title: Transepidermal water loss and cerebral hemodynamics in preterm infants: conventional versus LED phototherapy.
abstract: 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.
authors.affiliation: Department of Critical Care Medicine and Surgery, Division of Neonatology, University of Florence School of Medicine, Careggi University Hospital, Florence, Italy. giovanna.bertini@unifi.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bertini
authors.forename: Silvia
authors.initials: S
authors.lastname: Perugi
authors.forename: Serena
authors.initials: S
authors.lastname: Elia
authors.forename: Simone
authors.initials: S
authors.lastname: Pratesi
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: Firmino F
authors.initials: FF
authors.lastname: Rubaltelli
mesh_terms: D001921:Brain / Q000098:blood supply*; D006439:Hemodynamics; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000000981:diagnostic imaging / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007558:Italy; D010789:Phototherapy / Q000009:adverse effects / Q000379:methods*; D014463:Ultrasonography; D014870:Water Loss, Insensible