Comparison of Phototherapy Using Neolight Skylife Versus Standardized Phototherapy for Hyperbilirubinemia in Newborns

Study Overview
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Brief Summary
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Phototherapy has served as a primary treatment for hyperbilirubinemia in newborn populations. The light emitted through phototherapy interacts with bilirubin at the skin level to transform it into water-soluble products eliminated in urine and stool. Efficacy of phototherapy relies on the irradiance dispensed at the skin level by the treatment and on the surface area of skin exposed. The purpose of this Investigator-initiated, prospective, two-arm, randomized control investigation is to compare the effect of a novel, newly available, FDA cleared, phototherapy device (Neolight Skylife) with the standard phototherapy treatments used in HonorHealth newborn nurseries (Natus-Neo Blue Blanket and GE Bili Soft Blanket) on healthy, newborns ≥ 35 weeks + 0 days Gestational Age (GA) at the time of birth in the treatment of hyperbilirubinemia. We hypothesize that the unconjugated bilirubin level will be comparably reduced across each treatment arm from baseline to 12 and 24 hour intervals.

Detailed Description
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This is an investigator-initiated, prospective, two-arm randomized control investigation to examine the mean values in patients' unconjugated bilirubin level for a new, FDA cleared device (Neolight Skylife) with the standard phototherapy treatment. Patient data on unconjugated bilirubin level, pressure ulcer and body temperature will be evaluated at baseline, 12-hours post-intervention, 24 hours post-intervention and at discharge. Neolight Skylife is a compact device that offers phototherapy to infants across all neonatal beds, supplanting multiple, enclosure specific phototherapy devices. Neolight Skylife weighs less than 10 lbs. and is ergonomically designed for portability that allows for easy carrying of the device between beds. Neolight Skylife offers the choice between treatment intensity levels. Neolight Skylife utilizes blue Light-Emitting Diodes (LEDs) to achieve low irradiance of 30 plus or minus 5 μw/cm²/nm, and high irradiance of 45 plus or minus 10, μw/cm²/nm. Neolight Skylife emits light in a narrow bandwidth between 430-475 nm. This light bandwidth corresponds to the spectral absorption of light by bilirubin, and is thus considered to be the most effective for treatment. Neolight Skylife eliminates the risk of UV exposure typically seen with phototherapy treatment through the use of blue LEDs, as this light source does not emit significant energy in the ultraviolet (UV) spectrum. However, as with all phototherapy treatment, protective eye coverings are used to protect the baby's eyes from excessive light exposure.

Official Title
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Comparison of Phototherapy Using Neolight Skylife Versus Standardized Phototherapy for Hyperbilirubinemia in Newborns

Conditions
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Jaundice, Neonatal, Neonatal Hyperbilirubinemia, Neonatal Disorder

Intervention / Treatment
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* Device: Skylife
* Device: Standard Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Provision of at least one parent/legal guardian's signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Infants born after 35 weeks and 0 days of gestation Infants who developed significant hyperbilirubinemia Infants who developed significant hyperbilirubinemia per BiliToolTM plot requiring phototherapy as determined by the attending neonatologist utilizing the American Academy of Pediatrics' Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation (Bhutani Nomogram) Guidelines for Phototherapy in Hospitalized Infants of 35 or More Weeks Gestation Exclusion Criteria: Participants will be screened on the following exclusion criteria at the time of enrollment: Perinatal asphyxia (Apgar score <4 at 1 minute or <7 at 5 minutes) Respiratory distress Exchange transfusion Major congenital malformations As identified throughout the course of the investigation, additional exclusion criteria include: Direct-reacting component of bilirubin >2 mg/dL Glucose-6-phosphate deficiency ABO incompatibility Evidence of hemolysis Evidence of sepsis Rhesus hemolytic disease Pyruvate kinase deficiency Severe dehydration

Ages Eligible for Study
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Minimum Age: 0 Minutes
Maximum Age: 7 Minutes

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Arm 1<br>Skylife device | Device: Skylife<br>* Newly FDA approved device<br>|
| Active Comparator: Arm 2<br>Standard therapy | Device: Standard Therapy<br>* Both devices are considered standard therapy<br>* Other names: GE Bili Soft Blanket;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in unconjugated bilirubin level from pre-test to post-test | heel stick blood draw for unconjugated bilirubin level | Assessment of the endpoint will occur at baseline, 12 hours following treatment, and 24 hours following initial treatment or prior to discharge. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maintain body temperature between 97.3F and 99.3F | monitor body temperature using a temperature monitoring device | Assessment of the endpoint will occur at baseline, 12 hours following treatment, and 24 hours following initial treatment or prior to discharge. | 
| Absence of skin irritation or ulceration | visual assessment of the skin for changes | Assessment of the endpoint will occur at baseline, 12 hours following treatment, and 24 hours following initial treatment or prior to discharge. |