Phototherapy Using a Light-Emitting Fabric (BUBOLight) Device in the Treatment of Newborn Jaundice: Protocol for an Interventional Feasibility and Safety Study

Fabienne Lecomte, Elise Thecua, Laurine Ziane, Pascal Deleporte, Alain Duhamel, Clémence Vamour, Serge Mordon, Thameur Rakza, Fabienne Lecomte, Elise Thecua, Laurine Ziane, Pascal Deleporte, Alain Duhamel, Clémence Vamour, Serge Mordon, Thameur Rakza

Abstract

Background: Neonatal jaundice is a common condition occurring in 60%-80% of all healthy-term and late-preterm neonates. In the majority of cases, neonatal jaundice resolves spontaneously and causes no harm; however, in some neonates, significant hyperbilirubinemia can develop and lead to kernicterus jaundice, a serious neurological disease. Phototherapy (PT) is the preferred treatment for jaundice; however, to be effective, PT devices need to have a broad light emission surface to generate no or little heat and to provide an optimal wavelength and light intensity (420-490 nm and ≥30 µW/cm²/nm, respectively).

Objective: This study aimed to investigate the feasibility, safety, and level of satisfaction of parents and health care teams with the BUBOlight device, an innovative alternative to conventional hospital PT, in which luminous textiles have been incorporated in a sleeping bag.

Methods: This interventional, exploratory, simple group, nonrandomized, single-center trial will be conducted at Lille Hospital. In total, 10-15 neonates and their parents will be included to obtain evaluable data from 10 parent-neonate pairs. Neonates weighing more than 2500 g at birth and born with ≥37 weeks of amenorrhea that required PT in accordance with the guidelines of the National Institute For Health and Clinical Excellence will receive one 4-hour session of illumination. Total serum bilirubin and transcutaneous bilirubin levels were obtained at the start and 2 hours after the end of PT. Cutaneous and rectal temperatures, heart rate, and oxygen saturation will be measured at the beginning and during PT. The number of subjects is therefore not calculated on the basis of statistical assumptions. We aim to obtain a minimum proportion of 90% (ie, 9 of 10) of the neonates included, who have been able to undergo 4-hour PT without unacceptable and unexpected toxicities. We will calculate the mean, median, quartiles, minimum and maximum values of the quantitative parameters, and the frequency of the qualitative parameters. The rate of patients with no unacceptable and unexpected toxicities (ie, the primary endpoint) will be calculated.

Results: The first patient is expected to be enrolled at the end of 2020, and clinical investigations are intended for up to June 2021. The final results of this study are expected to be available at the end of 2021.

Conclusions: Our findings will provide insights into the safety and feasibility of a new PT device based on light-emitting fabrics for the treatment of newborn jaundice. This new system, if proven effective, will improve the humanization of neonatal care and help avoid mother-child separation.

Trial registration: ClinicalTrials.gov NCT04365998; https://ichgcp.net/clinical-trials-registry/NCT04365998.

International registered report identifier (irrid): PRR1-10.2196/24808.

Keywords: jaundice; light; light emitting fabrics; neonate; newborn jaundice; perinatal; phototherapy.

Conflict of interest statement

Conflicts of Interest: None declared.

©Fabienne Lecomte, Elise Thecua, Laurine Ziane, Pascal Deleporte, Alain Duhamel, Clémence Vamour, Serge Mordon, Thameur Rakza. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 25.05.2021.

Figures

Figure 1
Figure 1
Complete device and light source.
Figure 2
Figure 2
Light-emitting fabrics in the sleeping bag.
Figure 3
Figure 3
Study design and data collection.

References

    1. Chang P, Lin Y, Liu K, Yeh S, Ni Y. Identifying term breast-fed infants at risk of significant hyperbilirubinemia. Pediatr Res. 2013 Oct;74(4):408–412. doi: 10.1038/pr.2013.120.
    1. Moncrieff G. Bilirubin in the newborn: Physiology and pathophysiology. Br J Midwifery. 2018 Jun 02;26(6):362–370. doi: 10.12968/bjom.2018.26.6.362. doi: 10.12968/bjom.2018.26.6.362.
    1. Bhutani VK, Wong RJ. Bilirubin neurotoxicity in preterm infants: risk and prevention. J Clin Neonatol. 2013 Apr;2(2):61–69. doi: 10.4103/2249-4847.116402.
    1. Porter ML, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002 Feb 15;65(4):599–606.
    1. Barrington KJ, Sankaran K, Société canadienne de pédiatrie. Comité d’étude du foetus et du nouveau-né Lignes directrices pour la détection, la prise en charge et la prévention de l’hyperbilirubinémie chez les nouveau-nés à terme et peu prématurés (35 semaines d’âge gestationnel ou plus) Paediatr Child Health. 2007;12(suppl_B):13B–24B. doi: 10.1093/pch/12.suppl_B.13B.
    1. McEwen M, Reynolds K. Noninvasive detection of bilirubin using pulsatile absorption. Australas Phys Eng Sci Med. 2006 Mar;29(1):78–83.
    1. Vandborg PK, Hansen BM, Greisen G, Ebbesen F. Dose-response relationship of phototherapy for hyperbilirubinemia. Pediatrics. 2012 Aug;130(2):e352–e357. doi: 10.1542/peds.2011-3235.
    1. Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med. 2008 Feb 28;358(9):920–928. doi: 10.1056/NEJMct0708376.
    1. Houlier M, Dusser P, Keslick A, Le Gouëz M, Marsaud C, Labrune P. Diagnostic et prise en charge de l’ictère à bilirubine libre. Médecine et Enfance. 2013;33(6):192–198.
    1. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297–316. doi: 10.1542/peds.114.1.297.
    1. Cortey A, Renesme L, Raignoux J, Bedu A, Casper C, Tourneux P, Truffert P. [Management of jaundice in the newborn≥35 GW: From screening to follow-up after discharge. Guidelines for clinical practice] Arch Pediatr. 2017 Feb;24(2):192–203. doi: 10.1016/j.arcped.2016.11.011.
    1. Bhutani VK, Committee on FetusNewborn. American Academy of Pediatrics Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2011 Oct;128(4):e1046–52. doi: 10.1542/peds.2011-1494.
    1. Neonatal jaundice. National Collaborating Centre for Women’s and Children’s Health. 2010. May, [2021-04-28]. .
    1. Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet. 1977 Feb 26;1(8009):466–9. doi: 10.1016/s0140-6736(77)91953-5.

Source: PubMed

3
Subskrybuj