Light-emitting diode phototherapy treatment for jaundice of the preterm infant presents adverse effects, such as discomfort, changes in metabolism, and overheating. This study quantified the body heat exchanges between the environment and a simulated preterm infant requiring phototherapy treatment in a closed incubator. Phototherapy treatment increased the mean incubator roof temperature by 2.9 °C (p < 0.001) and the incubator air temperature by 1 °C (p < 0.001). Analytical calorimetry was used to calculate the additional energy received during phototherapy and thus deduce the optimal incubator air temperature for ensuring thermoneutrality and preventing hyperthermia. The optimal air temperature settings inside the incubator during phototherapy were − 0.51 to − 1.25 °C lower than references, for preterm infant weighing 500 to 2000 g.
Conclusion: Phototherapy treatment for jaundice of the preterm infant increased the incubator air temperature. To prevent overheating in the preterm during phototherapy, new curves for optimal air temperature settings inside the incubator were calculated with analytic calorimetry.
What is Known|
•Phototherapy treatment is the first-line treatment for jaundice in the preterm infant.
•Phototherapy treatment increases the risk of overheating.
What is New
•The heat transfers and risk of overheating were quantified using a thermal manikin during phototherapy treatment.
•Phototherapy treatment increased the incubator roof temperature and heat transfers.
•New incubator’s air temperature settings during phototherapy treatment were calculated with analytical calorimetry for preterm infant weighing 500–2000 g.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
- T a :
Incubator air temperature, °C
- T ROOF :
Roof temperature, °C
- T WALL :
Wall temperature, °C
Hansen TWR, Maisels MJ, Ebbesen F, Vreman HJ, Stevenson DK, Wong RJ, Bhutani VK (2019) Sixty years of phototherapy for neonatal jaundice – from serendipitous observation to standardized treatment and rescue for millions. J Perinatol 40:180–193. https://doi.org/10.1038/s41372-019-0439-1
Bhutani VK, the Committee on Fetus and Newborn (2011) Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 128:e1046–e1052. https://doi.org/10.1542/peds.2011-1494
Pezzati M, Fusi F, Dani C, Piva D, Bertini G, Rubaltelli FF (2002) Changes in skin temperature of hyperbilirubinemic newborns under phototherapy: conventional versus fiberoptic device. Am J Perinatol 19:439–444. https://doi.org/10.1055/s-2002-36839
Delanaud S, Chahin Yassin F, Durand E, Tourneux P, Libert JP (2019) Can mathematical models of body heat exchanges accurately predict thermal stress in premature neonates? Appl Sci 9:1541. https://doi.org/10.3390/app9081541
Delanaud S, Decima P, Pelletier A, Libert JP, Durand E, Stephan-Blanchard E, Bach V, Tourneux P (2017) Thermal management in closed incubators: new software for assessing the impact of humidity on the optimal incubator air temperature. Med Eng Phys 46:89–95. https://doi.org/10.1016/j.medengphy.2017.06.002
Deguines C, Dégrugilliers L, Ghyselen L, Chardon K, Bach V, Tourneux P (2013) Impact of nursing care on temperature environment in preterm newborns nursed in closed convective incubators. Acta Paediatr 102:e96–e101. https://doi.org/10.1111/apa.12109
Tourneux P, Durand E, Pelletier A, Ghyselen L, Bach V, Libert JP (2017) Use of a polyethylene bag to reduce perioperative regional and whole-body heat losses in low-birth-weight neonates. Biomed Res Int 2017:1–6. https://doi.org/10.1155/2017/8243184
Tridente A, De Luca D (2012) Efficacy of light-emitting diode versus other light sources for treatment of neonatal hyperbilirubinemia: a systematic review and meta-analysis: LED phototherapy: a meta-analysis. Acta Paediatr 101:458–465. https://doi.org/10.1111/j.1651-2227.2011.02561.x
Bertini G, Perugi S, Elia S et al (2008) Transepidermal water loss and cerebral hemodynamics in preterm infants: conventional versus LED phototherapy. 167:37–42. https://doi.org/10.1007/s00431-007-0421-3
Arnold CC, Tyson JE, Pedroza C, Carlo WA, Stevenson DK, Wong R, Dempsey A, Khan A, Fonseca R, Wyckoff M, Moreira A, Lasky R (2020) Cycled phototherapy dose-finding study for extremely low-birth-weight infants a randomized clinical trial. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.0559
van Imhoff DE, Hulzebos CV, van der Heide M, van den Belt VW, Vreman HJ, Dijk PH, the BARTrial Study Group (2013) High variability and low irradiance of phototherapy devices in Dutch NICUs. Arch Dis Child Fetal Neonatal Ed 98:F112–F116. https://doi.org/10.1136/archdischild-2011-301486
Ng PL, Carlisle T, Ly M, Morris SA (2017) Heating of newborn infants due to blue light-emitting diode fibreoptic phototherapy pads. Neonatology 112:103–109. https://doi.org/10.1159/000464318
We would like to thank Médipréma SAS for lending the medical devices, Professor Jean-Pierre Libert for his critical review of the manuscript and valuable suggestions, and David Fraser (Biotech Communication SARL, Ploudalmezeau, France) for copyediting assistance.
European Regional Development Fund, grant PI0012894: PhD fellowship to FCY.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animal performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Communicated by Daniele De Luca
Electronic supplementary material
About this article
Cite this article
Yassin, F.C., Delanaud, S., Szcrupak, C. et al. Optimization of the incubator air temperature during LED phototherapy treatment for the preterm infant. Eur J Pediatr (2020). https://doi.org/10.1007/s00431-020-03724-2
- Preterm infant
- Air temperature