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Journal : Paediatrica Indonesiana

Rebound serum bilirubin levels after single vs. double phototherapy Widyastuti, Widyastuti; Supriatmo, Supriatmo; Tjipta, Guslihan Dasa
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (113.766 KB) | DOI: 10.14238/pi54.5.2014.260-5

Abstract

Background Hyperbilirubinemia is the most common clinicalphenomenon found in newborns. Phototherapy is the standardtreatment for lowering bilirubin levels in neonates. Whileintensive (double) phototherapy produces a more rapid declinein serum bilirubin levels than standard (single) phototherapy,greater rebound effects may occur.Objective To assess bilirubin levels in neonates with hyperbilirubinemiawho underwent single or double phototherapy, includingrebound bilirubin levels after phototherapy termination.Methods An open, randomized, controlled trial was con ductedat H. Adam Malik Hospital and Dr. Pirngadi Hospital, Medan,from August 2009 until January 2010. Subjects with indirecthyperbilirubinemia were divided into two groups. One groupreceived single phototherapy (n = 41) and other receiveddouble photo therapy (n = 40) . Measurements of total plasmabilirubin level were conducted at 12 hours and at 24 hoursof phototherapy, as well as at 24 hours after phot otherapytermination. Rebound bilirubin serum level was defined asan increment of about 1 - 2 mg/dL serum bilirubin afterphototherapy discontinuation.Results The decreases in serum bilirubin levels were significantlygreater in the do uble phototherapy group for observationsat 12 h ours , 24 h ours, and 24 hours after phototherapyt ermination (P = 0.0001). At the 24-hour observation afterterminationofphototherapy, only 1 neonate (2.7%) in the singlephototherapy group compared to 4 neonates (10.8%) in thedouble phototherapy group had serum bilirubin level increasesof 1 - 2 mg/dL. Fisher's exact test did not reveal a significantdifference in rebound serum bilirubin occurrence in the twogroups (P = 0.358).Conclusion Double phototherapy shows significantly greaterdecrease in bilirubin level compared to single phototherapywithin a same period of time. Rebound serum bilirubin levels aftersingle and double phototherapy may occur in some patients withhyperbilirubinemia, as bilirubin production continues. However,260 • Paediatr Irulones, Vol. 54, No. 5, September 2014there is no significant difference in rebound effects between singlevs. double phototherapy.
Co-Authors Adang Hardi Gunawan Affandi, Iqbal Arif Afif, Muhammad Nur Afif, Muhammad Nur Agung Cahyono Agung Putra Wijaya, Agung Putra AGUS FRIANTO Agus Sugiarto Agustina, Safitri Andini, Yuri Tri Anwar, Hilwa Aprilia Aprilia, Aprilia Aprilina, Ulfah Ari Subowo Arnelis Djalil Asandimitra, Nadia Asri, Peggy Nurida Bambang Sri Anggoro Bidari, Masgusti Dinda Caswita Caswita Cecep Taufik Rustendi Charyadie, Arlita Gladys Tricia Damaiyanti, Dian Widya Dewi, Brigita Ayu Kirana Dharma Himawan, Muhammad Agung Dian Mulawarmanti, Dian Diba, Shofura Farah Dwi Kurniawati, Dwi Dwi Laila Sulistiowati, Dwi Laila Elin Erlina Sasanti Eni Indriani Eni Kartika, Eni Enny Lestari Eva Meizara Puspita Dewi, Eva Meizara Fantari, Hanifah Rifnola Febby Eka Putri Fitri Rahmawati Fitri, Rizkana Fitriyani ZS, Syawalia Florensia Evindonta Bangun, Florensia Evindonta Fu'aidah, Wisda Isma Gunawan, A. H. Guslihan Dasa Tjipta, Guslihan Dasa Hamzah Afandi Hanafiah A. Haninda Bharata Hasaruddin Hafid, Hasaruddin Husen, Mariyani Indah Damayanti, Indah Iswanti, Nina Iwan Nurwantoro, Iwan Jayadinata, Asep Kurnia Jermsittiparsert, Kittisak Juhamzah, Sulfiani Karim, Nina Karina Katibi, Ahmad Yakub Kesumawati, Amelia Khairi, Husain Komarudin Komarudin Kusuma, Ariya Eka Laksmi A. Lenap, Indria Puspitasari Lucia Maria Santoso, Lucia Maria M Coesamin M. Coesamin Mahfudho, Zahidatun Marlita, Deta Maskuroch Adesty MONIKA TIARAWATI Mora Claramita, Mora Muhammad Yusuf Mulia, Septi Dianna Bunga Mursini, Septian Dwi Mustika, Lia Nanda, Evi Tirto Nasrun Nasrun Ningrum, Nia Widya Ningsih, Santi Mulya Novianti, Elvita Lia Nur?ainingsih, Dyah Nurfadhilah, Nurfadhilah Nurhanurawati Nurhanurawati Nurlaili Nurlaili Nurul Rohmah Nurvita Nurvita Octavia, Nur Pentatito Gunowibowo Pertiwi, Intania Pratiwi, Ganjar Febriyani Pratiwi, Rafi Puji Rahayu Purnama Dewi Putri, Vevia Risa Qorri Ayuni R, Dyah Lestarining Rahmy, Aghnesia Ramadhana Komala, Ramadhana Rani, wayan Widya Regina Lichteria Panjaitan, Regina Lichteria Retna Siwi Padmawati, Retna Siwi Retno Cahyani, Retno ria septiana Ridfah, Ahmad Ridfah, Ahmad Ridfah, Ahmad Rini Asnawati Rini Rita T Marpaung Risdianti, Ernia Riyanto Riyanto Robith Hudaya Rosa, Wanda Restia Rosalia Deviana Cahyaningrum Rusdi Setiono Sab'ati, Mila Sabati, Mila Sangaji, Darma Sapitri, Nonik Mega Saptaswari, Dianty Saputri, Suci Indah Sarlina Sarlina, Sarlina Setiyowati, Yunda Silvana, Silvana Siti Laelatul Chasanah, Siti Laelatul Slamet Suprayogi Soraya, Rahayu Sri Hastuti Noer Sri Hastuti Noer Sri Setiyowati Sri Setyowati Sri Wahyuningsih Sriyono Sriyono Sugandi, Awan Sugeng Sutiarso Sukma, Nova Permata Sukmawati, Fitriani Supriatmo Supriatmo, Supriatmo Syakir Mahid Tina Yunarti Titi Murniati Utami, Fithrina Yudha Utari Rezki Veronika Yulianti Wayan Rumite Wijayanti, Chusna Yessy Artanti Yuliana Yuliana Yulisa Yulisa Yuniarti, Tina Yunilda Yunilda YUSLI MARIADI Zuma Herdiyanti