Контроль проведения фототерапии при неонатальной желтухе: ОРИГИНАЛЬНЫЕ СТАТЬИ

Галина Николаевна  Чумакова; Дмитрий Олегович  Иванов; Елена Венедиктовна  Бем; Софья Тарасовна  Посмашная; Наталья Алексеевна  Кривонос; Светлана Евгеньевна  Павлова; Александра Сергеевна  Панченко; Лариса Арзумановна  Федорова; Дмитрий Валерьевич  Шакалис

doi:10.56871/PED.2025.36.87.003

Control of phototherapy for neonatal jaundice

ORIGINAL STUDIES

Galina N. Chumakova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Dmitry O. Ivanov Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Elena V. Bem Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Sofia T. Posmashnaya Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Natalia A. Krivonos Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Svetlana E. Pavlova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Alexandra S. Panchenko Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Larisa A. Fedorova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Dmitry V. Shakalis Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Keywords:

желтухи новорожденных неонатальная гипербилирубинемия новорожденный доношенный новорожденный фототерапия осложнения фототерапии контроль фототерапии jaundice of newborns neonatal hyperbilirubinemia newborn term newborn phototherapy complications of phototherapy control of phototherapy

Abstract

Background. The main method of neonatal jaundice treatment is phototherapy (PT), which has been successfully used for 65 years. Like any highly effective type of therapy, this treatment method can cause short- and long-term adversere actions in newborns.

Aim of the study: to optimize phototherapy in the conditions of the level 3A perinatal center, to evaluate the clinical and laboratory indications for the appointment of standard (SPT) and intensive phototherapy (IPT), to determine the validity of the duration of PT and the adequacy of monitoring the level of total serum bilirubin (TSB) during and after SPT and IPT.

Materials and methods. 78 infants’ histories who received phototherapy due to the presence of hyperbilirubinemia of various etiologies were retrospectively studied.

Results. In 21.7%, the visualization of jaundice was assessed on the Kramer scale. The level of reticulocytes was determined in 12.7% of cases. Indications for SPT were observed in 52.9%, and for IPT — in 40% of cases. Bilirubin levels were monitored after the start of PT at intervals according to clinical recommendations in 70.6% of cases with SPT and in 50.0% with IPT. PT withdrawal according to indications was carried out in 13% of children with SPT and in 21.4% of newborn sreceiving IPT. Post-PT monitoring was performed in 56.36% of cases according to clinical recommendations.

Conclusions. Indications for PT are not observed both in the appointment of SPT and in IPT. PT control according to clinical recommendations is not carried out in one third of children with SPT and in half of children with IPT. In most cases, the transfer from IPT to SPT and the cancellation of SPT is carried out untimely, which increases the risk of PT complications.

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