THE TEN COMMANDMENTS OF PHOTOTHERAPY

[摘要] Thou shalt1. Not use phototherapy prior to determination of etiology.1,22. Not use phototherapy in infants with direct hyperbilirubinemia (conjugated direct bilirubin level > 2 mg/100 ml).1,33. Not judge jaundice clinically in infants treated with phototherapy, but measure serum bilirubin level every 4 to 12 hours as indicated.1,24. Monitor temperature of infants placed under phototherapy initially every hour for the first four hours and thereafter every four to six hours.2,35. Weigh low-birth-weight infants receiving phototherapy twice daily. Increase their fluid intake above requirements by 2% to 10% depending on postnatal age, cardiac status, and whether the infant is under a radiant warmer or an adequately humidified incubator.1,36. Protect eyes with adequately designed patches. Turn off light and remove eye patches when parents are visiting.2,37. Monitor hematocrit value, particularly in hemolytic diseases.1,28. Watch for rebound of bilirubin level following discontinuation of phototherapy. Delay discharge by about 6 to 12 hours till rebound can definitely be ruled out.29. Change the lamps after 20% decrease of original irradiance output. Consult with the manufacturer of the individual lamps used, or energy output in the blue spectrum (425 to 475 mm) every 200 hours of use.1,210. Check all phototherapy units for proper electrical grounding.

[学科分类] 儿科学