Irradiance footprint of phototherapy devices: a comparative study.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
01
07
2021
accepted:
04
10
2021
revised:
13
09
2021
pubmed:
4
11
2021
medline:
4
10
2022
entrez:
3
11
2021
Statut:
ppublish
Résumé
Phototherapy (PT) is the standard treatment of neonatal unconjugated hyperbilirubinemia. The irradiance footprint, i.e., the illuminated area by the PT device with sufficient spectral irradiance, is essential for PT to be effective. Irradiance footprint measurements are not performed in current clinical practice. We describe a user-friendly method to systematically evaluate the high spectral irradiance (HSI) footprint (illuminated area with spectral irradiance of ≥30 μW cm Six commercially available LED-based overhead PT devices were evaluated in overhead configuration with an incubator. Spectral irradiance (µW cm The average measured spectral irradiance ranged between 27 and 52 μW cm Spectral irradiance of LED-based overhead PT devices is often lower than manufacturer's specifications, and HSI footprints not always cover the average BSA of a newborn infant. The proposed measurement method will contribute to awareness of the importance of irradiance level as well as footprint measurements in the management of neonatal jaundice. While a sufficient spectral irradiance footprint is essential for PT to be effective, some PT devices have spectral irradiance footprints that are too small to cover the entire body surface area (BSA) of a newborn infant. This study introduces a user-friendly, accessible method to systematically evaluate the spectral irradiance level and footprint of PT devices. This study supports awareness on the role of the spectral irradiance footprint in the efficacy of PT devices. Irradiance footprint can be easily measured during phototherapy with the proposed method.
Sections du résumé
BACKGROUND
Phototherapy (PT) is the standard treatment of neonatal unconjugated hyperbilirubinemia. The irradiance footprint, i.e., the illuminated area by the PT device with sufficient spectral irradiance, is essential for PT to be effective. Irradiance footprint measurements are not performed in current clinical practice. We describe a user-friendly method to systematically evaluate the high spectral irradiance (HSI) footprint (illuminated area with spectral irradiance of ≥30 μW cm
MATERIALS AND METHODS
Six commercially available LED-based overhead PT devices were evaluated in overhead configuration with an incubator. Spectral irradiance (µW cm
RESULTS
The average measured spectral irradiance ranged between 27 and 52 μW cm
CONCLUSION
Spectral irradiance of LED-based overhead PT devices is often lower than manufacturer's specifications, and HSI footprints not always cover the average BSA of a newborn infant. The proposed measurement method will contribute to awareness of the importance of irradiance level as well as footprint measurements in the management of neonatal jaundice.
IMPACT
While a sufficient spectral irradiance footprint is essential for PT to be effective, some PT devices have spectral irradiance footprints that are too small to cover the entire body surface area (BSA) of a newborn infant. This study introduces a user-friendly, accessible method to systematically evaluate the spectral irradiance level and footprint of PT devices. This study supports awareness on the role of the spectral irradiance footprint in the efficacy of PT devices. Irradiance footprint can be easily measured during phototherapy with the proposed method.
Identifiants
pubmed: 34728809
doi: 10.1038/s41390-021-01795-x
pii: 10.1038/s41390-021-01795-x
pmc: PMC9522581
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
453-458Informations de copyright
© 2021. The Author(s).
Références
Le Pichon, J. B., Riordan, S. M., Watchko, J. & Shapiro, S. M. The neurological sequelae of neonatal hyperbilirubinemia: definitions, diagnosis and treatment of the kernicterus spectrum disorders (KSDs). Curr. Pediatr. Rev. 13, 199–209 (2017).
pubmed: 28814249
Maisels, M. J. & McDonagh, A. F. Phototherapy for neonatal jaundice. N. Engl. J. Med. 358, 920–928 (2008).
doi: 10.1056/NEJMct0708376
Bhutani, V. K. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics (Evanst.) 128, e1046–e1052 (2011).
doi: 10.1542/peds.2011-1494
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 114, 297–316 (2004).
doi: 10.1542/peds.114.1.297
Vreman, H. J., Wong, R. J. & Stevenson, D. K. Phototherapy: current methods and future directions. Semin. Perinatol. 28, 326–333 (2004).
doi: 10.1053/j.semperi.2004.09.003
Ebbesen, F., Hansen, T. W. R. & Maisels, M. J. Update on phototherapy in jaundiced neonates. Curr. Pediatr. Rev. 13, 176–180 (2017).
doi: 10.2174/1573396313666170718150056
Hart, G. & Cameron, R. The importance of irradiance and area in neonatal phototherapy. Arch. Dis. Child Fetal Neonatal Ed. 90, 437 (2005).
doi: 10.1136/adc.2004.068015
Dicken, P., Grant, L. J. & Jones, S. An evaluation of the characteristics and performance of neonatal phototherapy equipment. Physiol. Meas. 21, 493–503 (2000).
doi: 10.1088/0967-3334/21/4/306
Lamola, A. A. A pharmacologic view of phototherapy. Clin. Perinatol. 43, 259–276 (2016).
doi: 10.1016/j.clp.2016.01.004
Hansen, T. W. R. et al. Sixty years of phototherapy for neonatal jaundice—from serendipitous observation to standardized treatment and rescue for millions. J. Perinatol. 40, 180–193 (2020).
doi: 10.1038/s41372-019-0439-1
van Erk, M. D. et al. How skin anatomy influences transcutaneous bilirubin determinations: an in vitro evaluation. Pediatr. Res. 86, 471–477 (2019).
doi: 10.1038/s41390-019-0471-z
Bosschaart, N., Mentink, R., Kok, J. H., van Leeuwen, T. G. & Aalders, M. C. Optical properties of neonatal skin measured in vivo as a function of age and skin pigmentation. J. Biomed. Opt. 16, 097003 (2011).
doi: 10.1117/1.3622629
Bhutani, V. K. et al. Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. J. Pediatr. 162, 477–482 (2013).
doi: 10.1016/j.jpeds.2012.08.022
van Imhoff, D. E. et al. High variability and low irradiance of phototherapy devices in dutch NICUs. Arch. Dis. Child. Fetal Neonatal Ed. 98, 112 (2013).
doi: 10.1136/archdischild-2011-301486
Hulzebos, C. V., van’t Klooster, S. J., Lorenz, K., Vreman, H. J. & Dijk, P. H. Irradiance levels of phototherapy devices: a national study in dutch neonatal intensive care units. J. Perinatol. 37, 839–842 (2017).
doi: 10.1038/jp.2017.13
General Electric Company. Giraffe™ blue spot PT lite™ Operation, Maintenance, and Service Manual (2020).
Arseus Medical. Infantulus, Super-LED Phototherapy (2015).
Draeger Medical Systems I. Instructions for Use BiliLux, LED Phototherapy Light, Software 1.n (2017).
Natus Medical Incorporated. neoBLUE® LED Phototherapy System User Manual (2015).
General Electric Company. Lullaby™ LED Phototherapy System Service Manual (2019).
Löwenstein Medical. Bilibluelight Phototherapy System, Reliable Phototherapy for Our Smallest Patients (2018).
Sampurna, M. T. A. et al. Current phototherapy practice on Java, Indonesia. BMC Pediatr. 19, 188 (2019).
doi: 10.1186/s12887-019-1552-1
Vreman, H. J., Wong, R. J., Murdock, J. R. & Stevenson, D. K. Standardized bench method for evaluating the efficacy of phototherapy devices. Acta Paediatr. 97, 308–316 (2008).
doi: 10.1111/j.1651-2227.2007.00631.x
Vandborg, P. K., Hansen, B. M., Greisen, G. & Ebbesen, F. Dose-response relationship of phototherapy for hyperbilirubinemia. Pediatrics 130, e352–e357 (2012).
doi: 10.1542/peds.2011-3235
Tan, K. L. Phototherapy for neonatal jaundice. Clin. Perinatol. 18, 423–439 (1991).
doi: 10.1016/S0095-5108(18)30506-2
Mims, L. C., Estrada, M., Gooden, D. S., Caldwell, R. R. & Kotas, R. V. Phototherapy for neonatal hyperbilirubinemia–a dose: response relationship. J. Pediatr. 83, 658–662 (1973).
doi: 10.1016/S0022-3476(73)80236-7
Maisels, M. J. Phototherapy–traditional and nontraditional. J. Perinatol. 21, S93–S97 (2001).
doi: 10.1038/sj.jp.7210642
Reda, S. M. & Faramawy, S. M. Developing an automated transition stage as a way to improve the quality of the measurements accuracy. IEEE Instrum. Meas. Mag. 23, 13–17 (2020).
doi: 10.1109/MIM.2020.9234760
General Electric. BiliBlanket Meter II Specifications (2011).
University of Oxford. Intergrowth Very Preterm; http://intergrowth21.ndog.ox.ac.uk/Content/PDF/VeryPreterm/INTERGROWTH-21st_Length_Standards_Boys.pdf . (assessed at 3-6-2021).
University of Oxford. Intergrowth NewBorn. http://intergrowth21.ndog.ox.ac.uk/Content/PDF/NewBorn/INTERGROWTH-21st_Length_Standards_Boys.pdf . (assessed at 3-6-2021).
Riddle, W. R. & DonLevy, S. C. Continuously tracking growth of preterm infants from birth to two years of age. J. Neonatol. Clin. Pediatr. https://doi.org/10.24966/NCP-878X/100011 (2015).
Reda, S. M., AbdElmageed, A. A., Monem, A. S., El-Gebaly, R. H. & Faramawy, S. M. Estimation of spectral mismatch correction factor f1’ indicated by radiometer responsivity toward phototherapic infant devices. Appl. Opt. 57, 9615–9619 (2018).
doi: 10.1364/AO.57.009615
Honsberg, C. B. & Bowden S. G. Fresnel Reflection calculator (n plastic=1.5), Photovoltaics Education Website (updated 2019); www.pveducation.org .
Morris, B. H. et al. Aggressive vs. conservative phototherapy for infants with extremely low birth weight. N. Engl. J. Med. 359, 1885–1896 (2008).
doi: 10.1056/NEJMoa0803024
van der Schoor, L. W. E. et al. Blue LED phototherapy in preterm infants: effects on an oxidative marker of DNA damage. Arch. Dis. Child Fetal Neonatal Ed. 105, 628–633 (2020).
doi: 10.1136/archdischild-2019-317024
Sampurna, M. T. A. et al. An evaluation of phototherapy device performance in a tertiary health facility. Heliyon 6, e04950 (2020).
doi: 10.1016/j.heliyon.2020.e04950