Effect of white curtain around the phototherapy unit on hyperbilirubinemia in full term neonates

Background and Objective: Hyperbilirubinemia is a disorder, which is manifested by yellow discoloration of tissue and skin of a neonate. Phototherapy is considered as the prime treatment for neonatal jaundice. Phototherapy is used as a treatment modality of neonatal jaundice for more than a century, and it is considered to be easily accessible and causes no harm. Even though conventional phototherapy is used as the method of treatment of hyperbilirubinemia, little is known about the ways to enhance its effect further. If the duration of phototherapy can be reduced by any means this would be very effective not only for the well being of the neonates but also it can reduce the duration of hospital stay, the aim of the study was to assess the effect of white curtain around the phototherapy unit on hyperbilirubinemia in term neonates and to compare with conventional phototherapy units. Methodology: A randomized controlled trial was used. The neonates included were term neonates with hyperbilirubinemia. Conventional phototherapy with curtains (n=47) were compared with those without curtains (n=47). The main outcomes measured were the duration of phototherapy and the rate of decline of serum bilirubin level. The control group was treated by standard phototherapy without cover around the unit and the experimental group received standard phototherapy with white curtain around the phototherapy unit. After enrollment, the total serum bilirubin was measured every 24 hours for 4 days. The cover was made of white cotton cloth which covered three sides of the phototherapy unit and one side was left uncovered for observing the newborn or for performing procedures. The distance between the infant and the phototherapy lamps was approximately 40cm. For all the infants under study, before starting phototherapy serum bilirubin was measured. While under phototherapy, neonates were left uncovered except for eye pads and diapers. Duration of phototherapy was recorded in hours. Results: There was no significant difference in the gestational age, birth weight, postnatal age at time of admission, birth weight and blood group of the mother between the two groups. Total serum bilirubin level in the curtained group declined significantly in 24 hours (p=0.00) and 48 hours (p=0.004). However no reduction in serum bilirubin level was noted after 72 hours (p=0.7) and 96 hours (p=0.8) of phototherapy. The duration of phototherapy was reduced in the experimental group (49.5±18.9) when compared to control group (62.8±17.7) (p=0.0007). Conclusion: White curtain around the phototherapy unit is an effective method in reducing the serum bilirubin level and at the same time it also reduces the duration of phototherapy. This can be used as a cost effect and non invasive method for the treatment of neonates with hyperbilirubinemia. The white curtain when made into practice can serve as a method that will reduce the hospital stay of the neonates thereby reducing the cost of treatment.