Introduction: Neonatal jaundice is common, especially in premature infants. Compliance treat-
ment protocols with standard serum bilirubin curves force the clinician to separate the child
from the mother after birth for phototherapy. The objective of this study is to evaluate the
effectiveness and safety of two innovative devices for phototherapy including a LED light
mesh: one sleeping bag and one blanket compared to conventional hospital or ambulatory
phototherapy.
Methods: Two randomised clinical trials were conducted: one with newborns >2000 g at birth
in the Neonatal Care Unit and the other with premature infants followed-up in an outpatient
Kangaroo Mother Care (KMC) programme. The gold standard for bilirubin measurement was
serum bilirubin, and ambulatory controls were performed with the Bilicheck®. Parents and
health personnel completed a questionnaire on comfort and perceptions.
Results: In the study using the bag, a linear regression was performed for the decrease in
bilirubin in mg/dL/h, controlling by early jaundice (<36 h) and the device type. The results were
similar between the two devices. For the blanket trial in the KMC programme, the decrease in
bilirubin levels with the new device was significantly greater. No differences in temperatures,
duration of phototherapy, re-admission, mortality, or side effects for both trials were found.
Parents and staff satisfaction with the two devices was identical for the two trials.safety in Phototherapy analyzer
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SAFETY CONCERNlllSafety and security and ways to use them
1. SAFETY CONCERNS
• Risk of eye and skin damage
• Effect of phototherapy on newborns’ retina
• Eye and skin protection
• Equipment check every 12 hours
• Risk of falls
• Use windows for baby care
• Patients’ education
• Hyperthermia and hypothermia
• Vital signs check every 4 hours
4. SAFETY: hypo- or hyperthermia
• Check the baby’s temperature every 4 hours
• Adjust isolette temperature settings according to baby’s temperature
Notas del editor
A study revealed that, one of the complications of the phototherapy is that it causes degeneration of the retina through exposure to light (Silva, 2008). Therefore, it is very important to provide eye and skin protection. The lights intensity has to be checked every twelve hours using a bili meter at the level of baby’s skin to prevent skin damage. Another risk for newborns’ safety is a risk of falls. Mothers have to be educated regarding isolette safety. All the equipment has to be checked every shift. Isolettes’ temperature settings have to be monitored and baby’s temperature checked every four hours to prevent hyper- and hypothermia in newborns in isolettes.
Eyes should be protected by eye mask and genitals should be protected by diaper at all times when baby is under lights.
Educate patients about the risk of falls. Teach them to care for the baby using isolette windows and to open isolette door only if in the case of an emergency. Provide handouts with pictures. Demonstrate how to use isolette and ask patients to teach back.
