Controlled clinical trial of phenobarbital (PB) and light for management of neonatal hyperbilirubinemia in a predominant Negro population

摘要

Low birth weight infants, less than 24 hrs of age, were randomly assigned to receive either oral PB, 5 mg/kg/day for 5 days, blue light (200–300 footcandles) continuously for 4 days, a combination of PB and light, or no treatment. 90% or more of the infants in each group were Negroes. Infants with a positive Coomb's test were excluded.By the 3rd day, infants receiving Pb, light, and PB and light had significantly lower mean bilirubin concentrations than the controls. Those receiving light had the lowest values. Combining PB with light did not have an additive effect. Bilirubin concentrations of 10 mg% or higher were found in 66% of the controls, 26% of the PB group and in none of the other 2 groups. Mild lethargy occurred in 5 infants receiving PB and mild diarrhea occurred in 2 receiving light. The findings indicate that in Negroes continuous phototherapy is more effective than PB in lowering the serum bilirubin concentration. Results are not improved by combined therapy. PB may be useful when phototherapy is not available.