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Efficacy of phototherapy devices and outcomes among extremely low birth weight infants: multi-center observational study

Journal of Perinatology volume 33, pages 126–133 (2013)Cite this article

Subjects

Abstract

Objective:

Evaluate the efficacy of phototherapy (PT) devices and the outcomes of extremely premature infants treated with those devices.

Study Design:

This substudy of the National Institute of Child Health and Human Development Neonatal Research Network PT trial included 1404 infants treated with a single type of PT device during the first 24±12 h of treatment. The absolute (primary outcome) and relative decrease in total serum bilirubin (TSB) and other measures were evaluated. For infants treated with one PT type during the 2-week intervention period (n=1223), adjusted outcomes at discharge and 18 to 22 months corrected age were determined.

Result:

In the first 24 h, the adjusted absolute (mean (±s.d.)) and relative (%) decrease in TSB (mg dl−1) were: light-emitting diodes (LEDs) −2.2 (±3), −22%; Spotlights −1.7 (±2), −19%; Banks −1.3 (±3), −8%; Blankets −0.8 (±3), −1%; (P<0.0002). Some findings at 18 to 22 months differed between groups.

Conclusion:

LEDs achieved the greatest initial absolute reduction in TSB but were similar to Spots in the other performance measures. Long-term effects of PT devices in extremely premature infants deserve rigorous evaluation.

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Acknowledgements

This work was supported by grants from the National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which provided oversight for study conduct.

Author information

Authors and Affiliations

  1. Department of Neonatology, Trinity Mother Frances Health System, Tyler, TX, USA

    B H Morris

  2. Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA

    J E Tyson & G E McDavid

  3. Stanford University School of Medicine, Palo Alto, CA, USA

    D K Stevenson & K P Van Meurs

  4. Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA

    W Oh & B R Vohr

  5. University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    D L Phelps

  6. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    T M O'Shea

  7. Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA

    C Grisby

  8. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA

    Q Yao, S Kandefer & D Wallace

  9. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    R D Higgins

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  1. B H Morris
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  2. J E Tyson
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  9. B R Vohr
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  10. C Grisby
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Corresponding author

Correspondence to B H Morris.

Ethics declarations

Competing interests

Natus Medical loaned light-emitting diode phototherapy lights to each center. These lights were used at the discretion of the attending neonatologist in treating infants in either treatment group. The lights were returned to Natus Medical or purchased at a prorated price after the study. Natus Medical has no role in the study design, data collection, data analysis or manuscript preparation or revision.

Appendix

Appendix

Acknowledgements

The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network's (NRN's) Phototherapy Trial (2002 to 2005).

Data collected at participating sites of the NICHD NRN were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, Dr Abhik Das (DCC Principal Investigator), Dr Qing Yao, Dr Dennis Wallace and Ms Sarah Kandefer (DCC Statisticians) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. The following investigators, in addition to those listed as authors, participated in this study:

NRN Steering Committee Chairs—Alan Jobe, MD PhD, University of Cincinnati (2001 to 2006); Michael S Caplan, MD, University of Chicago, Pritzker School of Medicine (2006 to present).

Alpert Medical School of Brown University and Women and Infants Hospital of Rhode Island (U10 HD27904)—Abbot R Laptook, MD; Angelita Hensman, BSN RNC; Lucy Noel RN.

Case Western Reserve University Rainbow Babies and Children's Hospital (U10 HD21364, M01 RR80)—Avroy A Fanaroff, MD; Michele C Walsh, MD MS; Deanne Wilson-Costello, MD; Nancy S Newman, RN; Bonnie S Siner, RN.

Cincinnati Children's Hospital Medical Center, University Hospital and Good Samaritan Hospital (U10 HD27853, M01 RR8084)—Edward F Donovan, MD; Kurt Schibler, MD; Jean Steichen, MD; Barb Alexander, RN; Cathy Grisby, BSN CCRC; Marcia Mersmann, RN; Holly Mincey, RN; Jody Shively, RN; Teresa Gratton, PA.

Duke University School of Medicine University Hospital, Alamance Regional Medical Center and Durham Regional Hospital (U10 HD40492, M01 RR30)—Ronald N Goldberg, MD; C Michael Cotten, MD MHS; Ricki F Goldstein, MD; Kathy J Auten, MSHS; Melody B Lohmeyer, RN MSN.

Emory University Children's Healthcare of Atlanta, Grady Memorial Hospital and Emory University Hospital Midtown (U10 HD27851, M01 RR39)—Barbara J Stoll, MD; Ira Adams-Chapman, MD; Ellen C Hale, RN BS CCRC.

Eunice Kennedy Shriver National Institute of Child Health and Human Development—Linda L Wright, MD; Elizabeth M McClure, MEd.

Indiana University Indiana University Hospital, Methodist Hospital, Riley Hospital for Children and Wishard Health Services (U10 HD27856, M01 RR750)—Brenda B Poindexter, MD MS; James A Lemons, MD; Anna M Dusick, MD; Diana D Appel, RN BSN; Dianne E Herron, RN; Lucy C Miller, RN BSN CCRC; Leslie Dawn Richard, BSN CCRC.

RTI International (U10 HD36790)—W Kenneth Poole, PhD; Betty Hastings; Elizabeth N McClure, MEd; Jamie E Newman, PhD MPH; Rebecca L Perritt, MS; Carolyn M Petrie Huitema, MS; Kristin M Zaterka-Baxter, RN BSN.

Stanford University Lucile Packard Children's Hospital (U10 HD27880, M01 RR70)—Susan R Hintz, MD MS; M Bethany Ball, BS CCRC.

University of Alabama at Birmingham Health System and Children's Hospital of Alabama (U10 HD34216, M01 RR32)—Waldemar A Carlo, MD; Namasivayam Ambalavanan, MD; Myriam Peralta-Carcelen, MD MPH; Monica V Collins, RN BSN MaEd; Shirley S Cosby, RN BSN; Vivien A Phillips, RN BSN.

University of California—San Diego Medical Center and Sharp Mary Birch Hospital for Women (U10 HD40461)—Neil N Finer, MD; Yvonne E Vaucher, MD MPH; Maynard R Rasmussen MD; David Kaegi, MD; Kathy Arnell, RNC; Clarence Demetrio, RN; Martha G Fuller, RN MSN; Chris Henderson, RCP CRTT; Wade Rich, BSHS RRT.

University of Miami Holtz Children's Hospital (U10 HD21397, M01 RR16587)—Charles R Bauer, MD; Shahnaz Duara, MD; Silvia Hiriart-Fajardo, MD; Ruth Everett-Thomas, RN BSN; Amy Mur Worth, RN MS; Silvia Frade Eguaras, MS.

University of Rochester Medical Center Golisano Children's Hospital (U10 HD40521, M01 RR44)—Ronnie Guillet, MD PhD; Gary J Myers, MD; Linda J Reubens, RN CCRC; Diane Hust, MS RN CS; Rosemary L Jensen; Erica Burnell, RN.

University of Texas Southwestern Medical Center at Dallas Parkland Health and Hospital System and Children's Medical Center Dallas (U10 HD40689, M01 RR633)—Walid A Salhab, MD; Pablo J Sanchez, MD; Charles R Rosenfeld, MD; Roy J Heyne, MD; Jackie Hickman, RN; Gay Hensley, RN; Nancy A Miller, RN; Janet Morgan, RN.

University of Texas Health Science Center at Houston Medical School, Children's Memorial Hermann Hospital and Lyndon Baines Johnson General Hospital/Harris County Hospital District.

(U10 HD21373, KL2 RR24149, UL1 RR24148)—Kathleen Kennedy, MD MPH; Pamela J Bradt, MD MPH; Patricia W Evans, MD; Laura L Whiteley, MD; Esther G Akpa, RN BSN; Patty A Cluff, RN; Anna E Lis, RN BSN; Claudia I Franco, RNC MSN; Maegan Currence, RN; Nora I. Alaniz, BS; Patti L Pierce Tate, RCP; Sharon L Wright, MT(ASCP).

Wake Forest University Baptist Medical Center, Brenner Children's Hospital, and Forsyth Medical Center (U10 HD40498, M01 RR7122)—Lisa K Washburn, MD; Nancy J Peters, RN CCRP; Barbara G Jackson, RN BSN.

Wayne State University Hutzel Women's Hospital and Children's Hospital of Michigan (U10 HD21385)—Seetha Shankaran, MD; Yvette Johnson, MD; Athina Pappas, MD; Rebecca Bara, RN BSN; Geraldine Muran, RN BSN; Deborah Kennedy, RN BSN.

Yale University Yale-New Haven Children's Hospital (U10 HD27871, M01 RR6022)—Richard A. Ehrenkranz, MD; Patricia Gettner, RN; Harris C Jacobs, MD; Christine Butler, MD; Patricia Cervone, RN; Monica Konstantino, RN BSN; Elaine Romano, MSN.

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Morris, B., Tyson, J., Stevenson, D. et al. Efficacy of phototherapy devices and outcomes among extremely low birth weight infants: multi-center observational study. J Perinatol 33, 126–133 (2013). https://doi.org/10.1038/jp.2012.39

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