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Войти в исследования Pediatrics international : official journal of the Japan Pediatric Society · 2025
Revised treatment criteria for safe reduction of phototherapy for hyperbilirubinemia.
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Matsui Sachiko, Iwatani Sota, Nakamura Hajime, Yoshimoto Seiji
Аннотация
BACKGROUND: To evaluate the usefulness of the revised Kobe University treatment criteria for preterm hyperbilirubinemia proposed by Morioka in 2017 (2017 revised Kobe University treatment criteria), we conducted a preliminary assessment by comparing the treatment approaches and peak bilirubin levels in preterm infants before and after the adoption of the revised criteria.
METHODS: This single-center retrospective cohort study enrolled patients with a gestational age <32 weeks who were delivered at our institution during two periods: 2014-2015 (Original Group), during which treatment was based on the 1992 Kobe University treatment criteria; and 2017-2018 (Revised Group), during which the 2017 revised Kobe University treatment criteria were followed. We examined the frequency and duration of phototherapy, frequency of exchange transfusion (ET), and the peak levels of total bilirubin and unbound bilirubin (UB) in both groups.
RESULTS: After excluding cases of death before discharge, transfer to other hospitals, and congenital disorders, 128 and 78 patients were assigned to the Original and Revised Groups, respectively. Regardless of the postnatal period, the duration of phototherapy was significantly shorter in the Revised Group (3 [0-21] days) than in the Original Group (8 [0-36] days). The frequency of ET was similar between the two groups. There were no differences in the percentages of patients who showed peak UB levels exceeding 0.8 or 1.0 μg/dL at any postnatal week between the two groups.
CONCLUSIONS: Our preliminary study suggests that the 2017 revised Kobe University treatment criteria safely reduce the duration of phototherapy in preterm infants.
METHODS: This single-center retrospective cohort study enrolled patients with a gestational age <32 weeks who were delivered at our institution during two periods: 2014-2015 (Original Group), during which treatment was based on the 1992 Kobe University treatment criteria; and 2017-2018 (Revised Group), during which the 2017 revised Kobe University treatment criteria were followed. We examined the frequency and duration of phototherapy, frequency of exchange transfusion (ET), and the peak levels of total bilirubin and unbound bilirubin (UB) in both groups.
RESULTS: After excluding cases of death before discharge, transfer to other hospitals, and congenital disorders, 128 and 78 patients were assigned to the Original and Revised Groups, respectively. Regardless of the postnatal period, the duration of phototherapy was significantly shorter in the Revised Group (3 [0-21] days) than in the Original Group (8 [0-36] days). The frequency of ET was similar between the two groups. There were no differences in the percentages of patients who showed peak UB levels exceeding 0.8 or 1.0 μg/dL at any postnatal week between the two groups.
CONCLUSIONS: Our preliminary study suggests that the 2017 revised Kobe University treatment criteria safely reduce the duration of phototherapy in preterm infants.