Journal of the Korean Pediatric Society 1997;40(7):931-938.
Published online July 15, 1997.
Oral Agar and Conventional Phototherapy Combination in the Treament of Neonatal Hyperbilirubinemia
Seong Wha Kim, Ji Hyang Doh, Jin Woo Choi, Min Hyang Kim, Ji Won Lee, Sung Taek Kim
Department of Pediatrics, Dong-Eui Medical Center, Pusan, Korea
신생아 황달의 치료에서 경구 Agar 투여와 고식적 광선치료 병합요법의 효과
김성화, 도지향, 최진우, 김민향, 이지원, 김성택
동의의료원 소아과
Abstract
Purpose
: Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we have read Caglayan' s 'Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia'. The result was very hopeful and attractive enough, and which gave us a motivation to study if it was really of value.
Methods
: From May 1995 to April 1996, a total 50 term neonates admitted in nursery of Dong-Eui Medical Center with the capillary serum bilirubin levels greater than 10mg/ dl were enrolled in the study. Those with pathologic causes and breast fed infants were all excluded. The neonates were randomly devided into two groups; 25 of conventional phototherapy alone(P group) and 25 of oral agar plus conventional phototherapy combination(A+P group). The study was terminated when the capillary serum bilirubins were decreased to 8mg/dl. Pastagar B(Pasteur Institute 64946) 500mg in 10ml distilled water were fed four times a day using 10ml syringes prior to bottle feeding. Capillary serum bilirubin levels were measured daily at 10:00 a.m. with heel pad samples. Daily stool frequency and adverse effects of treatment were observed closely.
Results
: 1) The decrement of the serum bilirubin levels at first 24 hours of therapy was significantly different between P and A+P groups showing as 1.7±1.2 and 2.4±1.0mg/dl respectively(p< 0.05). 2) Mean time for bilirubin to decrease to 8mg/dl was shorter in A+P group than in P group showing as 45.7±20.8 and 57.5±32.3 hours each other, but those differences were statistically insignificant(p> 0.05). 3) No adverse effects such as rashes or abdominal pains were observed during treatment. Differences of mean stool frequency were significant between P and A+P groups showing as 3.7±1.2 and 4.7±2.0 times per day respectively(p< 0.05).
Conclusion
: The agar plus conventional phototherapy combination was superior to conventional phototherapy alone at first 24 hours of therapy in neonatal hyperbilirubinemia, but further more careful researches would be necessary for using it routinely in the treatment of neonatal hyperbilirubinemia in future.
Key Words: Oral Agar, Phototherapy, Neonatal Hyperbilirubinemia


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