Can exchange transfusion be replaced by double-LED phototherapy?
Can exchange transfusion be replaced by double-LED phototherapy?
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DOI：
10.1515/med-2021-0320
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Fujioka K
中科院分区：
文献类型：
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作者：
Abe S;Fujioka K
光疗是新生儿黄疸的常规治疗方法，被广泛认为是一种安全的方法。发光二极管（LED）光疗设备的最新发展使更有效的治疗成为可能。尽管存在各种并发症的风险，但换血（ET）通常适用于难治性重度高胆红素血症的病例。由于光疗的治疗效果与其辐照度相关，因此可以通过执行较高辐照度的光疗来避免ET。最近，我们采用双LED光疗作为ET的桥接治疗来治疗一例重度高胆红素血症。在这种情况下，胆红素水平的持续增加在给药后立即受到抑制，不需要ET。在整个治疗过程中，没有观察到并发症或氧化应激增加。此外，在1年随访时，神经发育适合患者的年龄，未观察到核黄疸的发现，包括物理和磁共振成像发现。我们假设双LED光疗可能是一种很好的治疗策略，可以取代ET治疗严重高胆红素血症的婴儿;然而，在临床适应之前，需要进一步研究安全性问题，包括急性和长期并发症。
Phototherapy is a conventional treatment for neonatal jaundice and widely considered as a safe procedure. Recent developments in light-emitting diode (LED) phototherapy devices have made more effective treatments possible. Exchange transfusion (ET) is typically applied for cases of refractory severe hyperbilirubinemia despite its risk of various complications. Since the therapeutic effect of phototherapy is correlated with its irradiance, ET may be avoided by performing phototherapy with higher irradiation. Recently, we adopted double-LED phototherapy as a bridging treatment to ET to treat a case of severe hyperbilirubinemia. In this case, the continual increase of bilirubin levels was suppressed immediately after its administration, and ET was not required. Throughout the treatment, no complications or increase in oxidative stress was observed. In addition, neurodevelopment was appropriate for the patient’s age at the 1-year follow-up, and no findings of kernicterus, including physical and magnetic resonance imaging findings, were observed. We hypothesized that double-LED phototherapy may be a good treatment strategy to replace ET for infants with severe hyperbilirubinemia; however, further investigations regarding safety issues including acute and long-term complications are needed before clinical adaptation.