TY - JOUR
T1 - A new blue light-emitting phototherapy device
T2 - A prospective randomized controlled study
AU - Seidman, Daniel S.
AU - Moise, Jonathan
AU - Ergaz, Zivanit
AU - Laor, Arie
AU - Vreman, Hendrik J.
AU - Stevenson, David K.
AU - Gale, Rena
N1 - Funding Information:
Supported by the National Institutes of Health, grant HD 14426, The Hess Research Fund, the Mary L. Johnson Research Fund, and a grant from the Stanford University Office of Technology Licensing. Submitted for publication June 9, 1999; revision received Nov 8, 1999; accepted Jan 6, 2000. Reprint requests: Daniel S. Seidman, MD, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, 52621 Tel-Hashomer, Israel. Copyright © 2000 by Mosby, Inc. 0022-3476/2000/$12.00 + 0 9/21/105651 doi: 10.1067/mpd.2000.105651 Phototherapy has remained the standard of care for treatment of neonatal hyperbilirubinemia for 4 decades. 1 However, the pattern of use in term infants has changed because of early postpartum discharge practices. 2'3 Currently, jaundice is frequently diagnosed after the newborn has returned home. 4 In such eases, it is not unusual to find total serum bilirubin levels of >20 mg/dL (342 ~tmoL/L) on readmission. Thus the need for highly effective therapeutic, rather than prophylactic, phototherapy is apparent. In patients with extreme hyperbilirubinemia or moderate degrees of hemolysis (eg, ABO incompatibility), intense phototherapy may prevent the need for exchange transfusions, s However, when conventional phototherapy devices are used, most term newborns receive phototherapy in a close that is well below the therapeutic optimum. 4 Furthermore, many infants with moderate levels of hyperbilirubinemia could remain at home if effective and convenient modes of home phototherapy were available. Home phototherapy is currently performed with devices containing either fragile fluorescent tubes or high-heat-producing halogen light bulbs or with fiberoptic devices that offer only limited surface area exposure. The need for new modes of phototherapy is therefore apparent.
PY - 2000
Y1 - 2000
N2 - Objective: To evaluate the efficacy of a new phototherapy light source with a narrow luminous blue spectrum. The device, made with high-intensity gallium nitride light-emitting diodes (LEDs), was compared with conventional phototherapy at similar light intensities. Setting: Two university-affiliated community hospitals in Jerusalem. Design: Prospective open randomized study. Participants: Sixty-nine jaundiced, but otherwise healthy, term infants who met the entry criteria for phototherapy set by the American Academy of Pediatrics' Practice Parameter. Main outcome measures: The duration of phototherapy and the rate of decrease in total serum bilirubin (TSB) concentration. Results: The mean TSB concentrations at initiation and termination of treatment did not differ between newborns receiving LED and those receiving conventional phototherapy. The duration of phototherapy and the rate of decrease in TSB concentration were not statistically different in the 2 groups. The average rate of decrease in TSB after adjustment by a linear regression analysis for confounding factors was -3.16 μmol/L/h (95% confidence limits -4.81, -1.51) in newborns receiving LED phototherapy compared with -2.19 μmol/L/h (-3.99,-0.40) in those treated with conventional phototherapy (P < .14). No side effects were noted in any of the newborns. Conclusions: The blue gallium nitride LED device is as effective as conventional phototherapy and is readily accepted by nursing staff. Future LED phototherapy devices can provide much higher irradiance, and thus greater efficacy, and offer a new highly versatile approach to the treatment of jaundice.
AB - Objective: To evaluate the efficacy of a new phototherapy light source with a narrow luminous blue spectrum. The device, made with high-intensity gallium nitride light-emitting diodes (LEDs), was compared with conventional phototherapy at similar light intensities. Setting: Two university-affiliated community hospitals in Jerusalem. Design: Prospective open randomized study. Participants: Sixty-nine jaundiced, but otherwise healthy, term infants who met the entry criteria for phototherapy set by the American Academy of Pediatrics' Practice Parameter. Main outcome measures: The duration of phototherapy and the rate of decrease in total serum bilirubin (TSB) concentration. Results: The mean TSB concentrations at initiation and termination of treatment did not differ between newborns receiving LED and those receiving conventional phototherapy. The duration of phototherapy and the rate of decrease in TSB concentration were not statistically different in the 2 groups. The average rate of decrease in TSB after adjustment by a linear regression analysis for confounding factors was -3.16 μmol/L/h (95% confidence limits -4.81, -1.51) in newborns receiving LED phototherapy compared with -2.19 μmol/L/h (-3.99,-0.40) in those treated with conventional phototherapy (P < .14). No side effects were noted in any of the newborns. Conclusions: The blue gallium nitride LED device is as effective as conventional phototherapy and is readily accepted by nursing staff. Future LED phototherapy devices can provide much higher irradiance, and thus greater efficacy, and offer a new highly versatile approach to the treatment of jaundice.
UR - http://www.scopus.com/inward/record.url?scp=0034088013&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(00)75202-4
DO - 10.1016/S0022-3476(00)75202-4
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 10839875
AN - SCOPUS:0034088013
VL - 136
SP - 771
EP - 774
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 6
ER -