4. Although infants with cholestatic jaundice may develop

the “bronze baby syndrome” when exposed to phototherapy (see H), the presence of direct hyperbilirubinemia is not considered to be a contraindication (1).

However, because the products of phototherapy are

excreted in the bile, the presence of cholestasis may

decrease the effectiveness of phototherapy.

C. Equipment

In order to have an understanding of the equipment available for phototherapy, it is necessary to be familiar with the

terminology involved (10).

1. Spectral qualities of the delivered light (wavelength

range and peak). Bilirubin absorbs visible light within

the wavelength range of 400 to 500 nm, with peak

absorption at 460 ± 10 nm considered to be the most

effective (2).

2. Irradiance (intensity of light), expressed as watts per

square centimeter (W/cm2

), refers to the number of

photons received per square centimeter of exposed

body surface area.

3. Spectral irradiance is irradiance that is quantitated

within the effective wavelength range for efficacy and is

expressed as mW/cm2

/nm. This is measured by various

commercially available radiometers. Specific radiometers are generally recommended for each phototherapy

system, because measurements of irradiance may vary

depending on the radiometer and the light source

(1,10).

A variety of phototherapy equipment devices exist

and may be free-standing, attached to a radiant warmer,

wall-mounted, suspended from the ceiling, or fiberoptic

systems. These in turn may contain various light sources

358 Section IX ■ Miscellaneous Procedures

to deliver the phototherapy. The clinician is, therefore,