Efficacy of different phototherapy regimens in the treatment of neonatal jaundice

Abstract

Neonatal jaundice is a prevalent condition in newborns, caused by the accumulation of bilirubin in the blood. Phototherapy is the standard treatment, transforming bilirubin into water-soluble forms to facilitate its excretion. This review compared the effectiveness of different phototherapy regimens: conventional blue light, broad-spectrum, intensive, and LED. The methodology included an integrative literature review, with the selection of 14 studies published between 2019 and 2024, following specific inclusion and exclusion criteria. The bibliographic search was conducted in databases such as PubMed and SciELO, using the PRISMA flowchart to ensure the transparency and reproducibility of the research. The results indicated that conventional blue light phototherapy is effective for mild to moderate cases of jaundice, while intensive phototherapy was shown to be superior for severe cases, particularly in premature neonates, with more rapid reduction of bilirubin levels. LED phototherapy has demonstrated comparable efficacy to intensive phototherapy, with additional benefits such as lower heat production and greater energy efficiency. However, there are debates about its effectiveness in neonates with special conditions, such as extreme prematurity or metabolic disorders. The choice of phototherapy regimen should be individualized, considering the severity of jaundice, gestational age, birth weight, and comorbidities, to optimize clinical outcomes and minimize risks. It is concluded that a personalized approach is essential for the effective management of neonatal jaundice. Adopting evidence-based protocols can improve health outcomes and reduce long-term complications. It is recommended that phototherapy be applied appropriately to each case, according to the clinical characteristics of the newborn and the available resources, in order to maximize the efficacy and safety of the treatment.