Abstract
This review was conducted to evaluate the efficacy of light-emitting diode (LED) phototherapy
as compared with the conventional phototherapy in neonates with unconjugated hyperbilirubinemia
and their adverse effects. We searched the following databases right from their inception
till April, 2021: MEDLINE, EMBASE, Cochrane Library, and LILACS. Randomized clinical
trials (RCTs) comparing the LED phototherapy with other light sources, which enrolled
newborns (term and preterm) with unconjugated hyperbilirubinemia were included. We
included 21 articles in this review. The treatment with the LED light therapy had
a lower failure rate as compared with the non-LED one (RR = 0.60, 95% CI: 0.39–0.94).
The mean duration of phototherapy was significantly shorter in the group with the
LED light source as compared with the one with the non-LED light source (mean difference
[hours]: −8.07, 95% CI: −8.45 to −7.68), regardless of the type of non-LED units.
However, the rate of bilirubin showed a comparable decline (mean difference [mg/dL/h]:
0.01, 95% CI: −0.00, 0.03) in both the light sources, irrespective of irradiance or
distance. No studies reported primary outcomes related to the neurotoxicity effects
of hyperbilirubinemia in neonates. The LED light devices caused a significantly higher
risk of hypothermia. Neonates were at a lower risk of developing hyperthermia and
skin rash with the LED light therapy. Our findings provide support for the use of
LED light source phototherapy due to its better clinical efficacy, which is evidenced
by its shorter duration and lower rate of treatment failure, as compared with the
non-LED light sources.
Key Points
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The efficacy of phototherapy is dependent on specific characteristics of light sources
of phototherapy devices.
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LED phototherapy demonstrated better efficacy with shorter duration and lower rate
of treatment failure.
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Adverse effects of phototherapy devices such as hypothermia, hyperthermia, and skin
rash should be monitored.
Keywords
phototherapy - hyperbilirubinemia - light-emitting diode - halogen spotlights - compact
fluorescent tube - neonate
