Severe neonatal jaundice is a common problem, carrying a risk of neurologic toxicity. Phototherapy has become the standard treatment for jaundiced infants, eliminating the need for exchange transfusion and the risk of neurotoxicity. We hypothesized that treatment with multi-directional phototherapy would be more rapid than with single-direction, high-intensity treatment from below (unidirectional) in the home setting. We performed a prospective, randomized, pilot trial comparing high-intensity multi-directional phototherapy to high-intensity unidirectional treatment in the home setting. Treatment time was determined from device timers. Serum bilirubin levels were obtained daily and as ordered by the pediatrician, serving as a basis for estimating the bilirubin reduction rates. Eight infants were treated with multi-directional phototherapy; nine were treated with unidirectional phototherapy. Multi-directional treatment was more rapid with treatment time of 15.1 ± 6.4 h vs. 25.1 ± 11.8 h; p = 0.05. The estimated rate of bilirubin reduction was more rapid with multi-directional phototherapy 0.40 ± 0.21 vs. 0.14 ± 0.10 mg/dL/h; p < 0.02.Conclusion: Multi-directional phototherapy was more rapid than treatment with unidirectional phototherapy in the home setting.Trial registration: ISRCTN88608924 29 January 2026, retrospectively registered.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> What is Known: •Home phototherapy for hyperbilirubinemia is safe and effective. •Treatment times with fiberoptic and wearable devices in the home setting can be lengthy and complicated by overheating and readmission. </entry> </row> <row> <entry align="left" colname="c1"> What is New: •Home phototherapy with multidirectional illumination is more effective than unidirectional undersurface phototherapy. •Multidirectional home phototherapy can lower bilirubin levels at a rate comparable to hospital devices. </entry> </row> </tbody> </tgroup> </Table>

Multi-directional phototherapy vs. unidirectional phototherapy from below for severe neonatal jaundice: a randomized pilot trial in home phototherapy

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发表日期：

2026年4月14日

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Susanna Magee,
Mary Roberts,
Gary E. Gilbert

摘要

Severe neonatal jaundice is a common problem, carrying a risk of neurologic toxicity. Phototherapy has become the standard treatment for jaundiced infants, eliminating the need for exchange transfusion and the risk of neurotoxicity. We hypothesized that treatment with multi-directional phototherapy would be more rapid than with single-direction, high-intensity treatment from below (unidirectional) in the home setting. We performed a prospective, randomized, pilot trial comparing high-intensity multi-directional phototherapy to high-intensity unidirectional treatment in the home setting. Treatment time was determined from device timers. Serum bilirubin levels were obtained daily and as ordered by the pediatrician, serving as a basis for estimating the bilirubin reduction rates. Eight infants were treated with multi-directional phototherapy; nine were treated with unidirectional phototherapy. Multi-directional treatment was more rapid with treatment time of 15.1 ± 6.4 h vs. 25.1 ± 11.8 h; p = 0.05. The estimated rate of bilirubin reduction was more rapid with multi-directional phototherapy 0.40 ± 0.21 vs. 0.14 ± 0.10 mg/dL/h; p < 0.02.

Conclusion: Multi-directional phototherapy was more rapid than treatment with unidirectional phototherapy in the home setting.

Trial registration: ISRCTN88608924 29 January 2026, retrospectively registered.

What is Known:

•Home phototherapy for hyperbilirubinemia is safe and effective.

•Treatment times with fiberoptic and wearable devices in the home setting can be lengthy and complicated by overheating and readmission.

What is New:

•Home phototherapy with multidirectional illumination is more effective than unidirectional undersurface phototherapy.

•Multidirectional home phototherapy can lower bilirubin levels at a rate comparable to hospital devices.