The Impact of Device Age on Phototherapeutic Efficacy in Neonatal Jaundice Management

Abstract

The use of phototherapy (PT) has become the mainstay treatment modality for neonatal jaundice (NJ), a condition endured by the majority of preterm and term babies in their early days of life. Nonetheless, the potency of the phototherapy device is dependent on technical metrics such as mean irradiance, spatial homogeneity, irradiance uniformity, and therapeutic guidelines. Notwithstanding the high use of the PT device, there is limited evaluation of their performance over varied ages of lamps and manufacturers. A quantitative analysis of 50 neonatal phototherapy devices was conducted, evaluating their spectral irradiance and uniformity for compliance with American Academy of Pediatrics (AAP) therapeutic guidelines. The findings revealed varied device performance, poor spatial uniformity, and an alarmingly significant portion (85%) of the devices failed to meet therapeutic guidelines, particularly those with high running hours (>2000 hrs.). These deficiencies in device performance led to suboptimal treatment efficacy, prolonged treatment times, and increased risk of complications. The study demonstrated that the performance of PT devices, in terms of mean irradiance and spatial uniformity, declines significantly with increased operational age, with most devices exceeding 1500 hours failing to meet clinical standards for effective neonatal jaundice treatment. These findings highlight the urgent need for regular irradiance assessment and timely replacement of aging PT devices in resource-constrained settings to ensure optimal patient outcomes.