However, these previous studies do not show whether the efficacy of intensive phototherapy with high levels of irradiance can be enhanced by increasing the light-exposed body surface area (double light), that is, by increasing the spectral power (irradiance x body. The levels of irradiance used in these studies were 7 to 33 W cm -2 nm -1 from above and 8 to 33 W cm -2 nm -1 from below. Thus, previous studies comparing single and double phototherapy have found double phototherapy to be more efficient than single phototherapy in both term and late preterm infants and in preterm infants. To increase the exposed body surface area of the infant, the light sources are often placed above and below the infant, that is, double light. Maximum irradiance is attained by bringing the light sources as close to the infant as possible. Intensive phototherapy has been defined by the American Academy of Pediatrics as a spectral irradiance of at least 30 W cm -2 nm -1 in the 430 to 490 nm wavelength band to as much of the infants' surface area as possible the irradiance was defined by a single measurement at the center of the footprint. In these situations, the level of bilirubin must be lowered as rapidly as possible.įluorescent tubes and halogen spots were formerly used as light sources, but they are now being replaced by light-emitting diodes (LEDs) because LEDs present several advantages: the emission spectrum is narrower (they produce less unnecessary wavelengths), the irradiance decreases more slowly over time and they generate less heat. These factors should always be considered when treating infants with phototherapy, especially if the total serum bilirubin concentration (TsB) is very high, increases rapidly or the infant has symptoms of acute bilirubin encephalopathy. Three factors have major influence on the efficacy of phototherapy: the spectrum of the light, the irradiance of the light and the body surface area of the infant exposed to light. This causes a decrease in the bilirubin concentration in the blood. These isomers are more water soluble than Z,Z-bilirubin and can be excreted into bile and urine without conjugation. In Scandinavia, 2 to 3% of infants born at term or late preterm are treated with phototherapy that converts bilirubin (Z,Z-bilirubin) in the skin to other isomers of bilirubin, the configurational isomers Z,E- and E,Z-bilirubin and the structural photoisomers lumirubins. Meets AAP Guidelines for Intensive phototherapy Blue. neoBLUE blanket system Ordering information neoBLUE Radiometer Regulatory Standards Cat. The neoBLUE radiometerintended for use with the neoBLUE LEDPhototherapy product line,including the neoBLUE,neoBLUE mini, neoBLUEneoBLUE blanket systems. Phototherapy is the current treatment of choice for neonatal hyperbilirubinemia and has almost replaced exchange transfusions because of its efficacy and safety. The neoBLUE system incorporates optimal blue LED technology for the treatment of newborn jaundice. The neoBLUE radiometer measures spectral irradiance LED light sources in the blue spectrum. However, in some infants plasma levels may rise excessively that can be of concern because unconjugated bilirubin is neurotoxic and can cross the blood-brain barrier causing brain damage. In most infants, the presence of unconjugated hyperbilirubinemia reflects a normal transitional phenomenon. Jaundice is the most common condition requiring medical attention in newborns. Author(s): M L Donneborg P K Vandborg B M Hansen M Rodrigo-Domingo F Ebbesen
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