349 - Action spectrum of phototherapy in hyperbilirubinemic neonates

Poster Number: 349
Publication Number: 349.123

Finn Ebbesen, Department of Pediatrics, University Hospital of Aalborg, DK 9000 Aalborg, Denmark., DK 9000 Aalborg, Denmark., Nordjylland, Denmark; Mette L. Donneborg, North Denmark Regional Hospital, Hjoerring, Nordjylland, Denmark; Pernille K. Vandborg, Viborg Hospital, Viborg, Midtjylland, Denmark; Hendrik J. Vreman, Stanford University, Los Altos, CA, United States

Background: Phototherapy (PT) with blue light matching the absorption spectrum of the bilirubin-albumin complex in plasma (460 nm) has been standard treatment of neonatal hyperbilirubinemia for decades.

Objective: Aim was clinically to demonstrate the action (efficacy) spectrum of PT in neonates with hyperbilirubinemia, which is the fraction of serum total bilirubin (TSB) removed by light with wavelengths ≥478 nm (blue-green) compared that of light of 452/459 nm (blue).

Design/Methods: Data were collected for three earlier investigations, in which neonates with hyperbilirubinemia were randomized to receive 24 hours of either blue-green (478/490/497 nm) light (intervention groups) of blue (452/459 nm) light (control groups) with equal irradiation and exposed body surface areas. TSB was measured before and after PT. Ratios between the decrease in TSB between intervention- and control groups were calculated.

Results: Efficacy ratios were: 1.31, 1.18 and 1.04, for 478-, 490- and 497 nm, respectively. When they were graphed versus wavelength, the course of the action spectrum is demonstrated. This course increases from 459 nm to maximum at 478 nm, from where it decreases to 1.18 and finally to 1.04.Conclusion(s): For optimal photo-therapeutic treatment neonates need to be treated with light with wavelength some 25 nm longer than presently used.
Table 1. Demographic and clinical data of the neonates included in the 3 randomized controlled trialsa mean ±SD. b median (min, max). NT: Not determined, because the effect of hemoglobin was not fully explored at this point.

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