Infant jaundice: Causes, symptoms, and treatments

BiliLux LED Phototherapy Light System From Dräger

The BiliLux is a compact and lightweight LED phototherapy light system for the treatment of neonatal jaundice. It provides superior phototherapy performance, individualized therapy with electronic documentation capabilities and the flexibility for seamless integration into practically every workplace.

Benefits

Superior phototherapy with even and broad irradiance distribution

​Phototherapy is effectively used for treating neonatal hyperbilirubinemia: The BiliLux phototherapy light has its irradiance peaks in the most effective wavelength range to reduce the bilirubin which is 460-490 nm. By achieving extremely high irradiance levels, the BiliLux fullfills the requirements of the American Academy of Prediatrics (AAP). In addition, the irradiance can be dimmed in 5 steps to provide the adequate therapy for the patient. The phototherapy light features a large surface area to cover full term and premature babies. The irradiance is evenly distributed over the entire mattress to ensure superior phototherapy.

Seamless workplace integration for more flexibility

​The BiliLux phototherapy light was designed for flexible use and seamless integration into the neonatal workplace. The phototherapy light can be placed on an incubator hood, mounted with the spring arm to warming therapy devices or ceiling supplies or used with a trolley. The BiliLux offers the perfect combination for every workplace. To simplify the process, the phototherapy light can be easily locked and unlocked by using the intuitive and safe quick-connect mechanism.

The BiliLux also features a white observation light to observe the baby between phototherapy sessions or to switch white light on during phototherapy to soften blue light.

Designed for a healthy and family-friendly environment

​The family-friendly and compact design saves space around the neonatal workplace while simultaneously providing high irradiances to treat neonatal jaundice. The BiliLux is lightweight for easy handling and storage. And most important: it is soundless to ensure a calm and nuturing atmosphere for the baby, parents and caregivers.

Infection prevention – priority in our development

​Hygiene and infection prevention is an important topic in the neonatal segment: the BiliLux was designed for easy and fast cleaning supported by smooth surfaces. Unlike some other phototherapy devices, the BiliLux does not have any ventilation slots or fans in order to improve infection prevention.

Individualized care and quality management – easy and safe

​The optional BiliLux Radiometer is specifically designed for the phototherapy light and instantly measures the irradiance. By using the radiometer, the correct positioning of the baby under the phototherapy light and the adequate irradiance that the baby receives can be ensured. In addition, each measurement (incl. Date and time) and the phototherapy duration can be stored and downloaded in a phototherapy report e.G. For patient documentation or quality control purposes.

Electronic data transfer – for more efficient workflows

​The phototherapy LED supports the hospital and clinical processes by providing the ability for electronic documentation. The electronic data transfer is much faster and less prone to errors. The work in the NICU becomes more efficient.

Microfluidics Show Promise As Safer, Simpler Treatment Option For Severe Neonatal Jaundice

Research by the Oregon State University College of Engineering has led to a promising potential therapy for neonatal jaundice that's more safe, simple and convenient than the blood transfusions currently given to babies suffering from the most dangerous forms of the condition.

The study led by Adam Higgins, associate professor of bioengineering, suggests microfluidics and high-intensity light can correct a dangerous bloodstream buildup of bilirubin. Bilirubin is the pigment that's responsible for the yellow skin color associated with jaundice and, at high enough levels, puts the afflicted infant at risk of sometimes irreversible neurological damage or even death.

Findings were published in Biomicrofluidics.

Neonatal jaundice is a common condition among newborns, whose bodies are busy breaking down the red blood cells used in the uterus and making new ones as the infant transitions to breathing ambient air once outside the womb.

Blood's red color stems from a protein called hemoglobin that carries oxygen, and as those red blood cells are broken down, the liver modifies hemoglobin into bilirubin. When an infant's immature liver can't keep up with all of the bilirubin it's producing, the pigment leaks into the bloodstream before settling in the skin, causing a yellowish appearance.

About two-thirds of all newborns experience some level of jaundice, typically a mild case. Much of the time it clears up on its own or with minimal treatment, such as getting more water into the infant's body.

Other cases, with higher levels of bilirubin in the blood, can require whole body phototherapy – using light to trigger chemical reactions that result in compounds more easily excreted than bilirubin. And in the most severe cases, rare in the United States but occurring in one birth in a 100 in much of the world, infants need all of their blood replaced by donor blood, twice, in what's known as a double-exchange transfusion – a complicated, labor-intensive and relatively risky procedure.

The Oregon State research aims to provide a simpler and safer alternative: treating the patient's blood by circulating it through an external device known as a microfluidic photoreactor.

Microfluidics is the study of how fluids behave as they travel through or are confined in microminiaturized devices equipped with channels and chambers. Surface forces as opposed to volumetric forces dominate fluids at the microscale, meaning fluids act much differently there than what is observed in everyday life.

Using human blood in a laboratory setting and also using a rat model, Higgins and collaborators at the College of Engineering, Oregon Health & Science University and the University of Washington studied the effect of LED light on extremely bilirubin-rich blood pumped through microfluidic photoreactors. The light-catalyzed reaction they looked at is the same as the one enabled by whole-body phototherapy, but the bilirubin in the blood is targeted directly, making for greater efficiency.

"The findings demonstrate that high-intensity light at a wavelength of 470 nanometers can be used to quickly reduce bilirubin levels without causing any appreciable damage to the blood cells' DNA," Higgins said. "Our work with Gunn rats showed that photoreactor treatment for four hours significantly pared down bilirubin levels – similar to the kind of bilirubin reduction seen in exchange transfusion and on a similar time scale. The mathematical model we developed suggests this new treatment approach that we tested at lab scale will perform better than exchange transfusion at the clinical scale, and it requires no donor blood."

Next steps, Higgins said, involve scaling up the device used with the Gunn rats so it will work on newborn humans, who are roughly 10 times larger, and measuring blood DNA damage in a preclinical animal model, such as the rhesus monkey, that can more closely replicate human neonatal jaundice.

"But overall, it looks like further development of the photoreactor technology can potentially bring a promising new approach for treating extremely high levels of bilirubin in newborns' blood," he said.

Working with Higgins were John Lahmann, Ryan Faase, Hsuan Yu Leu, Kate Schilke and Joe Baio of the College of Engineering, Steve Jacques of the University of Washington and Brian Scottoline of Oregon Health & Science University.

The Oregon State University Venture Development Fund, the M.J. Murdock Charitable Trust and the National Institutes of Health supported this research.

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