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Osteopathic Manipulative Treatment plus Phototherapy in the Management of Neonatal Hyperbilirubinemia: A Case Report

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 10-11. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/8/482676/LBORC-NUFA-Poster-Abstracts-2022-Residents)

Keywords:

case report [514]
neonatal hyperbilirubinemia [1]
newborns [11]
pediatrics [375]
OMT [2951]
osteopathic manipulative treatment [2973]
phototherapy [1]

Abstract:

Introduction/Background: Neonatal hyperbilirubinemia (NH) has complications and is costly. Current standard of care for NH is phototherapy. Osteopathic manipulative treatment (OMT) has been shown to be safe and effective in other neonatal and infantile conditions. There is little literature on OMT and NH, although some studies have shown that massage therapy can be used safely and effectively in NH. We show a patient with NH treated with OMT plus phototherapy, which resulted in rapidly lowered bilirubin. Patient was discharged much sooner than the average reported length of stay (LOS) for NH managed with phototherapy alone according to current literature. Case: Patient was a 4-day-old term female readmitted for NH. Osteopathic structural exam: head: cranial base compression, bilateral occipitomastoid membranous articular strain, right condylar compression (treatment: osteopathic cranial manipulative medicine), cervical: OA right facet restriction, C6-7 restriction (treatment: myofascial release/MFR), sacrum: S1-3 compression (treatment: MFR), innominate: right intraosseous compression (treatment: MFR), upper extremity: right clavicle restriction, left scapulothoracic restriction (treatment: MFR), and abdomen: bilateral hemidiaphragm restriction (treatment: MFR), liver capsular restriction (treatment: visceral manipulation). Results: Patient’s bilirubin dropped rapidly following OMT. Average LOS for NH managed with phototherapy alone = 45.97 hours. Patient’s LOS = 24.90 hours. No adverse events were reported as a result of OMT. Discussion: We show a case of NH managed with OMT plus phototherapy rapidly lowering bilirubin and resulting in a much sooner-than-anticipated discharge than if patient’s NH was managed with phototherapy alone. Hence, OMT plus phototherapy may be superior to phototherapy alone for management of NH. However, this study is limited because n = 1. Hence, more research is needed, such as a small pilot study eventually leading to randomized controlled trials.


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