Indications of phototherapy in newborns

Phototherapy or light therapy is a medical technique used to treat neonatal hyperbilirubinemia, which causes neonatal jaundice, a clinical condition characterized by yellowing of the skin and mucosa of newborns, due to excess bilirubin in blood, this jaundice may be present at birth or appear at any time neonatal, depending on its etiology. It commonly starts in the facial area and as blood bilirubin levels increase it spreads to the abdomen and then to the feet.

The light that is used in phototherapy has the property of acting on the bilirubin to transform it into isomers of bilirubin, compounds that are excreted in an easier way through the feces and urine, so using phototherapy is achieved to decrease the levels of bilirubin in blood. This is of paramount importance because hyperbilirubinemia in newborns if not treated in time, can have irreversible consequences in children, directly affecting their nervous system (Kernicterus).

How is pathological neonatal hyperbilirubinemia diagnosed?

Pathological hyperbilirubinemia in term newborns is diagnosed if:

  • Jaundice occurs within the first 24 hours, after the first week of life, or persists after 2 weeks.
  • Total serum bilirubin increases > 5 mg/dL per day.
  • Total serum bilirubin is > 18 mg/dL.
  • The newborn shows signs or symptoms of a serious illness.

Among the most frequent pathological causes of neonatal hyperbilirubinemia we found: immune and non-immune hemolytic anemia, hematoma reabsorption, sepsis and hypothyroidism.

How does phototherapy work in newborns?

Phototherapy works by markedly lowering the blood bilirubin level or preventing it from increasing. For this, phototherapy employs the properties of light energy (light) to modify the shape and structure of bilirubin, turning it into substances that can be excreted more easily.

Phototherapy consists of the irradiation of light on the naked skin of the child locally. When light used in phototherapy penetrates into the inner light of the skin capillaries, it triggers three types of photochemical reactions (structural isomerization, photoisomerization and photooxidation) on the bilirubin, producing non-toxic and water-soluble metabolites that can be easily eliminated through urine and feces, thus decreasing blood bilirubin levels that can cause brain neurotoxicity.

Indications of phototherapy

Phototherapy is the definitive treatment of neonatal hyperbilirubinemia, as it prevents Kernicterus as mentioned above. In newborns ≥ 35 weeks of gestational age, phototherapy is a good option when unconjugated bilirubin is greater than 12 mg/dL and may be indicated when unconjugated bilirubin is greater than 15 mg/dL at 25-48 h, 18 mg/dL at 49-72 h and 20 mg/dL at 72 h. It is important to note that phototherapy is not indicated in case of conjugated hyperbilirubinemia.

For newborns less than 35 weeks of gestational age, the threshold for bilirubin treatment is lower because preterm infants are at increased risk of neurotoxicity. The more preterm the newborn, the lower the threshold. It should also be noted that the effectiveness of phototherapy will depend on the wavelength of light irradiated (blue light being the most effective) and its intensity, the distance between the newborn and the emitting lamp, the body area exposed and the exposure time. The most effective lamps for phototherapy are special blue lamps with a maximum power between 425 and 475 nm.

What does Kalstein offer you?

Kalstein is a company MANUFACTURER of medical and laboratory equipment of the highest quality and the best technology at the best PRICES in the market, so you can make your PURCHASE with us, knowing that you have the service and advice of a company specialized in the field and committed to provide you with safe, economical and effective options for the performance of your functions in the right way. This time we present our Child bilirubin phototherapy unit YR02195. This equipment has the following characteristics:

  • This model has 4 suction cup legs to be fixed in an incubator.
  • LED as radiant elements of phototherapy.
  • Fan-less design for quiet atmosphere.
  • Large area light source for better curing.
  • It can be used with most other types of baby incubators.

For more information we invite you to take a look at: HERE