TABLE 3

Practice Considerations for Optimal Administration of Phototherapy

ChecklistRecommendationImplementation
Light source (nm)Wavelength spectrum in ∼460- 490-nm blue-green light regionKnow the spectral output of the light source
Light irradiance (μW·cm−2·nm−1)Use optimal irradiance: >30 μW·cm−2·nm−1 within the 460- to 490-nm wavebandEnsure uniformity over the light footprint area
Body surface area (cm2)Expose maximal skin areaReduce blocking of light
Timeliness of implementationUrgent or “crash-cart” intervention for excessive hyperbilirubinemiaMay conduct procedures while infant is on phototherapy
Continuity of therapyBriefly interrupt for feeding, parental bonding, nursing careAfter confirmation of adequate bilirubin concentration decrease
Efficacy of interventionPeriodically measure rate of response in bilirubin load reductionDegree of total serum/plasma bilirubin concentration decrease
Duration of therapyDiscontinue at desired bilirubin threshold; be aware of possible rebound increaseSerial bilirubin measurements based on rate of decrease