Multi-directional home phototherapy reduced treatment time and increased bilirubin reduction rates compared to unidirectional devices in severe neonatal jaundice.
Photo by lian xiao / Unsplash
Key Takeaway
Note that multi-directional home phototherapy reduced treatment time and increased bilirubin reduction rates compared to unidirectional devices in this pilot trial.
This randomized pilot trial investigated the efficacy of multi-directional phototherapy compared to unidirectional phototherapy from below in a population of 17 infants with severe neonatal jaundice or hyperbilirubinemia. The study was conducted in a home setting, though the specific publication type and phase were not reported.
Regarding primary outcomes, treatment time was significantly shorter with multi-directional phototherapy (15.1 ± 6.4 hours) compared to the unidirectional comparator (25.1 ± 11.8 hours), with a p-value of 0.05. Secondary outcomes showed a more rapid estimated rate of bilirubin reduction for the multi-directional device (0.40 ± 0.21 mg/dL/h) versus the comparator (0.14 ± 0.10 mg/dL/h), with a p-value less than 0.02.
Safety and tolerability data were not reported in this trial, and no adverse events, discontinuations, or serious adverse events were documented. The study authors note that the multi-directional home phototherapy can lower bilirubin levels at a rate comparable to hospital devices.
Key limitations include the small sample size of 17 participants and the classification of the study as a pilot trial. Funding sources and potential conflicts of interest were not reported. While the practice relevance suggests multidirectional home phototherapy is more effective, the evidence remains preliminary due to the pilot design and lack of reported safety data.
View Original Abstract ↓
UNLABELLED: Severe neonatal jaundice is a common problem, carrying a risk of neurologic toxicity. Phototherapy has become the standard treatment for jaundiced infants, eliminating the need for exchange transfusion and the risk of neurotoxicity. We hypothesized that treatment with multi-directional phototherapy would be more rapid than with single-direction, high-intensity treatment from below (unidirectional) in the home setting. We performed a prospective, randomized, pilot trial comparing high-intensity multi-directional phototherapy to high-intensity unidirectional treatment in the home setting. Treatment time was determined from device timers. Serum bilirubin levels were obtained daily and as ordered by the pediatrician, serving as a basis for estimating the bilirubin reduction rates. Eight infants were treated with multi-directional phototherapy; nine were treated with unidirectional phototherapy. Multi-directional treatment was more rapid with treatment time of 15.1 ± 6.4 h vs. 25.1 ± 11.8 h; p = 0.05. The estimated rate of bilirubin reduction was more rapid with multi-directional phototherapy 0.40 ± 0.21 vs. 0.14 ± 0.10 mg/dL/h; p < 0.02.
CONCLUSION: Multi-directional phototherapy was more rapid than treatment with unidirectional phototherapy in the home setting.
TRIAL REGISTRATION: ISRCTN88608924 29 January 2026, retrospectively registered.
WHAT IS KNOWN: •Home phototherapy for hyperbilirubinemia is safe and effective. •Treatment times with fiberoptic and wearable devices in the home setting can be lengthy and complicated by overheating and readmission.
WHAT IS NEW: •Home phototherapy with multidirectional illumination is more effective than unidirectional undersurface phototherapy. •Multidirectional home phototherapy can lower bilirubin levels at a rate comparable to hospital devices.
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