An evaluation of phototherapy device performance in a tertiary health facility
Mahendra T A Sampurna1, Risa Etika1, Martono T Utomo1
1Department of Pediatrics, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.
Insights
Phototherapy device irradiance decays over time, potentially leading to ineffective treatment for infant hyperbilirubinemia. Routine intensity measurements are crucial to ensure therapeutic levels are maintained for all infants.
Area of Science:
- Neonatal care
- Medical device engineering
- Phototherapy applications
Background:
- Phototherapy is a standard treatment for infant hyperbilirubinemia.
- The American Academy of Pediatrics recommends regular intensity checks of phototherapy devices.
- Ensuring effective phototherapy is vital for treating newborns with jaundice.
Purpose of the Study:
- To determine the irradiance decay velocity of phototherapy devices in a tertiary care hospital.
- To assess the efficacy of current phototherapy device maintenance protocols.
- To inform the development of standardized maintenance procedures for consistent infant treatment.
Main Methods:
- Prospective observational study conducted at Dr. Soetomo Academic Teaching Hospital.
- Measured intensities of 11 phototherapy devices (9 fluorescent, 2 LED) using a Bili Blanket Meter II.
- Calculated irradiance decay velocity in μW/cm²/nm/hour of use.
Main Results:
- All phototherapy devices exhibited irradiance decay.
- Mean irradiance decay velocity for fluorescent lamps was 0.02 (±0.03) μW/cm²/nm/hour.
- Mean irradiance decay velocity for LED lamps was 0.015 (±0.007) μW/cm²/nm/hour.
- One fluorescent device's intensity fell below therapeutic levels.
Conclusions:
- Irradiance decay is a universal characteristic of phototherapy lamps.
- Routine intensity measurements are essential, irrespective of manufacturer guidelines.
- Regular checks prevent ineffective phototherapy due to sub-therapeutic light intensities.
Introduction:
A range of phototherapy devices are commercially available. The American Academy of Pediatrics (2004) recommends routine intensity measurement of phototherapy devices to ensure that babies affected by hyperbilirubinemia receive effective phototherapy.
Objective:
The aims of this study were to calculate the irradiance decay velocity of phototherapy devices used in a tertiary care hospital to evaluate whether current maintenance procedures for phototherapy devices are effective, and to contribute to the improvement of a standardized maintenance procedure in daily practice, thus helping to ensure that all babies affected by hyperbilirubinemia receive prompt treatment.
Methods:
This research represents a prospective observational study conducted at Dr. Soetomo Academic Teaching Hospital in Surabaya, Indonesia from February 2019-July 2019. The intensities of 11 phototherapy devices were measured at specific times using a Bili Blanket Meter II. We calculated the Δ irradiance differences in μW/cm2/nm and calculated them as velocity μW/cm2/nm/hour of use.
Results:
Among the 11 phototherapy devices included in this study, nine were fluorescent and two were light-emitting diode (LED) machines. The mean (standard deviation) irradiance decay velocity of the fluorescent lamps was 0.02 (±0.03) μW/cm2/nm/hour of use, while that of the LED lamps was 0.015 (±0.007) μW/cm2/nm/hour of use. The fastest irradiance decay velocity was 0.08 μW/cm2/nm/hour of use, while the slowest irradiance decay velocity was <0.01 μW/cm2/nm/hour of use, both of which were from fluorescent-based devices. There was one fluorescent-based device that provided an intensity lower than the therapeutic level.
Conclusion:
Irradiance decay occurred in all phototherapy device lamps. It is important to perform routinely intensity measurements, regardless of manufacturer recommendations, to avoid ineffective phototherapy resulting from intensities lower than the required therapeutic levels.
