PHOTO RX

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The primary objective of this randomized, unmasked, controlled study is to determine whether the incidence of death or neurodevelopmental impairment at 18-22 months among extremely low birth weight (ELBW) infants differs according to whether they were treated with aggressive or conservative phototherapy. Peak serum bilirubin, age at inception of phototherapy, duration of phototherapy, and number of exchange transfusions performed will be compared between the two treatment groups. In addition, adverse outcomes will be compared to various measures of bilirubin exposure such as peak total serum bilirubin, peak indirect serum bilirubin, duration of bilirubin values exceeding a particular level to assess which measure best predicts adverse outcome. Whether the predictors of adverse outcome differ by treatment group will also be investigated. Secondary objectives are to determine whether the use of an aggressive or conservative phototherapy regimen results in differences at 18-22 months in death, cerebral palsy, Bayley II developmental scores, blindness, and deafness. A secondary study addresses if unbound bilirubin is a better predictor of neurodevelopmental outcome than total bilirubin concentration.