An evaluation of the characteristics and performance of neonatal phototherapy equipment

This paper reviews the current state of knowledge and practice in neonatal phototherapy, and assesses methods of evaluating the characteristics and performance of different equipment. Artificial lighting (usually fluorescent) has been used for the past 30 years in the treatment of neonatal jaundice. Widely differing light outputs and spectra are used, making comparison and evaluation difficult for clinicians. Manufacturers of neonatal phototherapy equipment have no standard for assessing the performance of their equipment, and information that is supplied is at best confusing or deceptive to the users. Best practice is usually based on empirical data from equipment in use, but there is wide agreement that present phototherapy is sub-optimal, i.e. does not achieve maximum rate of bilirubin clearance for minimum therapeutic dose. Several studies in the last ten years have emphasized the importance of both the wavelength and intensity of light for optimal phototherapy. These are discussed and a technique is proposed for normalizing the output of different systems to make comparison easier and to enable optimal treatments to be designed.