Palavras-chave
hiperbilirrubinemia
fototerapia
recém-nascido
nascimento prematuro
Como Citar
Resumo
Esta revisão sistemática avaliou intervenções terapêuticas para icterícia neonatal e hiperbilirrubinemia em recém-nascidos e prematuros com base em ensaios clínicos randomizados publicados no PubMed nos últimos cinco anos. O objetivo principal foi sintetizar evidências sobre a eficácia e segurança da fototerapia, exsanguineotransfusão, imunoglobulinas intravenosas, fenobarbital e ácido ursodeoxicólico, juntamente com terapias adjuvantes. A revisão identificou vinte e cinco ensaios clínicos randomizados elegíveis. Os resultados confirmam a fototerapia como tratamento principal, com achados sugerindo benefícios de variações como fototerapia intermitente e circunferencial, bem como comprimentos de onda de LED específicos (478 nm). Terapias adjuvantes como zinco oral, probióticos/simbióticos, ácido ursodeoxicólico e massagem demonstraram potencial na redução dos níveis de bilirrubina e/ou encurtamento da duração da fototerapia. A fototerapia domiciliar surgiu como uma alternativa segura e custo-efetiva para lactentes selecionados. Embora a evidência apoie a otimização da fototerapia e a exploração de adjuvantes, a heterogeneidade entre os estudos e as limitações na qualidade dos relatos exigem mais pesquisas rigorosas para confirmar benefícios a longo prazo e orientar diretrizes clínicas.
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