Phototherapy for Neonatal Jaundice
Phototherapy is the first-line treatment for neonatal hyperbilirubinemia, effectively converting unconjugated bilirubin into water-soluble isomers for excretion.
1. Mechanism & Optimal Parameters
- Mechanism: Uses blue light (wavelength 420-470 nm) to induce photo-isomerization of bilirubin into lumirubin and photo-bilirubin, which are easily excreted in urine and bile.
- Efficiency Factors: Effectiveness depends on light intensity (irradiance), surface area exposed, and the distance from the infant.
2. Clinical Guidelines
| Parameter | High-Yield Note |
|---|---|
| Eye Protection | Essential to prevent retinal damage. |
| Hydration | Increased insensible water loss; ensure adequate breastfeeding/fluids. |
| Monitoring | Monitor serum bilirubin levels periodically and check for potential rebound. |
3. Complications
- Short-term: Loose stools, skin rash, dehydration, and Bronze Baby Syndrome (in infants with cholestatic jaundice).
- Long-term: Potential concerns regarding DNA damage/genotoxicity, though not clinically significant with standard practice.
NEET PG Hint: Remember that phototherapy is contraindicated in cases of conjugated hyperbilirubinemia, as it can lead to the “Bronze Baby Syndrome.” For infants with hemolysis (e.g., ABO/Rh incompatibility), intensive phototherapy is often required.