Skip to main content
SpringerLink
Log in

Transepidermal water loss and cerebral hemodynamics in preterm infants: conventional versus LED phototherapy

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The aim of our study was to evaluate whether high-intensity gallium nitride light-emitting diode (LED) phototherapy (LPT) influences transepidermal water loss (TEWL) and cerebral hemodynamics in preterm neonates in comparison with conventional phototherapy (CPT). Thirty-one preterm infants were randomized for conventional (n = 14) and for LED (n = 17) phototherapy. All infants were studied using a Tewameter TM 210 and cerebral Doppler ultrasound immediately before phototherapy (time 0), 30 min (time 1), 1–6 h (time 2), and 12–24 h (time 3) after the start of phototherapy, and 6–12 h after discontinuing phototherapy (time 4). The study shows that LPT does not induce significant changes in TEWL (time 0: 2.75 ± 4.71 ml/m2/h; time 3: 14.45 ± 3.68 ml/m2/h), in peak systolic, end diastolic and mean cerebral blood flow velocity (CBFV), and in the resistence index (RI). On the contrary, CPT is associated with a significant increase of TEWL (time 0: 13.22 ± 5.61 ml/m2/h; time 3: 20.94 ± 3.21 ml/m2/h), which disappeared at time 4, when phototherapy had stopped. The peak systolic and mean CBFV increased, respectively, from 0.11 ± 0.03 m/s at time 0 to 0.16 ± 0.07 m/s at time 3. We conclude that LPT, emitting light within the 450–470-nm spectrum for optimal bilirubin degradation, can be preferable to CPT for the therapy of hyperbilirubinemia in preterm infants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

CBFV:

cerebral blood flow velocity

CPT:

conventional phototherapy

LED:

high-intensity gallium nitride light-emitting diodes (LEDs)

LPT:

LED phototherapy

RI:

resistence index

TEWL:

transepidermal water loss

TSB:

total serum bilirubin

Vdiast :

end diastolic blood flow velocity

Vmean :

mean blood flow velocity

Vsyst :

peak systolic blood flow velocity

References

  1. Barel AO, Clarys P (1995) Study of the stratum corneum barrier function by transepidermal water loss measurements: comparison between two commercial instruments: Evaporimeter and Tewameter. Skin Pharmacol 8(4):186–195

    Article  PubMed  CAS  Google Scholar 

  2. Bell EF, Neidich GA, Cashore WJ, Oh W (1979) Combined effect of radiant warmer and phototherapy on insensible water loss in low-birth-weight infants. J Pediatr 94(5):810–813

    Article  PubMed  CAS  Google Scholar 

  3. Benders MJNI, van Bel F, van de Bor M (1999) Cardiac output and ductal reopening during phototherapy in preterm infants. Acta Paediatr 88(9):1014–1019

    Article  PubMed  CAS  Google Scholar 

  4. Benders MJNI, van Bel F, van de Bor M (1998) The effect of phototherapy on renal blood flow velocity in preterm infants. Biol Neonate 73(4):228–234

    Article  PubMed  CAS  Google Scholar 

  5. Bertini G, Dani C, Tronchin M, Rubaltelli FF (2001) Is breastfeeding really favoring early neonatal jaundice? Pediatrics 107(3):E41

    Article  PubMed  CAS  Google Scholar 

  6. Bertini G, Dani C, Pezzati M, Rubaltelli FF (2001) Prevention of bilirubin encephalopathy. Biol Neonate 79(3–4):219–223

    PubMed  CAS  Google Scholar 

  7. Dani C, Bertini G, Martelli E, Pezzati M, Filippi L, Prussi C, Tronchin M, Rubaltelli FF (2004) Effects of phototherapy on cerebral haemodynamics in preterm infants: is fibre-optic different from conventional phototherapy? Dev Med Child Neurol 46(2):114–118

    Article  PubMed  Google Scholar 

  8. Dani C, Martelli E, Reali MF, Bertini G, Panin G, Rubaltelli FF (2001) Fiberoptic and conventional phototherapy effects on the skin of premature infants. J Pediatr 138(3):438–440

    Article  PubMed  CAS  Google Scholar 

  9. Engle WD, Baumgart S, Schwartz JG, fox WW, Polin RA (1981) Insensible water loss in the critically ill neonate. Combined effect of radiant-warmer power and phototherapy. Am J Dis Child 135(6):516–520

    PubMed  CAS  Google Scholar 

  10. Fisher DJ (1986) Comparative effects of metabolic acidemia and hypoxemia on cardiac output and regional blood flows in unanesthetized newborn lambs. Pediatr Res 20(8):756–760

    Article  PubMed  CAS  Google Scholar 

  11. Furchgott RF (1991) Endothelium-dependent relaxation, endothelium-derived relaxing factor and photorelaxation of blood vessels. Sem Perinatol 15(1):11–15

    CAS  Google Scholar 

  12. Grünhagen DJ, de Boer MGJ, de Beaufort AJ, Walther F (2002) Transepidermal water loss during halogen spotlight phototherapy in preterm infants. Pediatr Res 51(3):402–405

    Article  PubMed  Google Scholar 

  13. Hammerman C, Kaplan M (2004) Comparative effects of two phototherapy delivery systems on cerebral blood flow velocity in term neonates. Biol Neonate 86(4):254–258

    Article  PubMed  Google Scholar 

  14. Jahnukainen T, Lindqvist A, Jalonen J, Kero P, Välimäki I (1999) Responsiveness of cutaneous vasculature to thermal stimulation during phototherapy in neonatal jaundice. Eur J Pediatr 158(9):757–760

    Article  PubMed  CAS  Google Scholar 

  15. Oh W, Yao AC, Hanson JS, Lind J (1973) Peripheral circulatory response to phototherapy in newborn infants. Acta Paediatr Scand 62(1):49–54

    Google Scholar 

  16. Oh W, Karecki H (1972) Phototherapy and insensible water loss in the newborn infant. Am J Dis Child 124(2):230–232

    PubMed  CAS  Google Scholar 

  17. Omar SA, DeCristofaro JD, Agarwal BI, La Gamma EF (1999) Effects of prenatal steroids on water and sodium homeostasis in extremely low birth weight neonates. Pediatrics 104(3 Pt 1):482–488

    Article  PubMed  CAS  Google Scholar 

  18. Pezzati M, Biagiotti R, Vangi V, Lombardi E, Wiechmann L, Rubaltelli FF (2000) Changes in mesenteric blood flow response to feeding: conventional versus fiber-optic phototherapy. Pediatrics 105(2):350–353

    Article  PubMed  CAS  Google Scholar 

  19. van Bel F, den Ouden L, van de Bor M, Stijnen T, Baan J, Ruys JH (1989) Cerebral blood-flow velocity during the first week of life of preterm infants and neurodevelopment at two years. Dev Med Child Neurol 31(3):320–328

    Article  PubMed  Google Scholar 

  20. Varvarigou A, Bardin LC, Beharry K, Chemtob S, Papageorgiu A, Aranda JV (1996) Early ibuprofen administration to prevent patent ductus arteriosus in premature newborn infants. J Am Med Ass 275(7):539–544

    Article  CAS  Google Scholar 

  21. Vreman HJ, Wong RJ, Stevenson DK, Route RK, Reader SD, Fejer MM, Gale R, Seidman DS (1998) Light-emitting diodes: a novel light source for phototherapy. Pediatr Res 44(5):804–809

    Article  PubMed  CAS  Google Scholar 

  22. Walther FJ, Wu PYK, Siassi B (1985) Cardiac output changes in newborns with hyperbilirubinemia treated with phototherapy. Pediatrics 76(6):918–921

    PubMed  CAS  Google Scholar 

  23. Wu PYK, Wong WH, Hodgeman JE, Levan N (1974) Changes in blood flow in the skin and muscle with phototherapy. Pediatr Res 8(4):257–262

    PubMed  CAS  Google Scholar 

  24. Wu PYK, Moosa A (1978) Effect of phototherapy on nitrogen and electrolyte levels and water balance in jaundiced preterm infants. Pediatrics 61(2):193–198

    PubMed  CAS  Google Scholar 

  25. Yao AC, Martinussen M, Johansen OJ, Brubakk AM (1994) Phototherapy-associated changes in mesenteric blood flow response to feeding in term neonates. J Pediatr 124(2):309–312

    PubMed  CAS  Google Scholar 

  26. Yosipovitch G, Maayan-Metzger A, Merlob P, Sirota L (2000) Skin barrier properties in different body areas in neonates. Pediatrics 106(1 Pt 1):105–108

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Critical Care Medicine and Surgery, Division of Neonatology, University of Florence School of Medicine, Careggi University Hospital, Florence, Italy

    Giovanna Bertini, Silvia Perugi, Serena Elia, Simone Pratesi, Carlo Dani & Firmino F. Rubaltelli

  2. Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria Careggi, Viale Morgagni, 85, 50134, Firenze, Italy

    Giovanna Bertini

Authors
  1. Giovanna Bertini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvia Perugi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Serena Elia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simone Pratesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carlo Dani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Firmino F. Rubaltelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giovanna Bertini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bertini, G., Perugi, S., Elia, S. et al. Transepidermal water loss and cerebral hemodynamics in preterm infants: conventional versus LED phototherapy. Eur J Pediatr 167, 37–42 (2008). https://doi.org/10.1007/s00431-007-0421-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-007-0421-3

Keywords

Search

Navigation