Home Phototherapy for Neonatal Jaundice

Home phototherapy is a recommended option for treating neonatal jaundice in healthy full-term infants. It allows for treatment at home instead of the hospital, which can be more convenient for families.

Measuring Bilirubin Levels

To ensure the treatment is effective, bilirubin levels need to be monitored. A device that measures bilirubin through the skin (transcutaneous bilirubin or TcB) can be used at home. This study looked at how accurate these measurements are compared to traditional blood tests (total serum bilirubin or TSB) before, during, and after treatment.

Study Overview

The study involved 141 infants and collected 856 pairs of bilirubin measurements. The results showed that TcB measurements often underestimated the bilirubin levels found through blood tests:

Before treatment, TcB was lower than TSB by an average of 75 μmol/L on the chest and 135 μmol/L on the lower back.
During treatment, the difference was 105 μmol/L for the hospital group and 50 μmol/L for the home group on the chest.
After treatment, the measurements were closer, with a difference of 29 μmol/L on the chest and 87 μmol/L on the lower back.

Conclusions

The findings suggest that while TcB measurements can be used, they should not replace blood tests for monitoring bilirubin levels in infants undergoing home phototherapy.

Opportunities for Clinics

Based on the trial data, clinics can:

Define clear goals for monitoring bilirubin levels in infants.
Select appropriate tools and technologies for measuring bilirubin.
Implement a step-by-step approach, starting with pilot projects to track outcomes and improve patient care.