Asian Journal of Clinical Pediatrics and Neonatology Original Article Comparison of Gallium nitride derived light-emitting diodes (LED) and compact fluorescent lamp (CFL) phototherapy units in management of neonatal hyperbilirubinemia at tertiary neonatal centre Surendra Kumar Meena 1 , Kailash Kumar Meena 2 , Mamta Meena 3 , Chetan Meena 3 , Mamta Meena 4 1 Senior resident, 2 Professor, 3 Junior resident, Department of pediatrics, 4 Senior resident, Department of obstetrics and gynaecology, SMS medical college and hospital, Jaipur. Abstract Background: Light emitting diode (LED) devices have been shown to be as effective as any other phototherapy device by in vitro and few in vivo studies, but the clinical data comparing LEDs with compact fluorescent lamp (CFL) phototherapy units are limited. Objectives: To compare the effectiveness of Gallium nitride derived LED versus CFL phototherapy units. Methods: Hemodynamically stable neonates of >34 weeks of gestation age, suffering from neonatal hyperbilirubinemia and requiring phototherapy were included in the study. Rh and ABO incompatible babies were also included. Jaundiced newborn who were requiring or already received exchange transfusion, sick newborns (e.g. birth asphyxia, acidosis, hypoglycaemia, respiratory distress, septicaemia etc.), newborns with conjugated hyperbilirubinemia and babies who developed any significant complication during the course of phototherapy were excluded. Results: The mean baseline photo irradiation in CFL group was 40.63±8.03 μW/cm2/nm, compared to 48.91±9.24 μW/cm2/nm in LED group (p value - 0.0006) and mean fall rate of serum bilirubin was significantly more in LED group (0.18±0.059 mg/dl/hr) as compared to CFL group (0.16±0.050 mg/dl/hr) (p value - 0.022), and mean duration of phototherapy in CFL group was 38.35±14.96 hours compared to 33.83±12.82 hours in LED group (p value - 0.02). Conclusion: Results of our study shows that LED phototherapy unit is better than CFL phototherapy unit for management of neonatal jaundice in terms of rate of fall of serum bilirubin, shorter duration of phototherapy and power saving device with minimal adverse effects. Key words: Gallium nitride derived light-emitting diodes (LED) phototherapy, Compact fluorescent lamp (CFL) phototherapy, Neonatal Hyperbilirubinemia, Exchange transfusion. INTRODUCTION Pathological or uncontrolled physiological neonatal jaundice can result in varying degree of neurological deficit or even death in extreme cases. [1] Therefore, to prevent the long term crippling devastating encephalopathy and death, it needs extra caution, vigilance and early intervention. Various modalities have been developed for the management of neonatal hyperbilirubinemia including phototherapy, exchange transfusion and drug therapy. [2] Phototherapy is relatively safe, non-invasive, and preferred modality for the management of neonatal jaundice with minimal side effects. Various types of phototherapy devices were evolved over the period of time, and efficacy of these depends on the spectrum of light emitted, spectral irradiance, the surface area exposed, and distance from light and initial serum bilirubin level. [2] Recently, the blue Gallium nitride derived light-emitting diodes (LEDs) have been utilized as light source in phototherapy units which emit a high intensity narrow band of blue light overlapping the peak spectrum of bilirubin breakdown. LEDs have several advantages which conventional devices are lacking such as light weight, compact size, high energy efficiency, low voltage battery and extreme long life (20,000 hours). [3,4] These unique characteristics of LEDs make them an attractive light Address for correspondence* Dr Mamta Meena Junior resident Department of Pediatrics. SMS medical college and hospital, Jaipur, 302004, India. Mob. No: +91-9636367130 source for the optimal phototherapy unit. Although, LED devices have been shown to be more effective than any other phototherapy device by in vitro and few in vivo studies, but the clinical data comparing LEDs with compact fluorescent lamp (CFL) and conventional phototherapy units are limited. [5,6] Therefore, we planned the present study to compare the efficacy of LED device with respect to bilirubin photo-degradation with commercially used conventional fluorescent tubes phototherapy device. MATERIAL AND METHODS The present study was carried out on newborns presenting with jaundice at a neonatal unit in the Department of Paediatrics of a tertiary care centre of Jaipur between November 2011 and October 2012. Hemdynamically stable neonates of more than 34 weeks of gestation, suffering from neonatal hyperbilirubinemia and requiring phototherapy (as per AAP charts), [7] were included in the study. Rh and ABO incompatible babies were also included in the study. Jaundiced newborn who were requiring or already received exchange transfusion, sick newborns (e.g. birth asphyxia, acidosis, hypoglycaemia, respiratory distress, septicaemia etc.), newborns with conjugated hyperbilirubinemia and babies who developed any significant complication during the course of phototherapy were excluded. All the neonates were clinically screened for jaundice. Those suspected to have clinically significant jaundice were investigated for blood serum bilirubin level for confirmation. Neonates who met inclusion criteria were enrolled for the study after taking informed written consent from mother/father/legal guardian. These neonates were enrolled on consecutive basis and recruited alternatively in two treatment groups, A and B. Neonates 6