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Firmino F. Rubaltelli - One of the best experts on this subject based on the ideXlab platform.
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Transepidermal water loss and cerebral hemodynamics in preterm infants: Conventional versus LED phototherapy
European Journal of Pediatrics, 2008Co-Authors: Giovanni Bertini, Silvia Perugi, Simone Pratesi, Carlo Dani, Serena Elia, Firmino F. RubaltelliAbstract: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.
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Fiberoptic and conventional phototherapy effects on the skin of premature infants
Journal of Pediatrics, 2001Co-Authors: Carlo Dani, Elena Martelli, Maria Francesca Reali, Giorgio Panin, Giovanni Bertini, Firmino F. RubaltelliAbstract:To evaluate the effects of conventional phototherapy and fiberoptic phototherapy on trans-epidermal water loss in preterm infants with and without skin ointment application, 20 infants were randomly assigned to receive conventional or fiberoptic phototherapy for non-hemolytic hyperbilirubinemia. After conventional phototherapy, there were no significant differences in trans-epidermal water loss between ointment-treated and untreated areas. After fiberoptic phototherapy, trans-epidermal water loss significantly increased from ointment-treated and untreated areas, but the increase was less in treated areas.
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Fiber-optic Phototherapy Changes in Mesenteric Blood Flow Response to Feeding: Conventional Versus Changes in Mesenteric Blood Flow Response to Feeding: Conventional Versus Fiber-optic Phototherapy
Pediatrics, 2000Co-Authors: Firmino F Rubaltelli Marco Pezzati, Roberto Biagiotti, Venturella Vangi, Marco Pezzati, Lisa Wiechmann, Enrico Lombardi, Firmino F. RubaltelliAbstract:Objective. To evaluate whether fiber-optic phototherapy influences the postprandial increase in mesenteric blood flow velocity similarly to conven-tional phototherapy in preterm infants. Patients and Methods. With the use of Doppler color ultrasonography, blood flow velocity in the superior mesenteric artery was measured both preprandially and postprandially in 19 preterm infants during and after conventional phototherapy, and in 20 preterm infants during and after fiber-optic phototherapy. The mean ar-terial blood pressure/mean flow velocity ratio was calcu-lated as an estimate of relative vascular resistance of the superior mesenteric artery. Results. The study shows that conventional photo-therapy blunts the postprandial mesenteric blood flow response to feeding in preterm infants. Furthermore, it shows that the postprandial increase in intestinal blood flow is not attenuated when fiber-optic phototherapy is administered, and that such postprandial increase of blood flow is significantly greater than in infants receiv-ing conventional phototherapy. During and after fiber-optic phototherapy, a significant reduction in postpran-dial relative vascular resistance was found; such reduction was significantly greater than during conven-tional phototherapy. Conclusions. Fiber-optic phototherapy is prefera-ble to conventional phototherapy for the treatment of hyperbilirubinemia in preterm infants because it does not affect the physiologic postprandial redistribution of blood flow from the periphery to the gastrointesti-nal system as does conventional phototherapy. Pediatrics 2000;105:350 –353; conventional photother-apy, fiber-optic phototherapy, mesenteric blood flow velocity, newborn. ABBREVIATIONS. SMA, superior mesenteric artery; BFV, blood flow velocity; PT, phototherapy; FO-PT, fiber-optic phototherapy; CPT, conventional phototherapy; EDV, end-diastolic velocity; MV, mean velocity; RVR, relative vascular resistance. D oppler ultrasonography is the method cur-rently used for the clinical assessment of ve-locity and volume of superior mesenteric ar-tery (SMA) blood flow. 1–5 Recently, several reports have shown that enteral feeding induces a significant and progressive increase in blood flow velocity (BFV) in the SMA that peaks 30 to 45 minutes after the meal. 5–12 Oh et al 13 have shown that infants re-ceiving phototherapy (PT) present an increase in pe-ripheral blood flow with changes in body tempera-ture and Yao et al 14 have shown that PT blunts the postprandial mesenteric blood flow response to feed-ing in full-term infants. The changes in blood flow distribution are probably because of the fact that PT induces peripheral vasodilation. 14 In the last few years a new device, the fiber-optic phototherapy (FO-PT) apparatus, has been introduced into neona-tal care. We hypothesized that this kind of PT, by using cold light and irradiating a minimal quantity of ultraviolet and infrared rays, 15 would not induce peripheral vasodilation as does conventional photo-therapy (CPT). Consequently, we hypothesized that FO-PT would not induce significant alterations on pre-and postprandial intestinal blood flow. Color Doppler ultrasonography was used in this study to evaluate whether FO-PT influences the postprandial increase in mesenteric BFV similarly to CPT in pre-term infants.
Hendrik J Vreman - One of the best experts on this subject based on the ideXlab platform.
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A Randomized Trial of Phototherapy with Filtered Sunlight in African Neonates
New England Journal of Medicine, 2015Co-Authors: Tina M Slusher, RONALD J WONG, Hendrik J Vreman, Ann M Brearley, Yvonne E Vaucher, Troy Lund, Bolajoko O Olusanya, A. Emokpae, David K StevensonAbstract:BACKGROUND Sequelae of severe neonatal hyperbilirubinemia constitute a substantial disease burden in areas where effective conventional phototherapy is unavailable. We previously found that the use of filtered sunlight for the purpose of phototherapy is a safe and efficacious method for reducing total bilirubin. However, its relative safety and efficacy as compared with conventional phototherapy are unknown. METHODS We conducted a randomized, controlled noninferiority trial in which filtered sunlight was compared with conventional phototherapy for the treatment of hyperbilirubinemia in term and late-preterm neonates in a large, urban Nigerian maternity hospital. The primary end point was efficacy, which was defined as a rate of increase in total serum bilirubin of less than 0.2 mg per deciliter per hour for infants up to 72 hours of age or a decrease in total serum bilirubin for infants older than 72 hours of age who received at least 5 hours of phototherapy; we prespecified a noninferiority margin of 10% for the difference in efficacy rates between groups. The need for an exchange transfusion was a secondary end point. We also assessed safety, which was defined as the absence of the need to withdraw therapy because of hyperthermia, hypothermia, dehydration, or sunburn. RESULTS We enrolled 447 infants and randomly assigned 224 to filtered sunlight and 223 to conventional phototherapy. Filtered sunlight was efficacious on 93% of treatment days that could be evaluated, as compared with 90% for conventional phototherapy, and had a higher mean level of irradiance (40 vs. 17 μW per square centimeter per nanometer, P
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The Need to Implement Effective Phototherapy in Resource-Constrained Settings
Seminars in Perinatology, 2011Co-Authors: Vinod K Bhutani, Benjamin K. Cline, Krista M. Donaldson, Hendrik J VremanAbstract:Phototherapy is the treatment of choice to reduce the severity of neonatal unconjugated hyperbilirubinemia regardless of its etiology. Its implementation requires a technical framework that conforms to existing evidence-based guidelines that promote its safer and effective use worldwide. Optimal use of phototherapy has been defined by specific ranges of total serum bilirubin thresholds configured to an infant's postnatal age (in hours) and potential risk for bilirubin neurotoxicity. Effective phototherapy implies its use at specific blue light wavelengths (peak emission, 450 ?? 20 nm) and emission spectrum (range, 400-520 nm), preferably in a narrow bandwidth that is delivered at an irradiance of ??30 ??W/cm 2/nm to up to 80% of an infant's body surface area. However, this is often not feasible in clinical settings with limited or constrained resources. To identify and bridge implementation barriers, we propose minimum criteria for device performance for safe and practical use of phototherapy as a prophylactic intervention to prevent severe hyperbilirubinemia. ?? 2011 Elsevier Inc.
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Phototherapy: current methods and future directions. [Review] [47 refs]
Seminars in Perinatology, 2004Co-Authors: Hendrik J Vreman, RONALD J WONG, David K StevensonAbstract:Phototherapy is the most common therapeutic intervention used for the treatment of hyperbilirubinemia. Although it has become a mainstay since its introduction in 1958, a better understanding of the photobiology of bilirubin, characteristics of the phototherapy devices, the efficacy and safety considerations of phototherapy applications, and improvements in spectroradiometers and phototherapy devices are necessary for more predictable and improved clinical practices and outcomes. A step forward in instituting consistent, uniform, and effective use of phototherapy is the recent American Academy of Pediatrics clinical guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, which outlines a clinical strategy for the diagnosis of hyperbilirubinemia and contains direct recommendations for the application of phototherapy. This article reviews the parameters that determine the efficacy of phototherapy, briefly discusses current devices and methods used to deliver phototherapy, and speculates on future directions and studies that are still needed to complement our presently incomplete knowledge of the facets of this common mode of therapy. [References: 47]
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Phototherapy: Current methods and future directions
Seminars in Perinatology, 2004Co-Authors: Hendrik J Vreman, RONALD J WONG, David K StevensonAbstract:Phototherapy is the most common therapeutic intervention used for the treatment of hyperbilirubinemia. Although it has become a mainstay since its introduction in 1958, a better understanding of the photobiology of bilirubin, characteristics of the phototherapy devices, the efficacy and safety considerations of phototherapy applications, and improvements in spectroradiometers and phototherapy devices are necessary for more predictable and improved clinical practices and outcomes. A step forward in instituting consistent, uniform, and effective use of phototherapy is the recent American Academy of Pediatrics clinical guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, which outlines a clinical strategy for the diagnosis of hyperbilirubinemia and contains direct recommendations for the application of phototherapy. This article reviews the parameters that determine the efficacy of phototherapy, briefly discusses current devices and methods used to deliver phototherapy, and speculates on future directions and studies that are still needed to complement our presently incomplete knowledge of the facets of this common mode of therapy. ?? 2004 Elsevier Inc. All rights reserved.
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Light-Emitting Diodes: A Novel Light Source for Phototherapy
Pediatric Research, 1998Co-Authors: Hendrik J Vreman, RONALD J WONG, SIDNEY D READER, R. K. Route, Martin M. Fejer, Rena Gale, David K Stevenson, DANIEL S SEIDMANAbstract:High intensity light-emitting diodes (LEDs) are being studied as possible light sources for the phototherapy of hyperbilirubinemic neonates. These power-efficient, low heat-producing light sources have the potential to deliver high intensity light of narrow wavelength band in the blue-green portion of the visible light spectrum, which overlaps the absorption spectrum of bilirubin (BR). We compared the efficacy between single LEDs of different color and then constructed a prototype phototherapy device using 300 blue LEDs. The efficacy of this device was compared with that of conventional phototherapy devices by measuring the in vitro photodegradation of BR in human serum albumin. When blue, blue-green, green, and white LEDs were compared, the blue light was the most effective in degrading BR by 28% of dark control, followed by blue-green (18% of control), and then white light (14% of control). Green light was the least effective (11% of control). The prototype device with three focused arrays, each with 100 blue LEDs, generated greater irradiance (>200 [micro]W[middle dot]cm-2[middle dot]nm-1) than any of the conventional devices tested. It also supported the greatest rate of BR photodegradation. We conclude that light from LEDs should be considered a more effective treatment for hyperbilirubinemia than light from presently used phototherapy devices. Furthermore, the unique characteristics of this light source may make it especially suitable for use in safe and lightweight home phototherapy devices. (C) International Pediatrics Research Foundation, Inc. 1998. All Rights Reserved.
David K Stevenson - One of the best experts on this subject based on the ideXlab platform.
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A Randomized Trial of Phototherapy with Filtered Sunlight in African Neonates
New England Journal of Medicine, 2015Co-Authors: Tina M Slusher, RONALD J WONG, Hendrik J Vreman, Ann M Brearley, Yvonne E Vaucher, Troy Lund, Bolajoko O Olusanya, A. Emokpae, David K StevensonAbstract:BACKGROUND Sequelae of severe neonatal hyperbilirubinemia constitute a substantial disease burden in areas where effective conventional phototherapy is unavailable. We previously found that the use of filtered sunlight for the purpose of phototherapy is a safe and efficacious method for reducing total bilirubin. However, its relative safety and efficacy as compared with conventional phototherapy are unknown. METHODS We conducted a randomized, controlled noninferiority trial in which filtered sunlight was compared with conventional phototherapy for the treatment of hyperbilirubinemia in term and late-preterm neonates in a large, urban Nigerian maternity hospital. The primary end point was efficacy, which was defined as a rate of increase in total serum bilirubin of less than 0.2 mg per deciliter per hour for infants up to 72 hours of age or a decrease in total serum bilirubin for infants older than 72 hours of age who received at least 5 hours of phototherapy; we prespecified a noninferiority margin of 10% for the difference in efficacy rates between groups. The need for an exchange transfusion was a secondary end point. We also assessed safety, which was defined as the absence of the need to withdraw therapy because of hyperthermia, hypothermia, dehydration, or sunburn. RESULTS We enrolled 447 infants and randomly assigned 224 to filtered sunlight and 223 to conventional phototherapy. Filtered sunlight was efficacious on 93% of treatment days that could be evaluated, as compared with 90% for conventional phototherapy, and had a higher mean level of irradiance (40 vs. 17 μW per square centimeter per nanometer, P
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Phototherapy: current methods and future directions. [Review] [47 refs]
Seminars in Perinatology, 2004Co-Authors: Hendrik J Vreman, RONALD J WONG, David K StevensonAbstract:Phototherapy is the most common therapeutic intervention used for the treatment of hyperbilirubinemia. Although it has become a mainstay since its introduction in 1958, a better understanding of the photobiology of bilirubin, characteristics of the phototherapy devices, the efficacy and safety considerations of phototherapy applications, and improvements in spectroradiometers and phototherapy devices are necessary for more predictable and improved clinical practices and outcomes. A step forward in instituting consistent, uniform, and effective use of phototherapy is the recent American Academy of Pediatrics clinical guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, which outlines a clinical strategy for the diagnosis of hyperbilirubinemia and contains direct recommendations for the application of phototherapy. This article reviews the parameters that determine the efficacy of phototherapy, briefly discusses current devices and methods used to deliver phototherapy, and speculates on future directions and studies that are still needed to complement our presently incomplete knowledge of the facets of this common mode of therapy. [References: 47]
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Phototherapy: Current methods and future directions
Seminars in Perinatology, 2004Co-Authors: Hendrik J Vreman, RONALD J WONG, David K StevensonAbstract:Phototherapy is the most common therapeutic intervention used for the treatment of hyperbilirubinemia. Although it has become a mainstay since its introduction in 1958, a better understanding of the photobiology of bilirubin, characteristics of the phototherapy devices, the efficacy and safety considerations of phototherapy applications, and improvements in spectroradiometers and phototherapy devices are necessary for more predictable and improved clinical practices and outcomes. A step forward in instituting consistent, uniform, and effective use of phototherapy is the recent American Academy of Pediatrics clinical guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, which outlines a clinical strategy for the diagnosis of hyperbilirubinemia and contains direct recommendations for the application of phototherapy. This article reviews the parameters that determine the efficacy of phototherapy, briefly discusses current devices and methods used to deliver phototherapy, and speculates on future directions and studies that are still needed to complement our presently incomplete knowledge of the facets of this common mode of therapy. ?? 2004 Elsevier Inc. All rights reserved.
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Light-Emitting Diodes: A Novel Light Source for Phototherapy
Pediatric Research, 1998Co-Authors: Hendrik J Vreman, RONALD J WONG, SIDNEY D READER, R. K. Route, Martin M. Fejer, Rena Gale, David K Stevenson, DANIEL S SEIDMANAbstract:High intensity light-emitting diodes (LEDs) are being studied as possible light sources for the phototherapy of hyperbilirubinemic neonates. These power-efficient, low heat-producing light sources have the potential to deliver high intensity light of narrow wavelength band in the blue-green portion of the visible light spectrum, which overlaps the absorption spectrum of bilirubin (BR). We compared the efficacy between single LEDs of different color and then constructed a prototype phototherapy device using 300 blue LEDs. The efficacy of this device was compared with that of conventional phototherapy devices by measuring the in vitro photodegradation of BR in human serum albumin. When blue, blue-green, green, and white LEDs were compared, the blue light was the most effective in degrading BR by 28% of dark control, followed by blue-green (18% of control), and then white light (14% of control). Green light was the least effective (11% of control). The prototype device with three focused arrays, each with 100 blue LEDs, generated greater irradiance (>200 [micro]W[middle dot]cm-2[middle dot]nm-1) than any of the conventional devices tested. It also supported the greatest rate of BR photodegradation. We conclude that light from LEDs should be considered a more effective treatment for hyperbilirubinemia than light from presently used phototherapy devices. Furthermore, the unique characteristics of this light source may make it especially suitable for use in safe and lightweight home phototherapy devices. (C) International Pediatrics Research Foundation, Inc. 1998. All Rights Reserved.
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Effect of phototherapy for neonatal jaundice on cognitive performance.
Journal of perinatology : official journal of the California Perinatal Association, 1994Co-Authors: DANIEL S SEIDMAN, Ido Paz, Y L Danon, Arie Laor, David K Stevenson, RE GaleAbstract:Phototherapy for neonatal hyperbilirubinemia was introduced to our medical center in March 1971. To assess the influence of phototherapy on subsequent cognitive outcome, we compared the intelligence test scores at 17 years of age of subjects born 4 months before and 10 months after the introduction of phototherapy. The intelligence quotient score (mean +/- SE) at 17 years for 84 subjects with severe neonatal hyperbilirubinemia was 108 +/- 2 for those treated by phototherapy and 107 +/- 2 for controls matched for gestational age and birth weight. The confounding effect on intelligence quotient scores of perinatal factors (bilirubin concentrations, gestational age, birth weight, Apgar score) and demographic characteristics (ethnic origin, socioeconomic status, paternal education) was taken into account in a multiple logistic regression analysis by using a General Linear Models procedure. Phototherapy was found to have no independent effect on intelligence quotient scores after adjustment for the effect of confounding factors. We conclude that for full-term newborn infants with neonatal hyperbilirubinemia, phototherapy had neither a beneficial nor an adverse effect on intellectual ability in late adolescence.
Carlo Dani - One of the best experts on this subject based on the ideXlab platform.
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Broad-Spectrum Light versus Blue Light for Phototherapy in Neonatal Hyperbilirubinemia: A Randomized Controlled Trial.
American journal of perinatology, 2015Co-Authors: Simone Pratesi, Cecilia Bresci, Shahar Bar, Corrado Di Natale, Sandra Di Fabio, Carlo DaniAbstract:Phototherapy is standard care for treatment of neonatal hyperbilirubinemia. Our aim was to compare the effectiveness of broad-spectrum light (BSL) to that of blue light emitting diodes (LED) phototherapy for the treatment of jaundiced late preterm and term infants. Infants with gestational age from 35(+0) to 41(+6) weeks of gestation and nonhemolytic hyperbilirubinemia were randomized to treatment with BSL phototherapy or blue LED phototherapy. A total of 20 infants were included in the blue LED phototherapy group and 20 in the BSL phototherapy group. The duration of phototherapy was lower in the BSL than in the blue LED phototherapy group (15.8 ± 4.9 vs. 20.6 ± 6.0 hours; p = 0.009), and infants in the former group had a lower probability (p = 0.015) of remaining in phototherapy than infants in the latter. We concluded that BSL phototherapy is more effective than blue LED phototherapy for the treatment of hyperbilirubinemia in late preterm and term infants. Our data suggest that these results are not due to the different irradiance of the two phototherapy systems, but probably depend on their different peak light emissions.
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Transepidermal water loss and cerebral hemodynamics in preterm infants: Conventional versus LED phototherapy
European Journal of Pediatrics, 2008Co-Authors: Giovanni Bertini, Silvia Perugi, Simone Pratesi, Carlo Dani, Serena Elia, Firmino F. RubaltelliAbstract: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.
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Fiberoptic and conventional phototherapy effects on the skin of premature infants
Journal of Pediatrics, 2001Co-Authors: Carlo Dani, Elena Martelli, Maria Francesca Reali, Giorgio Panin, Giovanni Bertini, Firmino F. RubaltelliAbstract:To evaluate the effects of conventional phototherapy and fiberoptic phototherapy on trans-epidermal water loss in preterm infants with and without skin ointment application, 20 infants were randomly assigned to receive conventional or fiberoptic phototherapy for non-hemolytic hyperbilirubinemia. After conventional phototherapy, there were no significant differences in trans-epidermal water loss between ointment-treated and untreated areas. After fiberoptic phototherapy, trans-epidermal water loss significantly increased from ointment-treated and untreated areas, but the increase was less in treated areas.
Firmino F Rubaltelli Marco Pezzati - One of the best experts on this subject based on the ideXlab platform.
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Fiber-optic Phototherapy Changes in Mesenteric Blood Flow Response to Feeding: Conventional Versus Changes in Mesenteric Blood Flow Response to Feeding: Conventional Versus Fiber-optic Phototherapy
Pediatrics, 2000Co-Authors: Firmino F Rubaltelli Marco Pezzati, Roberto Biagiotti, Venturella Vangi, Marco Pezzati, Lisa Wiechmann, Enrico Lombardi, Firmino F. RubaltelliAbstract:Objective. To evaluate whether fiber-optic phototherapy influences the postprandial increase in mesenteric blood flow velocity similarly to conven-tional phototherapy in preterm infants. Patients and Methods. With the use of Doppler color ultrasonography, blood flow velocity in the superior mesenteric artery was measured both preprandially and postprandially in 19 preterm infants during and after conventional phototherapy, and in 20 preterm infants during and after fiber-optic phototherapy. The mean ar-terial blood pressure/mean flow velocity ratio was calcu-lated as an estimate of relative vascular resistance of the superior mesenteric artery. Results. The study shows that conventional photo-therapy blunts the postprandial mesenteric blood flow response to feeding in preterm infants. Furthermore, it shows that the postprandial increase in intestinal blood flow is not attenuated when fiber-optic phototherapy is administered, and that such postprandial increase of blood flow is significantly greater than in infants receiv-ing conventional phototherapy. During and after fiber-optic phototherapy, a significant reduction in postpran-dial relative vascular resistance was found; such reduction was significantly greater than during conven-tional phototherapy. Conclusions. Fiber-optic phototherapy is prefera-ble to conventional phototherapy for the treatment of hyperbilirubinemia in preterm infants because it does not affect the physiologic postprandial redistribution of blood flow from the periphery to the gastrointesti-nal system as does conventional phototherapy. Pediatrics 2000;105:350 –353; conventional photother-apy, fiber-optic phototherapy, mesenteric blood flow velocity, newborn. ABBREVIATIONS. SMA, superior mesenteric artery; BFV, blood flow velocity; PT, phototherapy; FO-PT, fiber-optic phototherapy; CPT, conventional phototherapy; EDV, end-diastolic velocity; MV, mean velocity; RVR, relative vascular resistance. D oppler ultrasonography is the method cur-rently used for the clinical assessment of ve-locity and volume of superior mesenteric ar-tery (SMA) blood flow. 1–5 Recently, several reports have shown that enteral feeding induces a significant and progressive increase in blood flow velocity (BFV) in the SMA that peaks 30 to 45 minutes after the meal. 5–12 Oh et al 13 have shown that infants re-ceiving phototherapy (PT) present an increase in pe-ripheral blood flow with changes in body tempera-ture and Yao et al 14 have shown that PT blunts the postprandial mesenteric blood flow response to feed-ing in full-term infants. The changes in blood flow distribution are probably because of the fact that PT induces peripheral vasodilation. 14 In the last few years a new device, the fiber-optic phototherapy (FO-PT) apparatus, has been introduced into neona-tal care. We hypothesized that this kind of PT, by using cold light and irradiating a minimal quantity of ultraviolet and infrared rays, 15 would not induce peripheral vasodilation as does conventional photo-therapy (CPT). Consequently, we hypothesized that FO-PT would not induce significant alterations on pre-and postprandial intestinal blood flow. Color Doppler ultrasonography was used in this study to evaluate whether FO-PT influences the postprandial increase in mesenteric BFV similarly to CPT in pre-term infants.
