Ghost Haemoglobin Affecting the Efficacy of Phototherapy

Introduction: Phototherapy is the treatment of choice for neonatal hyperbilirubinemia. It converts the unconjugated bilirubin from polar and neurotoxic Z-Z-bilirubin to the more polar photobilirubin. It has been hypothesized that high level of hemoglobin or hematocrit interferes in the effectiveness of phototherapy. The objective of the current study is to find out the association of hemoglobin/hematocrit to change in total serum bilirubin concentration during phototherapy. Methods: A prospective cohort study was conducted on 296 neonates with uncomplicated hyperbilirubinemia. Before initiating the phototherapy, hemoglobin, hematocrit and total serum bilirubin levels were measured. After treating the neonates with phototherapy using LED-light for 24 hours, the total serum bilirubin level was measured again. The data were analyzed by using SPSS version-20. Results: The majority of study participants were male (60.8%), with mean postnatal age of 4.66 ± 1.65, having mean birth weight of 2.41 ± 0.41. Considering Pearson correlation, the hemoglobin had a significant inverse association with ΔTsB0-24 while birth weight and postnatal age also had inverse association but p-values were non-significant, while TsB0 had presented a very weak but significant positive association. The results might be evident of the fact that increase in hemoglobin concentration results in minimal change in total serum bilirubin concentration during phototherapy. Conclusion: Current study found a significant effect of hemoglobin on efficacy of phototherapy, as the change in total serum bilirubin concentration is inversely correlated with the level of hemoglobin. This is important for the physician in treating neonates with hyperbilirubinemia by using phototherapy.