Transepidermal water loss and cerebral hemodynamics in preterm infants: conventional versus LED phototherapy

Abstract

The aim of our study was to evaluate whether high-intensity gallium nitride light-emitting diode (LED) phototherapy (LPT) influences transepidermal water loss (TEWL) and cerebral hemodynamics in preterm neonates in comparison with conventional phototherapy (CPT). Thirty-one preterm infants were randomized for conventional (n = 14) and for LED (n = 17) phototherapy. All infants were studied using a Tewameter TM 210 and cerebral Doppler ultrasound immediately before phototherapy (time 0), 30 min (time 1), 1-6 h (time 2), and 12-24 h (time 3) after the start of phototherapy, and 6-12 h after discontinuing phototherapy (time 4). The study shows that LPT does not induce significant changes in TEWL (time 0: 2.75 +/- 4.71 ml/m(2)/h; time 3: 14.45 +/- 3.68 ml/m(2)/h), in peak systolic, end diastolic and mean cerebral blood flow velocity (CBFV), and in the resistence index (RI). On the contrary, CPT is associated with a significant increase of TEWL (time 0: 13.22 +/- 5.61 ml/m(2)/h; time 3: 20.94 +/- 3.21 ml/m(2)/h), which disappeared at time 4, when phototherapy had stopped. The peak systolic and mean CBFV increased, respectively, from 0.11 +/- 0.03 m/s at time 0 to 0.16 +/- 0.07 m/s at time 3. We conclude that LPT, emitting light within the 450-470-nm spectrum for optimal bilirubin degradation, can be preferable to CPT for the therapy of hyperbilirubinemia in preterm infants.

Effect of phototherapy with turquoise vs. blue LED light of equal irradiance in jaundiced neonates

“…Contrary to phototherapy with fluorescent light, LED light therapy does not cause significant transepidermal water loss, because LEDs emit significantly less infrared radiation (18). During routine care of the infants, the average weight gain was 0.7%, independent of light source.…”

Is the light-emitting diode a better light source than fluorescent tube for phototherapy of neonatal jaundice in preterm infants?

“…Bertini and colleagues showed that conventional phototherapy units result in a significant increase of transepidermal water loss in preterm infants, and this side effect was not observed with LED units. [6] Therefore, regarding better safety and efficacy, LED phototherapy seems to be better than conventional phototherapy with halogen or fluorescent light sources in preterm infants, though further studies are required in this regard.…”

“…There are, however, few available reports comparing the efficacy and safety of LED phototherapy with the conventional devices, only two of them used fluorescent tubes, and the results have been controversial. [6–11] Also, there is no sufficient data for preterm infants in this regard. In this study, we assessed and compared the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia in preterm infants.…”

Efficacy of light‐emitting diode versus other light sources for treatment of neonatal hyperbilirubinemia: a systematic review and meta‐analysis

“…This, in turn, could reduce duration of treatment and length of hospital stay. (12) LED phototherapy does not appear to have a significant effect on transepidermal water loss and cerebral hemodynamics (13). As LED devices utilize direct current power supply (9,10), they do not usually produce any flickering, a phenomenon that could be related to nausea and dizziness in healthcare professionals.…”