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Standardization of phototherapy for neonatal hyperbilirubinemia using multiple-wavelength irradiance integration.

Abstract

BACKGROUND

Phototherapy with radiation of 460-490 nm wavelengths provides the most potent therapeutic effect for neonatal jaundice. However, the efficacy of phototherapy has been estimated using single-wavelength detectors with sensitivity at approximately 460 nm. Cyclobilirubin formation capacity (CFC), which comprises the sum of the irradiance values from three wavelengths multiplied by their specific coefficients, has been proposed as an alternative marker to evaluate the efficacy of phototherapy. This study aimed to test whether two types of phototherapy devices with distinct spectral characteristics provide similar therapeutic effects on adjustment of device-to-patient distances to deliver similar CFCs.

METHODS

Using a three-wavelength spectroradiometer, CFCs and footprints of the light-emitting diode and fluorescent tube devices were assessed. Having determined the device-specific distances that ensured similar CFCs, 32 newborn infants, requiring phototherapy for hyperbilirubinemia, were randomized into the light-emitting diode and fluorescent tube groups. The total serum bilirubin levels before and after phototherapy were assessed.

RESULTS

The light-emitting diode and fluorescent tube devices had comparable CFCs at distances of 60 and 50 cm, respectively. Phototherapy reduced the total serum bilirubin levels from 18.1 to 14.6 mg/dL and from 19.1 to 15.1 mg/dL in the light-emitting diode and fluorescent tube groups, respectively. The two groups did not differ significantly with respect to the patients' clinical backgrounds, serum bilirubin levels, or changes before and after phototherapy.

CONCLUSION

At similar CFCs, the two phototherapy devices reduced the total serum bilirubin levels by comparable amounts. Hence, determining CFCs may help predict phototherapy efficacy. This may ensure better safety and greater efficacy of the treatment for newborn infants.

Authors+Show Affiliations

Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Electronic address: shink@med.nagoya-cu.ac.jp.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.Department of Neonatology, Aichi Human Service Center Central Hospital, 713-8 Jinya-cho, Kasugai 480-0304, Japan.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.Department of Pediatrics, Kainan Hospital, 396 Minamihonda, Maegasu-cho, Yatomi 498-8502, Japan.Department of Pediatrics, Seirei-Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu 433-8558, Japan.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; Department of Pediatrics, Nagoya City West Medical Center, 1-1-1 Hirate-Cho, Kita-ku, Nagoya 462-8508, Japan.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; Department of Pediatrics, Nagoya City West Medical Center, 1-1-1 Hirate-Cho, Kita-ku, Nagoya 462-8508, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31473126

Citation

Kato, Shin, et al. "Standardization of Phototherapy for Neonatal Hyperbilirubinemia Using Multiple-wavelength Irradiance Integration." Pediatrics and Neonatology, 2019.
Kato S, Iwata O, Yamada Y, et al. Standardization of phototherapy for neonatal hyperbilirubinemia using multiple-wavelength irradiance integration. Pediatr Neonatol. 2019.
Kato, S., Iwata, O., Yamada, Y., Kakita, H., Yamada, T., Nakashima, H., ... Togari, H. (2019). Standardization of phototherapy for neonatal hyperbilirubinemia using multiple-wavelength irradiance integration. Pediatrics and Neonatology, doi:10.1016/j.pedneo.2019.07.002.
Kato S, et al. Standardization of Phototherapy for Neonatal Hyperbilirubinemia Using Multiple-wavelength Irradiance Integration. Pediatr Neonatol. 2019 Aug 12; PubMed PMID: 31473126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Standardization of phototherapy for neonatal hyperbilirubinemia using multiple-wavelength irradiance integration. AU - Kato,Shin, AU - Iwata,Osuke, AU - Yamada,Yasumasa, AU - Kakita,Hiroki, AU - Yamada,Takaharu, AU - Nakashima,Hideyuki, AU - Sugiura,Tokio, AU - Suzuki,Satoshi, AU - Togari,Hajime, Y1 - 2019/08/12/ PY - 2019/03/29/received PY - 2019/05/10/revised PY - 2019/07/08/accepted PY - 2019/9/2/entrez PY - 2019/9/2/pubmed PY - 2019/9/2/medline KW - bilirubin KW - cyclobilirubin KW - irradiance KW - light-emitting diode KW - spectroradiometer JF - Pediatrics and neonatology JO - Pediatr Neonatol N2 - BACKGROUND: Phototherapy with radiation of 460-490 nm wavelengths provides the most potent therapeutic effect for neonatal jaundice. However, the efficacy of phototherapy has been estimated using single-wavelength detectors with sensitivity at approximately 460 nm. Cyclobilirubin formation capacity (CFC), which comprises the sum of the irradiance values from three wavelengths multiplied by their specific coefficients, has been proposed as an alternative marker to evaluate the efficacy of phototherapy. This study aimed to test whether two types of phototherapy devices with distinct spectral characteristics provide similar therapeutic effects on adjustment of device-to-patient distances to deliver similar CFCs. METHODS: Using a three-wavelength spectroradiometer, CFCs and footprints of the light-emitting diode and fluorescent tube devices were assessed. Having determined the device-specific distances that ensured similar CFCs, 32 newborn infants, requiring phototherapy for hyperbilirubinemia, were randomized into the light-emitting diode and fluorescent tube groups. The total serum bilirubin levels before and after phototherapy were assessed. RESULTS: The light-emitting diode and fluorescent tube devices had comparable CFCs at distances of 60 and 50 cm, respectively. Phototherapy reduced the total serum bilirubin levels from 18.1 to 14.6 mg/dL and from 19.1 to 15.1 mg/dL in the light-emitting diode and fluorescent tube groups, respectively. The two groups did not differ significantly with respect to the patients' clinical backgrounds, serum bilirubin levels, or changes before and after phototherapy. CONCLUSION: At similar CFCs, the two phototherapy devices reduced the total serum bilirubin levels by comparable amounts. Hence, determining CFCs may help predict phototherapy efficacy. This may ensure better safety and greater efficacy of the treatment for newborn infants. SN - 2212-1692 UR - https://www.unboundmedicine.com/medline/citation/31473126/Standardization_of_phototherapy_for_neonatal_hyperbilirubinemia_using_multiple-wavelength_irradiance_integration L2 - https://linkinghub.elsevier.com/retrieve/pii/S1875-9572(19)30487-5 DB - PRIME DP - Unbound Medicine ER -