Neonatal phototherapy machine

Phototherapy (light therapy) for newborns is used as the main method of conservative treatment. The effectiveness of the technique is based on the effect of light radiation in the range of 450-470 nm on the icteric cover of the child (stopping the manifestations of the disease without additional drug treatment). The device for phototherapy of newborns is used from the first days of life and is characterized by minor contraindications.

Purpose of the device

The expediency of use and the mode of phototherapy is determined by the doctor – if one newborn is enough for several sessions of therapy, then for others a whole complex of medical procedures is needed. For phototherapy, a neonatal phototherapeutic irradiator is used for hyperbilirubinemia (an increase in indirect bilirubin).

The device for phototherapy of newborns is used not only in the treatment of jaundice, but also for preventive purposes (if the baby is premature).

Under the influence of light energy, the chemical structure and, accordingly, the physicochemical properties of indirect bilirubin change – it turns into photobilirubin, excreted by liver cells into bile, as well as into biliverdin, dipyrrole or monopyrrole – water-soluble products of bilirubin excreted from the body with urine.

Consequently, with the help of a phototherapy device, the concentration of indirect bilirubin in the blood of a newborn is gradually reduced, which reduces the likelihood of developing encephalopathy (if we are talking about the prevention of newborns).

Distinctive features of the device

The device for phototherapy of newborns is used in maternity and perinatal departments. The latest generation devices are equipped with a timer, which simplifies the care of newborns. The control unit allows you to adjust the flow of light remotely, and this speeds up the process of treating newborns. Features of the installation: high efficiency is ensured over large areas (irradiation zone), the device is equipped with pendant lamps with removable lafones and a control unit. If necessary, an apparatus is installed above the incubator (on a transparent cover) for weakened children, who are better not to be transported.

It is possible to connect the lower plafond (light-emitting diode) to the device. The small size of the device ensures its portability – it is installed near any incubator or beds (cuvettes and plastic structures to support the life of a newborn). The design of the device is convenient for quick work: the flannel envelope has transparent inserts (in the area of ​​the back and sternum) that let light through. It is necessary to protect the child’s eyes only when the radiation is directed from above, the lower exposure does not need additional protective measures.

Indications for phototherapy

Children who need phototherapy are prescribed a full course, after which the newborns undergo a repeated comprehensive clinical, laboratory and instrumental examination. Infants who are at risk of developing hemolytic disease, as well as newborns with a perinatal risk of developing hyperbilirubinemia (such a risk is determined during pregnancy) are subjected to such treatment:

• increase in antibody titer in a woman;
• signs of dropsy of the fetus, which are visible on ultrasound;
• the first blood group of the mother, which increases the likelihood of developing jaundice in the newborn.

Newborns with signs of polyfunctional immaturity and premature babies must undergo a course of phototherapy. Indications are also hemorrhages under the skin (extensive or multiple). Newborns who need resuscitation receive phototherapy in the order prescribed by the doctor. The likelihood of developing hemolytic anemia is a direct indication for phototherapy – for these cases, the full history of the child’s parents is taken into account, which will show how dangerous anemia is for the fetus.

The indication for the treatment procedure of phototherapy is the level of bilirubin in the child’s blood from 50 to 68 µmol/l, which indicates the risk of developing anemia. Conjugational jaundice is the most common reason for a course of phototherapy.

Treatment of neonatal jaundice with phototherapy

In most cases, the need for light therapy is associated with neonatal jaundice. There are several dangerous forms of this disease:

• hemolytic (there is an increased destruction of red blood cells);
• physiological (the hemoglobin system is rebuilt);
• conjugation (the liver has a low binding capacity);
• obstructive (no outflow of bile is produced);
• parenchymal (liver cells are affected by infections and toxins).

The transient form of the disease (physiological) occurs in half of the newborns and manifests itself on the 2nd-3rd day of the child’s life – the changes are associated with an increase in bilirubin in the body of the newborn.

Transient jaundice does not threaten the child, but safe and effective methods are needed for its treatment.

Phototherapy does not cause pain – it is an easy way to reduce the level of indirect bilirubin in the child’s body. This procedure helps in the prevention of liver diseases in a newborn, which cannot cope with a large amount of the substance. In total, the yellowish tint of the skin lasts up to 3 weeks, and with complex treatment up to 2 weeks. The purpose of the procedure allows to reduce the number of replacement plasma transfusions.

Factors affecting the number of procedures

The minimum value of bilirubin is an indication for the first procedure in a newborn (pathological factors act on the child and there is a risk of encephalopathy). The bilirubin index depends on the body weight of the newborn and affects the number of prescribed phototherapy procedures. If the body weight is less than one and a half kilograms, the permissible norm of bilirubin is from 85 to 140 μmol / l. The weight of a child up to 2 kg determines the boundary level of bilirubin – 200 µmol / l. With a weight of more than 2,5 kg, the critical value of this indicator is 295 µmol / l. Averaged indicators can be complicated by concomitant diseases; before the appointment of the procedure, the newborn undergoes a complete examination.

Противопоказания

Not all newborns can receive safe and effective phototherapy. The first and significant contraindication for infants is liver disease and obstructive jaundice. Recent studies have shown that exposure to the rays is dangerous for children with retinal damage (even with protection installed). The testes can be damaged by overexposure to ultraviolet rays. Protection of the eyes and genitals in male infants is mandatory.

Side effects

Side effects occur in more cases when the child has too sensitive skin or the newborn is prone to allergic reactions. Light therapy can cause severe skin rashes after exposure to the rays, and a smaller number of newborns develop copious loose stools. Bronze skin tone can be a rare side effect of phototherapy. Any deviations are associated with the accumulation of bilirubin (its photoisomers) in the child’s body. At the end of treatment or prevention, side effects disappear, and the skin of the newborn quickly recovers.

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