Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study

Abstract

Background: To evaluate the outcomes of jaundiced neonates using 2 different total serum bilirubin (TSB) thresholds for discontinuing phototherapy. Purpose: The study aims to evaluate the outcomes of jaundiced neonates by comparing 2 different TSB thresholds for discontinuing phototherapy. Methods: All consecutive jaundiced neonates in a tertiary care hospital with a gestational age of ≥35 weeks and ≥3 days postnatal age were randomly assigned to 2 groups. Results: Eighty neonates were included. The mean±standard deviation TSB at the time of phototherapy discontinuation was 13.1±2.2 mg/dL in the recommended threshold group and 10.5±2.5 mg/dL in the low threshold group. After discontinuing phototherapy, 17 infants in the recommended threshold group and 21 in the low threshold group experienced an increased TSB, with 3 and 9 crossing the treatment threshold, respectively. Following the National Institute for Health and Clinical Excellence (NICE) guidelines, there was a 14.3% increase in the reinstitution of treatment, averaging 28.11 hours with no reported adverse outcomes. Conclusion: Discontinuation of phototherapy in neonates led to increased TSB levels, with a reinstitution rate of 14.3%. While adherence to the NICE guidelines is important, careful posttreatment monitoring is essential. Incorporating the 2022 American Academy of Pediatrics guidelines into future research could provide a more comprehensive understanding of safe practices in this area.