Palabras clave
hyperbilirubinemia
phototherapy
infant newborn
premature birth
Cómo citar
Resumen
Esta revisión sistemática evaluó las intervenciones terapéuticas para la ictericia neonatal y la hiperbilirrubinemia en recién nacidos y prematuros basándose en ensayos clínicos controlados aleatorios publicados en PubMed en los últimos cinco años. El objetivo principal fue sintetizar la evidencia sobre la eficacia y seguridad de la fototerapia, la exanguinotransfusión, las inmunoglobulinas intravenosas, el fenobarbital y el ácido ursodesoxicólico, junto con terapias adyuvantes. La revisión identificó veinticinco ensayos clínicos controlados aleatorios elegibles. Los resultados confirman la fototerapia como tratamiento fundamental, con hallazgos que sugieren beneficios de variaciones como la fototerapia intermitente y circunferencial, así como longitudes de onda LED específicas (478 nm). Terapias adyuvantes como el zinc oral, probióticos/simbióticos, ácido ursodesoxicólico y masajes mostraron potencial para reducir los niveles de bilirrubina y/o acortar la duración de la fototerapia. La fototerapia domiciliaria surgió como una alternativa segura y rentable para lactantes seleccionados. Si bien la evidencia respalda la optimización de la fototerapia y la exploración de adyuvantes, la heterogeneidad entre los estudios y las limitaciones en la calidad de los informes exigen más investigación rigurosa para confirmar los beneficios a largo plazo y guiar las pautas clínicas.
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