Photo therapy is still considered to be the most widely used method to treat neonatal jaundice. The commonest cause of neonatal jaundice is associated with excess indirect bilirubin in the blood and phototherapy helps to break the concentration of the bilirubin. Though blue light alone is not the factor, and importance is also given to wavelengths as well as the intensity of light. The right intensity of light helps to break the bilirubin in the skin and reach to a safe level while too high intensity can cause burns.
The commonly available Phototherapy units have a very simple mechanical structure with bulbs mounted overhead to provide the required intensity of light. It should me made sure that the equipment emits light with wavelength in accepted range which has to be checked through calibrated bilimeter.
Photo therapy units that produce light wavelength between 425 nm and 475nm helps in photoisomerization of the excess bilirubin as it is thought that bilirubin are more sensitive to light between these wavelength. After photoisomerization of bilirubin, it results in formation of water-soluble isomers, referred as photobilirubin which can be carried through the blood stream for excretion.
It is recommended to regularly check the intensity of the tubes at regular interval because if the required wavelength of light is not emitted, the therapy will be ineffective. Tubes having output different than the prescribed range should be changed. It is essential that the replaced tube produces the prescribed wavelength as the color alone is not sufficient for phototherapy. The manufacture guidelines should be read properly to make sure which bulbs can be used as replacement. Recent advancement has brought phototherapy blankets in the market which can be wrapped around the baby making it more portable than the traditional phototherapy units.
Pediatric Oncall Journal
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