The Use of the NeoBlue LED and Wallaby Lights vs. the Bilibed for Treatment of Infants with Hyperbilirubinemia

Wednesday, July 13, 2011: 4:25 PM

Lisa Waraksa, RN, BSN, CPN
Pediatrics, Bryn Mawr Hospital, Bryn mawr, PA
Patricia Decina, RN, BSN, CPN, MHA
Pediatrics, Bryn Mawr Hospital, Bryn Mawr, PA

Learning Objective 1: The learner will be able to evaluate the most effective, cost efficient, safe and timely method to treat infants hospitalized with hyperbilirubinemia.

Learning Objective 2: The learner will appreciate that intensive phototherapy in the hospital will decrease the length of hospital stay and promote parent infant bonding.

PurposeTo investigate the advantages to treating infants hospitalized for hyperbilirubinemia with the NeoBlue / Wallaby instead of the Bilibed.  The effectiveness of phototherapy depends on several major factors, including spectrum, color of light, intensity of light, exposed body surface area, distance from the source, and duration of exposure.

Key element of treatment, identified by the American Academy of Pediatrics, is intensive phototherapy with greater than equal to 30 microwatts/cm2/nm of light in the 430-490nm light spectrum range because bilirubin is yellow pigment with peak absorption in that narrow range.  The NeoBlue Phototherapy system utilizes high intensity, blue-light-emitting diodes to deliver blue-light in the narrow wavelength band 450-470nnm, which is within the accepted range for optimal bilirubin degradation.  A light diffuser, integral to the NeoBlue unit, allows the light to be delivered uniformly to the surface of the skin.

MethodPerformed a retrospective chart review, including infants treated for Hyperbilirubinemia using the NeoBlue/Wallaby.  We reviewed 127 charts for our study.  The inclusion criteria were infants greater than, or equal to, 35 weeks gestation, greater than 24 hours old, not requiring IV hydration, NG feeds, or antibiotic therapy.

DataData collected included the infants admission total bilirubin level, length of hospital stay, approximation of total hours on the lights, discharge total bili level and the irradiance level.

Comparison:                                       Neo/Wallaby               Bilibed           

Avg.Admission:                          19.3mg/dl                    19.0mg/dl                        

Avg.Irradiance:                          46.8W/cm2/mn              65.8W/cm2/nm

Avg. Approx. Hrs.onLight:           12.5hrs.                               21.9hrs.

Avg.Length Stay:                        20.4hrs.                               33.7hrs.

ResultsNeoblue/Wallaby provide significantly quicker reduction in bilirubin to acceptable levels than the Bilibed; also demonstrated significantly shorter treatment time, and length of stay that was shorter by nearly one-third, potentially decreasing the cost of care.  Anxiety for parents may be decreased since the time of treatment and the interruption of breast feeding and parent-infant bonding will be very limited.