Literature DB >> 29393277

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area.

Amy R Borden1, Katie M Satrom, Paul Wratkowski, Thomas N George, Constance A Adkisson, Hendrik J Vreman, Austin P Johnson, Kent J Nichols, Tina M Slusher.   

Abstract

BACKGROUND: Phototherapy (PT) is widely used to prevent and treat severe hyperbilirubinemia and its associated risks for both acute and chronic bilirubin encephalopathy. Intensive PT, recommended for inpatient treatment of hyperbilirubinemia in term and near-term infants, is defined as having a spectral irradiance of ≥30 μW/cm2/nm.
OBJECTIVES: We aimed to assess local PT practices by measuring the irradiance of PT devices in local neonatal intensive care units and newborn nurseries.
METHODS: The irradiance footprint, including maximum irradiance at the center of the footprint, of 39 PT devices in 7 area hospitals was measured according to current practice in these facilities.
RESULTS: The mean ± SD (range) footprint irradiance was 20.7 ± 5.8 (8.8-29.4) μW/cm2/nm. The mean ± SD maximum irradiance at the footprint center for all devices at a mean clinically used treatment distance of 33.1 ± 9.3 (25.5-60.0) cm was 27.8 ± 7.0 (14.7-42.0) μW/cm2/nm. Sixty-two percent of the devices did not meet the minimum recommended spectral irradiance for intensive PT. For the sites without irradiance-based protocols, the maximum irradiance of the devices (n = 33) at the treatment distances was 25.8 ± 6.1 μW/cm2/nm.
CONCLUSIONS: Despite established PT guidelines, local protocols and practices vary. Based on an assessment of 7 local hospitals, intensive PT was suboptimal for 62% of devices. Straightforward changes, such as decreasing the distance between an infant and the light source and establishing a consistent irradiance-based protocol, could substantially improve the quality of the intervention.
© 2018 S. Karger AG, Basel.

Entities:  

Keywords:  Bilirubin; Hyperbilirubinemia; Irradiance; Neonatal jaundice; Phototherapy

Mesh:

Year:  2018        PMID: 29393277      PMCID: PMC5860931          DOI: 10.1159/000485369

Source DB:  PubMed          Journal:  Neonatology        ISSN: 1661-7800            Impact factor:   4.035


  24 in total

Review 1.  Severe neonatal jaundice: is it a rare event in Australia?

Authors:  Angela McGillivray; Nick Evans
Journal:  J Paediatr Child Health       Date:  2011-11-14       Impact factor: 1.954

2.  The importance of irradiance and area in neonatal phototherapy.

Authors:  G Hart; R Cameron
Journal:  Arch Dis Child Fetal Neonatal Ed       Date:  2005-05-04       Impact factor: 5.747

3.  The use of intensive phototherapy in severe neonatal hyperbilirubinemia.

Authors:  May Ahmed Khairy Abd-Ellatif; Dalia Ahmed Khairy Abd-Ellatif
Journal:  J Egypt Soc Parasitol       Date:  2012-08

4.  Phototherapy device effectiveness in Nigeria: irradiance assessment and potential for improvement.

Authors:  Benjamin K Cline; Hendrik J Vreman; Kelly Faber; Hannah Lou; Krista M Donaldson; Emmanuel Amuabunosi; Gabriel Ofovwe; Vinod K Bhutani; Bolajoko O Olusanya; Tina M Slusher
Journal:  J Trop Pediatr       Date:  2013-05-10       Impact factor: 1.165

5.  Effectiveness of phototherapy units in Cameroon.

Authors:  Katie Satrom; Tina Slusher; Jared Satrom
Journal:  J Trop Pediatr       Date:  2014-01-10       Impact factor: 1.165

Review 6.  The need to implement effective phototherapy in resource-constrained settings.

Authors:  Vinod K Bhutani; Benjamin K Cline; Krista M Donaldson; Hendrik J Vreman
Journal:  Semin Perinatol       Date:  2011-06       Impact factor: 3.300

7.  High variability and low irradiance of phototherapy devices in Dutch NICUs.

Authors:  Deirdre E van Imhoff; Christian V Hulzebos; Maaike van der Heide; Vera W van den Belt; Hendrik J Vreman; Peter H Dijk
Journal:  Arch Dis Child Fetal Neonatal Ed       Date:  2012-05-18       Impact factor: 5.747

8.  Kernicterus in the 21st century: frequently asked questions.

Authors:  V K Bhutani; L Johnson
Journal:  J Perinatol       Date:  2009-02       Impact factor: 2.521

9.  Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Authors: 
Journal:  Lancet       Date:  2014-12-18       Impact factor: 79.321

Review 10.  Bilirubin neurotoxicity in preterm infants: risk and prevention.

Authors:  Vinod K Bhutani; Ronald J Wong
Journal:  J Clin Neonatol       Date:  2013-04
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  2 in total

1.  An evaluation of phototherapy device performance in a tertiary health facility.

Authors:  Mahendra T A Sampurna; Risa Etika; Martono T Utomo; Siti A D Rani; Abyan Irzaldy; Zahra S Irawan; Kinanti Ayu Ratnasari; Arend F Bos
Journal:  Heliyon       Date:  2020-09-16

2.  Improving Effectiveness of Phototherapy in an Academic Center: A Quality Improvement Project.

Authors:  Ashajyothi M Siddappa; Frances L Prekker; Tina M Slusher
Journal:  Glob Pediatr Health       Date:  2020-10-29
  2 in total

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