Let there be light—but should there be less?

Recent advances in the management of neonatal jaundice

“…58 One caveat to this approach is that the irradiance in the earlier Eunice Kennedy Shriver National Institute of Child Health and Human Development study from the 1970s was presumably low. [73][74][75] As a result, intermittent or cycled, as opposed to continuous, phototherapy is being given consideration as a potential alternative treatment strategy in the extremely low birth weight neonate. 73,75 exchange transfusion…”

“…[73][74][75] As a result, intermittent or cycled, as opposed to continuous, phototherapy is being given consideration as a potential alternative treatment strategy in the extremely low birth weight neonate. 73,75 exchange transfusion…”

Uniform national guidelines do not prevent wide variations in the clinical application of phototherapy for neonatal jaundice

“…Another argument for more frequent TSB follow‐up during phototherapy would be to keep the duration of phototherapy short. In studies that have shown that phototherapy could be toxic, the determining factor was the duration of phototherapy, not irradiance . Other reasons for limiting the duration of phototherapy are to increase the parents’ interactions with the baby, as well as making nursing access and observations less cumbersome.…”

“…Some NICUs used more than one type of device. All NICUs, except one, had a schedule for maintaining their phototherapy units: 19 NICUs carried these out every year and one did so every five years.…”

Phototherapy in the neonatal intensive care unit – quantity and quality

“…It should also be noted that infants in the aggressive PT group received, on average, 88 hours of PT compared with only 35 hours in the conservative group. DNA damage is linearly related to the duration of PT , and Hansen has suggested that the increased duration of PT could be a key factor leading to the increase in mortality . If duration is, indeed, an important risk factor, it can potentially be reduced by as much as 75% using intermittent or cycled PT which might be effective in controlling TSB levels in ELBW infants .…”