title: High variability and low irradiance of phototherapy devices in Dutch NICUs.
abstract: OBJECTIVE
  To evaluate phototherapy practices by measuring the irradiance levels of phototherapy (PT) devices.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary neonatal intensive care units.
  
  
  METHODS
  None.
  
  
  METHODS
  Irradiance levels of PT devices used in the 10 Dutch Neonatal Intensive Care Units (NICUs) were measured according to the local PT practice patterns. The irradiance levels of all overhead and fibre-optic PT devices were measured with a radiometer using an infant silhouette model.
  
  
  RESULTS
  Eight different PT devices were used in the 10 NICUs; five were overhead devices and three fibre-optic pads. The median (range) irradiance level for overhead PT devices was 9.7 (4.3-32.6) µW/cm(2)/nm and for fibre-optic pads 6.8 (0.8-15.6) µW/cm(2)/nm. Approximately 50% of PT devices failed to meet the minimal recommended irradiance level of 10 µW/cm(2)/nm. Maximal irradiance levels for overhead PT spot lights were inversely related to the distance between device and infant model (R2=0.33). The distances ranged from 37 cm to 65 cm.
  
  
  CONCLUSIONS
  PT devices in the Dutch NICUs show considerable variability with often too low irradiance levels. These results indicate that suboptimal PT is frequently applied and may even be ineffective towards reducing total serum bilirubin levels. These results underline the need for greater awareness among all healthcare workers towards the requirements for effective PT including measurements of irradiance and distance.
authors.affiliation: Department of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, The Netherlands.
authors.forename: Deirdre E
authors.initials: DE
authors.lastname: van Imhoff
authors.forename: Christian V
authors.initials: CV
authors.lastname: Hulzebos
authors.forename: Maaike
authors.initials: M
authors.lastname: van der Heide
authors.forename: Vera W
authors.initials: VW
authors.lastname: van den Belt
authors.forename: Hendrik J
authors.initials: HJ
authors.lastname: Vreman
authors.forename: Peter H
authors.initials: PH
authors.lastname: Dijk
mesh_terms: D005336:Fiber Optic Technology / Q000295:instrumentation / Q000592:standards; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D009426:Netherlands; D010789:Phototherapy / Q000295:instrumentation* / Q000592:standards; D011364:Professional Practice / Q000592:standards; D011446:Prospective Studies; D011874:Radiometry / Q000379:methods; D015203:Reproducibility of Results