PHOTOTHERAPHY

PHOTOTHERAPHY

DEFINITION

          Phototheraphy is use of flouroscent light for breakdown of bilirubin.

MEANING

          Phototheraphy is the use of the flouroscent light on the infant exposed skin to convert the bilirubin into colourless nontoxic water soluble bilirubin. It is the main treatment for uncongugated hyper bilirubinemia.

MECHANISM OF ACTION

Ø      Phototheraphy acts by oxidizing the bilirubin

Ø      Converting the uncongugated bilirubin to more soluble form of bilirubin by photo isomerism

Ø      Converting the bilirubin to lumirubin, which is non toxic water soluble bilirubin which excreted through bile and urine.

TECHNIQUE

          Bilirubin absorbs light maximally in the blue range light of 420-500 nm, but blue lamps needs observations of the skin and cause. Headache and Nausea. Hence the combination of blue and white lamps are preferred. A unit with four special blue and four daylights will give effective irradiance.

INDICATIONS

          It is used in newborn to decrease the bilirubin level in Jaundiced newborn.

COMPLICATIONS

Ø      Hyperpyrexia

Ø      Dehydration

Ø      Irritability

Ø      Transient skin rash

MANAGEMENTS

Ø      Neonate’s clothing is removed, eyes are covered with the eye cover

Ø      The infant is frequently turned to expose the skin of the whole body to have maximum effect of photo theraphy.

Ø      Lights are positioned 50cm to 75cm. Higher from the infant. The shadow on the infant is prevented.

Ø      The infant should be given slightly more fluids than the requirement because the fluid is lost due to overheating, exposure, and loose stools. The stools may be Green

Ø      Body temperature should be monitored frequently and maintained within N limits

Ø      Hydration states should be maintained

Ø      Blood levels of bilirubin and haemoglobin must be monitored

Ø      Phototheraphy may be used for two to three days. A slight increase may be seen after withdrawal of the phototherapy. Why?