Summary
Phototherapy (PT) with white (day-light) or monochromatic (blue light) lamps is widely used for the prevention and treatment of neonatal hyperbilirubinemia. PT has the following advantages: it is inexpensive and easy to use; the breakdown products of bilirubin are not toxic for the CNS and are rapidly eliminated through the kidneys and liver; it is the most effective of all modes of prevention and treatment of neonatal hyperbilirubinemia, with the exception of exchange-transfusion. Despite the above mentioned advantages, there is still some reluctance in the use of PT for fear of unknown immediate and/or long term side effects. Immediate side effects described in newborn infants include: decreased intestinal transit time, with loose, greenish stools; increased insensible water loss with slow weight gain; skin rashes and, rarely, a brownish discoloration of skin, urines and plasma. Other possible side effects, described in vitro and/or in experimental animals, include: retinal damage; liver cell damage; alterations of the pineal gland with modifications of serotonin metabolism; suppression of cyrcadian rithms; modifications of hormonal secretion and plasma levels; acceleration or delay in sexual maturation; photoxidation of structures or substances in the body, other than bilirubin (i.e. vitamines, aminoacids, albumin, red blood cells, etc.). Further studies are needed in order to exclude, some of the above mentioned side effects. Meanwhile PT, when indicated, should be used with caution and under well controlled circumstances.
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References
Maisels M,J,: Bilirubin, On understanding and influencing its metabolism in the newborn infant. Ped.Clin. N. Amer., 19: 447, 1972.
Stern L.,Doray B,,Chan G, and Schiff D.: Bilirubin metabolism and the induction of kernicterus.Natl,Found, Birth Defects.Orig,Art.Ser. vol. 12,N°2,pg 255,1976.
Boggs T.R.Jr.,Hardy J.R. and Frazier T.M.: Correlation of neonatal serum total bilirubin concentration and developmental status at age 6 months. J.Pediat. 71: 553, 1967.
Sisson T.R.C.: Visible light therapy of neonatal hyperbilirubinemia. Photochem.Photobiol.Rev. 1: 241, 1976.
McDonagh A.F.: Photochemistry and photometabolism of bilirubin IX. Natl.Found.Birth.Defects.Orig.Art.Ser. vol.12, N° 2, pg. 30, 1976.
Indyk L.: Physical aspects of phototherapy. Natl.Found. Birth.Def.Orig.Art.Ser. vol.12,N° 2,pg 23, 1976.
Ostrow J.D.,Berry C.S.,Knodell R.G. and Zarembo J.F.: Effect of phototherapy on bilirubin excretion in man and the rat. Natl.Found.Birth.Def.Orig.Art.Ser. vol.12,N°2, pg 81, 1976.
Lund H.T. and Jacobsen J.: Influence of phototherapy on the biliary bilirubin excretion pattern in newborn infants with hyperbilirubinemia. J.Pediat.,85,262,1974.
Orzalesi M., Panero A. e Tambucci S.: Vantaggi e svantaggi della fototerapia nell’ittero neonatale, in “Problemi Attuali di Nutrizione in Pediatria”.Plasmon 1975.
Lucey J.F.: Neonatal Jaundice and Phototherapy. Ped. Clin.N.Amer., 19, 827, 1972.
Kopelman A.E., Brown R.S. and Odell G.B.: The “bronze” baby syndrome: A complication of phototherapy. J. Pediat., 81, 466, 1972.
Wurtman R.J. and Cardinali D.P.: The effects of light on man. Natl.Found.Birth.Def.Orig.Art.Ser. vol. 12,N° 2, pg 100, 1976.
Sisson T.R.C., Glauser S.C.,Glauser E.M.,Tasman W. and Kuwabara T.: Retinal changes produced by phototherapy. J.Pediat., 77, 221, 1970.
Halaris A. and Matussek N.: Effect of continuous illumination on mitochondria of the pineal body. Experientia, 25, 486, 1969.
Nir I.,Hirschmann and Sulman F.G.: The effect of light and darkness on lactic acid content of the pineal gland. Proc.Soc.Exp.Biol.Med., 133, 452, 1970.
Spennati G.F.,Girotti F. and Orzalesi M.: Urinary excretion of 5-hydroxyindolacetic acid in low birth weight infants with and without phototherapy. J.Pediat., 82, 286, 1973.
Iester A.,Quazza G.F.,Bertolotti E.,Moscatelli P., Fregonese B.,Lanzavecchia G. e Cordone G.: Studio sperimentale sulle modificazioni indotte dalla fototerapia sulle cellule epatiche. Min.Ped., 20, 870, 1969.
Fregonese B.,Moscatelli P.,Lanzavecchia L. e Cordone G.: Variazioni indotte dalla fototerapia sul contenuto in glicogeno del fegato di ratto neonato. Min.Ped., 21, 984, 1969.
Quazza G.F.,Cordone G.,Iester A,,Fregonese B.,Moscatelli P. e Lanzavecchia C.: Enzimoistochimica del fegato e fototerapia. Min.Ped., 21, 1233, 1960.
Orzalesi M., Natoli G.,Panero A. and Ciocca M.: Plasma hepatic enzymes in jaundiced newborn infants treated with phototherapy. Natl.Found.Birth.Def.Orig.Art.Ser. vol.12,N° 2, pg 93, 1976.
Casadei A.M.,Panerò A.,Tambucci S. and Orzalesi M.: Blood glucose response to the administration of glucagon in jaundiced newborn infants treated with phototherapy. To be published.
Ballowitz L.,Heller R.,Natzschka J. and Oh H.: The effect of blue light on infant Gunn rats. Natl.Found. Birth.Def.Orig.Art.Ser. 6, 106, 1971.
Kendall S.,Golberg S. and Sisson T.: Influence of visible light on growth rates of Gunn rats. Clin.Res., 28, 377. 1970.
Sisson T.R.C.,Goldberg S. and Slaven B.: The effect of visible light on the Gunn rat: convulsive threshold, bilirubin concentration and brain color. Pediat.Res., 8, 647, 1974.
Hodgman J.E.:Clinical application of phototherapy in neonatal jaundice. Natl.Found.Birth.Def.Orig.Art.Ser., vol. 12, N° 2, pg 3,1976.
Odell G.,Brown R. and Holtzman N.: Dye-sensitized photo-oxidation of albumin associated with a decreased capacity for protein-binding of bilirubin. Natl.Found. Orig.Art.Ser., 6, 31, 1970.
Odell G.B.,Brown R.S.,Kopelman A.E.: The photodynamic action of bilirubin on erythrocytes. P.Pediat., 8l, 473, 1972.
Blackburn M.G.,Orzalesi M. and Pigram P.: Effect of light and bilirubin on fetal red blood cells in vitro. Biol.Neonate, 21, 35, 1972.
Castro M.,Tambucci S.,Panero A.,Giardini O. e Orzalesi M.: Studio in vitro degli effetti della luce sui lipidi del globulo rosso. Min.Ped., 28, 391, 1976.
Blackburn M.G.,Orzalesi M. and Pigram P.:Effect of light on fetal red blood cells in vivo. J.Pediat.,80, 640,1972.
Sisson T.R.C.,Slaven B. and Hamilton P.B.: Effect of broad and narrow spectrum fluorescent light on blood constituents. Natl.Found.Birth.Def.Or ig.Art.Ser.,, vol. 12,N° 2, pg 122, 1976.
Meloni T.,Costa S.,Dore A. and Cutillo S.: Phototherapy for neonatal hyperbilirubinemia in mature newborn infants with erythrocyte G-6-PD deficiency, J.Pediat., 65, 560, 1974.
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© 1977 Plenum Press, New York
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Orzalesi, M. (1977). Advantages and Disadvantages of Phototherapy (PT) in Neonatal Hyperbilirubinemia. In: Castellani, A. (eds) Research in Photobiology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-4160-4_43
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DOI: https://doi.org/10.1007/978-1-4613-4160-4_43
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