PEDIATRICS Vol. 75 No. 2 February 1985, pp. 427-441
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Metabolic Aspects of Phototherapy

Paul Y. K. Wu MD1, Joan E. Hodgman MD1, Barry V. Kirkpatrick MD1, Nathaniel B. White Jr M Phil1, and Dolores A. Bryla MPH1

1 From the Department of Pediatrics, University of Southern California School of Medicine, LAC/USC Medical Center, Los Angeles; Department of Pediatrics, Medical College of Virginia, Virginia Commonwealth University, Richmond, and Biometry Branch, Epidemiology and Biometry Research Program, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

Recent studies have shown that exposure to nonionizing radiant energy may induce physical and metabolic effects in the neonate. The effects include changes in body temperature37,105,108; peripheral blood flow75,105,108; insensible water loss75,76,105; gastrointestinal (GI) tract motility; and nutrient, electrolyte, and water balances.4,76,85,89,106 In an effort to evaluate the influence of intake of fluid and calories on neonatal jaundice and the efficacy of phototherapy, the metabolic data obtained from the National Institute of Child Health and Human Development (NICHD) phototherapy study were analyzed. The results constitute the subject of this report.

MATERIALS AND METHODS

The data were collected from 1,339 infants enrolled in the study from the six participating institutions as described by Bryla.18

Fluid Intake

To determine whether the daily total fluid intake might affect total serum bilirubin levels, the data were analyzed by dividing the control and phototherapy-treated infants in each weight group into four subgroups according to their total daily intake. The subgroups are: A, <60 mL/kg/24 hours; B, 60 to 89 mL/kg/24 hours; C, 90 to 119 mL/kg/24 hours; and D, ge120 mL/kg/24 hours.

The amount of total fluid intake used for characterization of the subgroups was determined initially by plotting all daily total intakes against total serum bilirubin levels for the corresponding day in a scattergram. The trend in clusters observed in the scattergram was then used to designate the amounts in the four subgroups.

Caloric Intake

To determine whether the mean daily total caloric intake might affect total serum bilirubin levels, the data were analyzed by separating the control and phototherapy-treated infants in each birth weight group into three subgroups according to their mean daily total caloric intake during the phototherapy period.




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