Background/aims Phototherapy (PT) is an effective treatment for hyperbilirubinemia, provided a minimum irradiance level is applied. Previously, we reported on low irradiance levels of PT devices in Dutch Neonatal Intensive Care Units (NICUs). These data were shared with all NICUs. We hypothesised that this knowledge would positively affect current applied irradiance levels. Therefore we determined irradiance levels of PT devices again in 2013.
Methods Irradiance levels of overhead and underneath PT devices in all 10 NICUs were measured with a Dale 40 radiometer (FlukeBiomedical, Everett, Washington, USA), in routinely applied PT practice patterns, using an infant silhouette model. The infant’s distance from the overhead device was measured.
Results Irradiance levels of 35 PT device-incubator combinations were measured (Table); 10 types of PT devices were in use in the 10 NICUs (8 overhead and 2 underneath). Overall irradiance levels increased (p = 0.01); irradiance levels of overhead and underneath PT devices also increased with 50% (NS) and 200% (p = 0.03), respectively. The mean (range) distance between overhead PT device and infant decreased with 7 cm to 38 (30–62) cm (p < 0.01). Minimal recommended irradiance levels of 10 µW/m2/nm were obtained for 70% of PT devices versus ~50% in 2008 (p = 0.02).
Conclusions Applied irradiance levels of PT devices in Dutch NICUs have markedly improved in 2013. Current data suggest that awareness among healthcare workers regarding requirements for effective PT results in improved use of PT devices, including smaller distances between PT device and infant. Moreover, the availability of better performing (Light Emitting Diode) PT devices might have contributed.