评估用于新生儿高胆红素血症的光疗设备。

Evaluation of phototherapy devices used for neonatal hyperbilirubinemia.

机构信息

Division of Neonatology, Department of Pediatrics, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian Pediatr. 2011 Sep;48(9):689-96. doi: 10.1007/s13312-011-0116-8. Epub 2010 Nov 30.

DOI:10.1007/s13312-011-0116-8

PMID:21169641

Abstract

OBJECTIVE

To compare phototherapy devices based on their physical and photo-biological characteristics viz spectral properties, maximum and mean irradiance, treatable percentage of body surface area, decay of irradiance over time and in vitro photoisomerisation of bilirubin.

DESIGN

In vitro experimental study.

SETTING

Ocular pharmacy laboratory at a tertiary care hospital. METHODLOGY: All the characteristics were measured at a fixed distance of 35 cm from one compact fluorescent lamp (CFL) and three light emitting diode (LED) phototherapy devices in a dark room with an irradiance of <0.1uW/cm2/nm. Estimation of products of in vitro photoisomerisation was done using liquid chromatography - tandem mass spectroscopy (LC-MS/MS).

RESULTS

The emission spectral data were comparable between the phototherapy devices. The devices, however, differed in their maximum irradiance with the spot and indigenous LED units having the highest and lowest values, respectively (56.5 and 16.8uW/cm2/nm). The mean irradiance measured in 5x5cm grids falling within the silhouette of a term baby of the spot and improvised LED devices were low (26.8uW/cm2/nm and 11.5uW/cm2/nm, respectively) possibly due to unevenness in the irradiance of light falling within the silhouette. There was a significant difference in the amount of bilirubin left after exposure to light over a 2hour time period (% reduction of bilirubin) among the four devices (P=0.001); at 120 minutes after exposure, the amount of bilirubin left was lowest for the CFL (16%) and spot LED (17%) devices and highest for the indigenous LED unit (41%).

CONCLUSIONS

The four phototherapy devices differed markedly in their physical and photobiological characteristics. Since the efficacy of a device is dependent not only on the maximum irradiance but also on the mean irradiance, rate of decay of irradiance, and treatable surface area of the foot print of light, each phototherapy device should have these parameters verified and confirmed before being launched for widespread use.

摘要

目的

根据光疗设备的物理和光生物学特性，包括光谱特性、最大和平均辐照度、可治疗的体表面积百分比、辐照度随时间的衰减以及胆红素的体外光异构化，对其进行比较。

设计

体外实验研究。

地点

三级医院眼科药房实验室。

方法

在暗室中，于距离紧凑型荧光灯（CFL）和三种发光二极管（LED）光疗设备 35cm 的固定距离处，测量所有特性的辐照度<0.1uW/cm2/nm。使用液相色谱-串联质谱法（LC-MS/MS）评估体外光异构化产物的估算。

结果

光疗设备的发射光谱数据具有可比性。然而，这些设备在最大辐照度方面存在差异，点光源和内置 LED 设备的辐照度最高和最低（分别为 56.5 和 16.8uW/cm2/nm）。在 5x5cm 网格中测量的平均值落在足月婴儿轮廓内的辐照度较低（点光源和临时 LED 设备分别为 26.8uW/cm2/nm 和 11.5uW/cm2/nm），这可能是由于落在轮廓内的光的辐照度不均匀所致。在 2 小时的光照暴露期间，四种设备之间胆红素剩余量（胆红素减少百分比）存在显著差异（P=0.001）；在暴露 120 分钟后，CFL（16%）和点光源 LED（17%）设备中胆红素剩余量最低，而内置 LED 单元最高（41%）。