be followed for longer periods, since some of them will need re-phototherapy.
authors.affiliation: Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Mila
authors.initials: M
authors.lastname: Barak
authors.forename: Irit
authors.initials: I
authors.lastname: Berger
authors.forename: Shaul
authors.initials: S
authors.lastname: Dollberg
authors.forename: Francis B
authors.initials: FB
authors.lastname: Mimouni
authors.forename: Dror
authors.initials: D
authors.lastname: Mandel
mesh_terms: D001663:Bilirubin / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007565:Jaundice / Q000628:therapy*; D008297:Male; D010789:Phototherapy / Q000592:standards*; D010865:Pilot Projects
chemical_list: D001663:Bilirubin