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Intermittent cycled phototherapy may control peak serum bilirubin levels and reduce mortality in extremely low birthweight infants
  1. Darren Cameron1,
  2. Jessica Burgess-Shannon2
  1. 1 General Paediatrics, Royal Hospital for Children, Glasgow, UK
  2. 2 Neonatology, Princess Royal Maternity Hospital, Glasgow, UK
  1. Correspondence to Dr Darren Cameron, General Paediatrics, Royal Hospital for Children, Glasgow, UK; darren.cameron{at}

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Study design

Design: Randomised controlled study.

Allocation: Remote randomisation stratified by centre and risk (high-risk group: birth weight ≤ 750g and ventilated at enrolment; low-risk group: birth weight > 750g or not ventilated).

Setting: 6 neonatal intensive care units in the USA.

Patients: 128 extremely low birthweight (ELBW) infants receiving continuous phototherapy were compared with 128 ELBW infants receiving cycled phototherapy ≥15 min/hour.

Primary outcomes

Mean peak total serum bilirubin (TSB) level and total phototherapy hours through to day 14. Predischarge wave V latency brainstem auditory-evoked responses (BAERs), which have been shown to correlate with bilirubin neurotoxicity.

Secondary outcome

Mortality and other indices of major morbidity including severe intraventricular haemorrhage, bronchopulmonary dysplasia, surgical necrotising enterocolitis, patent ductus arteriosus requiring intervention, severe retinopathy of prematurity and late-onset sepsis.

Main results

Cycled phototherapy reduced phototherapy hours compared with continuous. Mean …

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  • Review of article Arnold C, Tyson JE, Pedroza C, et al. Cycled phototherapy dose-finding study for extremely low-birth-weight infants: A randomized clinical trial. JAMA Paediatrics. 2020 (Epub ahead of print: 27 Apr 2020). doi:10.1001/jamapediatrics.2020.0559.

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  • Contributors The abstract was written by DC. The commentary was written by JB-S. Both authors reviewed the final article.

  • Provenance and peer review Not commissioned; internally peer reviewed.