Background: blue light with peak emission near 460nm is the first choice for the treatment of neonatal high gallbladder disease.
However, studies using fluorescent tubes suggest that turquoise light with peak emission at 490nm may be more effective.
At present, the main light source for light therapy is the light emitting diode (LEDs).
Therefore, the purpose of this study is to compare bilirubin-
The reduction effect of jaundice newborns treated with turquoise or blue LED light, with peak emission of 497 or 459 nm, respectively, has the same irradiance for infants.
Methods: children with gestational age ≥ 33 weeks and high gallbladder without complications were randomly divided into blue-green or blue LED lights for 24 hours.
The average irradiance footprint at the skin level is 5. 2u2009×u20091015 and 5.
1x1015 photon/cm 2/s. Results:Forty-
Six infants were exposed to turquoise light and 45 infants received blue light. The median (
95% confidence intervals)
Serum total bilirubin decreased by 35. 3% (32. 5; 37. 3)and 33. 1% (27. 1; 36. 8)
Babies treated with turquoise and blue light respectively.
No significant difference (P = 0. 53).
This decline was positively correlated with the age of birth and negatively correlated with the birth weight.
Conclusion: LED lights with the same irradiance, turquoise and blue light have the same bilirubin-
Reduce the effect of high jaundice in newborns.
The babies received the study from January 1-20, 2013 to December 31 in the neonatal intensive care unit at the University Hospital of orburg.
The inclusion criteria were healthy newborns with no complications of bilirubin, gestational age ≥ 33 weeks, birth weight ≥ 1,800g, birth age> 24 h and ≤ 28 d,
Due to the risk of low body temperature at low weight, the lower limit of birth weight is set to 1,800 μg.
Indications for light therapy follow regional guidelines ().
It does not include infants with severe treatment of double light or blood exchange indications.
The neonatal specialist in charge registers and assigns the patient to their group.
The opaque envelope sealed by the baby is randomly assigned to turquoise or blue light.
Randomization was balanced in groups of 2, 4 or 6 infants.
The light therapy device is placed above the baby.
In addition to eye pads and diapers, all infants are exposed to continuous light therapy for 24 hours, with 30 minutes of feeding and care interrupted every 3 hours.
A previous study has shown that, through this practice, infants receive treatment for an average of 85% of the time ().
Refer to a 24-
H. Reduction of TSB in previous studies ()
, The sample size was calculated to demonstrate that the difference in TSB decline between the two groups after 24 hours of light therapy was 6%, which was judged as clinically relevant.
Determine the significance level of 0.
05 and power 0.
8. The required sample size should be at least 36 infants in each group.
Hundreds of babies are eligible for the study.
Parents of six babies refused to attend.
As a result, 98 infants were randomly grouped, 50 infants were randomly grouped, and 48 infants were randomly grouped.
Two babies from the turquoise group withdrew from the study: one was due to the high TSB at the beginning of the light therapy (TSB)
It is also suspected that ABO isosolemia requires double light treatment, and the other is due to communication with the mother.
In addition, two infants were excluded: one for liver disease and the other for failure to draw blood.
In the Blu-ray group, due to the high TSB, ABO isodissoluble was suspected, one infant withdrew from the study, and two infants were excluded from the failure of blood collection.
The study therefore included 46 infants receiving turquoise light and 45 infants receiving blue light.
TSB in capillary serum extracted by heel prick at the beginning of light therapy and 24 hours after treatment (TSB)
Determination of heavy nitrogen-
The method of using Cobas 8000 (
Roche Diagnostics International, Mannheim, Germany)().
The inaccuracy expressed by the coefficient of variation is 3. 0 and 1.
At the TSB levels of 4% and 176 mol/l, respectively, 333.
The external quality assessment showed that the deviation was less than 5% during the time interval of 10-1,000 mol/l.
The light therapy equipment is produced by an author (H. J. V. )
Each consists of an open aluminum corner clamp with five T8 tubes (60u2009×u20092. 5u2009cm)
Each contains 9 equal spacing 3-W LEDs.
LED tube and external driver (60u2009W)
Provided by bright LED (Canoga Park, California.
The geometry of the two lighting systems is the same.
Photons are fundamental particles of light.
However, not all photons are the same because they can have different levels of energy depending on their wavelength (color).
For example, the blue photon of 459 nm has more energy than the turquoise photon of 497nm.
Therefore, exposure to each photon leads to a different structure
Change the reaction to a specific molecule, such as bilirubin.
Because we want to determine the effect of light of different colors on bilirubin conversion rate, we measure the number of photons in each color and therefore the number of photons with different energies (459 or 497u2009nm).
This measurement of the irradiance rate is slightly different (
Ratio through their wavelength)
Bedside measurements of irradiance are performed depending on the total energy transmitted, such as w/cm or w/cm/nm.
Because the photon injection rate (irradiance)
The turquoise LEDs are lower than the blue LEDs, the distance from the physiotherapy light to the mattress is adjusted to 31 cm of the turquoise LEDs and 37 cm of the Blu-ray LEDs, so, the average light irradiance of the two groups of skin levels is the same.
This means that the distance between turquoise and blue light from the lamp to the baby\'s abdominal skin is 23 and 29 cm, respectively.
In practice, the distance between the lamp and the baby\'s skin is adjusted with a properly sized wooden stick.
Measuring the flux density of photons using a spectrometer (Model 2000+;
Marine Optics, Dunedin, FL)
, With n constant spectral sensitivity in the range of 200-1,100 nm.
According to the average height on the exposed baby skin mattress, the irradiation is 8 cm higher than the mattress level.
These measurements were carried out in the light footprint of measuring 28 × 49 × cm, consisting of 4 × 7 = 28 squares of 7 × cm.
The average irradiance of the footprint is 5. 2u2009×u200910 and 5.
At the beginning of the study, 1 × 10 photons/CM/sec of turquoise and blue light were measured, respectively.
The range is from 3. 6u2009×u200910 to 5.
There was no significant change in irradiance during the study.
In addition, the irradiance of blue light is transmitted through the handheld clinical radiometer neoBLUE (
Natus Medical, San Carlos, California)
And BiliBlanket instrument II (
General Electric Medical Technology (WI).
The features of the turquoise and blue LED LED Light module
sources are shown.
The study was approved by the Biomedical Research Ethics Committee of the Northern eutland region of Denmark.
Verbal and written informed consent from parents was obtained.
The study was registered at the clinical trial registry numbered NCT 02154165.
Fisher\'s precise test of the join table was used to test the significant difference in the intermediate values between the two groups. The two-by-
By calculating the overall median for the whole study group, and then calculating the number of infants with a decrease below or above the overall median decrease for each treatment group, two tables were obtained.
To calculate the confidence intervals of each set of intermediaries, we apply an approximation based on the number of binomial distributions implemented in the R-functionpackage .
To further study the effect of turquoise light compared to blue light, a simple linear regression was performed [TSB (%)]
As a reaction and light source, TSB, gestational age, birth weight, birth age, and the number of infant formula milk powder are used as explanatory variables.
Each explanatory variable is then included in a multi-linear model with the same response.
A QQ confirmed the normal assumption.
Figure of residual value.
Statistics software program R for all analysis (version 3. 1. 2)was used.
The significance level is set to ≤ 0. 05.
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