“Evaluation of Factors Affecting the Phototherapeutic Properties of Commonly Used Phototherapy Units for Treatment of Neonatal Hyperbillirubinemia in India”: A Descriptive Cross Sectional Study
Journal Title: Progressing Aspects in Pediatrics and Neonatology - Year 2018, Vol 1, Issue 4
Abstract
Objective: To study the spectral characteristics of the phototherapy systems and to identify variations in spectral properties with changes in height, voltage, tilt and temperature output. Setting: Research laboratory at a tertiary care hospital. Methods: The spectral characteristics were measured from two compact fluorescent lamp (CFL) and eight light emitting diode (LED) phototherapy devices in a dark room with an irradiance of <0.1μW/cm2/nm. The variations in the spectral characteristics with changes in height, tilt and voltage were measured. Heat output was documented. Results: The peak spectral wavelength of all the devices tested had a peak centering around 450±10 nm, in billirubin absorption spectrum. LEDs achieved a higher maximum irradiance compared to CFL units across all the heights tested. CFL and Array LEDs showed a better mean irradiance compared to Spot/Multispot LEDs. CFL and Array LEDs demonstrated the best footprint whereas the Spot and Multispot LED units had a narrow footprint (approximately half or less of CFL or Array LEDs).Tilt angles influenced the mean irradiance. Most of the units showed a decrease in mean irradiance with tilting except for one Array LED namely Brilliance Classic. CFLs showed an inconsistent mean irradiance when tested at different voltage inputs LEDs had a consistent irradiance in spite of voltage fluctuations. LEDs had minimal irradiance decay of irradiance compared to CFLs. Both CFL and LED units showed increasing temperature output over time, which is more pronounced in CFL units. Conclusion: The phototherapy units differ in spectral properties which influence their therapeutic efficacy. Spectral parameters and its variations with tilt height and voltage changes must be considered when phototherapy device are used. The Array LEDs and CFL devices seem to score over other devices in most of the parameters tested.Neonatal jaundice is a common problem in day to day practice of a neonatologist. Options for treatment of neonatal jaundice include Phototherapy, Exchange transfusion and drugs. The major factor in phototherapy efficacy is the dose of light delivered, measured in photons per unit area, making phototherapy conceptually similar to pharmacotherapy [1]. Efficacy of phototherapy is influenced by dose of light which in turn depends on [1] a) Spectral qualities of the light source (Peak wavelength and band width) b) Intensity of the light (Irradiance) c) Body surface area irradiated ( “footprint “of the light source ) d) Distance between the light and the infant’s skin A thorough evaluation of these spectral qualities of light is essential for optimizing the application of phototherapy in clinical practice.
Authors and Affiliations
Santosh Kumar K, Mangalabharathi S, Kamalarathnam CN
Keywords
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- EP ID EP580442
- DOI 10.32474/PAPN.2018.01.000117
- Views 61
- Downloads 0
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