Pediatric Bright Light Therapy FAQ

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Pediatric Bright Light Therapy FAQ 2017-05-29T22:06:55+00:00

Unfortunately, medical professionals not familiar with PEP’s Bright Embrace or Ultra BiliLight often equated “home care” with “slow care”. They experienced slow results with portable devices sold for home care and became discouraged. Phototherapy moved back to the hospital – with all the expense and risk of infection.

In addition, reimbursement for rented home phototherapy equipment deteriorated so that equipment providers often could not recover their cost of two trips to the home – once to install the equipment and again to retrieve it. So, many quit providing this service altogether. Now, comes the Bright Embrace to change the paradigm and rejuvenate home phototherapy! With this low-cost, single-patient device, expensive trips to the home are eliminated. Pediatricians or equipment dealers can now sell the Bright Embrace directly to the parents, instruct them on-site with an animated DVD and written instructions. When phototherapy is complete, they simply mail it back to PEP for a partial refund, so parts can be re-cycled. The device now becomes a supply rather than a capital purchase. And since the new baby, if the family has insurance, has its own deductible – which is probably much higher than the cost of the Bright Embrace, home phototherapy is now very affordable and very attractive.

In the publication Guidelines for Pediatric Home Health Care, the American Academy of Pediatrics recommends “intense phototherapy” – defined as an irradiance over 30 microwatts/cm2/nm to “as much body surface area as possible”. So, how do doctors and medical equipment dealers determine which neonatal phototherapy device is best for baby?

* Make an “apples to apples” comparison with PTUs:

  1. Measure the amount of healing light a device emits (irradiance)
  2. Determine the percent body surface area (BSA) of a baby that is receiving this healing light
  3. Multiply the irradiance x BSA, to determine Phototherapy Treatment Units (PTUs )

The higher the PTUs, the faster the treatment times. Quicker healing time is good clinically, emotionally and financially.
Below, you can see PTU comparisons of the neonatal phototherapy units being used today:

Device

Irradiance
microwatts/cm2/nm
% Surface Area PTUs
PEP Bright Embrace 38 65 2470
PEP Ultra BiliLight 60 40 2400
Natus neoBlue 30 40 1200
Philips Bili Tx 40 20 800
Medela BiliBed 50 10 500

Conclusion: The PEP Bright Embrace and Ultra BiliLight provide more healing light therapy than any other conventional or fiberoptic device on the market today, including double-banking devices used in hospitals.

PEP is proud to manufacture the best neonatal phototherapy equipment in the world. Over 26 years of leadership in this field while working with medical professionals tells us the PEP Ultra BiliLight, and now the new Bright Embrace, each treats jaundiced babies faster (often under 24 hours) than any competing unit (typically 72 to 96 hours). Faster treatment and healing time is best for baby, parents, doctors, health insurance companies, and Medicaid.

The PEP Bright Embrace and Ultra BiliLight provide the most convenient phototherapy treatment available. Parent-infant bonding can be maintained in the first days of life in a more natural environment. Baby is healed in less time at optimal treatment levels, avoiding chafing and other problems associated with fiberoptic panels or blankets.

As explained in the PTU’s (Phototherapy Treatment Units) comparison in our Certified Neonatal Phototherapist course, the PEP Ultra BiliLight and now the Bright Embrace provide up to 12 times more phototherapy treatment units than fiberoptic equipment.

The PEP Bright Embrace or Ultra BiliLight treats baby faster than any other conventional or fiberoptic phototherapy equipment on the market, including double-banked hospital units. Additionally, PEP’s devices’ higher irradiance levels result in high bili levels such as 19 – 20 often being reduced to 14 – 15 within 24 hours. These results give physicians the confidence to write prescriptions for in-home treatment using PEP units. On the other hand, medical professionals know that fiberoptic devices may result in slower treatment.

The PEP Bright Embrace or Ultra BiliLight’s use of intermittent treatment (e.g., 50 minutes on / 10 minutes off) allows for natural contact while nursing and cuddling. And clinicians may choose to allow a parent-sleep break from phototherapy at night. Intermittent therapy with the PEP Bright Embrace or Ultra BiliLight will cure baby faster than 24-hour continuous treatment with a fiberoptic light system.

The PEP Bright Embrace and Ultra BiliLight have no hidden costs. No expensive light meter is required. No need to continually purchase expensive fiberoptic panels or blankets as they wear out. No problems of hot halogen bulbs that often burn out after just a few treatments. The Bright embrace is used only once per patient and the Ultra Bili Light lamps last 2,000 hours. You can be confident using the PEP Bright Embrace or Ultra BiliLight that baby is receiving the best therapy possible at the lowest per treatment cost in the industry (after adding up all the not-so-evident expenses of using fiberoptic devices). PEP also provides you with complete and on-going market support, marketing collateral, and evaluation units to assist you in penetrating your local market.

When choosing your next phototherapy device, listen to the voice of experience:

“…I appreciate very much your willingness to work with us in providing a new PEP Bed, and in return we are sending you this fiberoptic light. It is my opinion that while the premise for the fiberoptic light system may be more desirable for treatment of hyperbilirubinemia, in actuality it does not perform as promised or as necessary. Treatment times using the (fiberoptic) light compared with the PEP Bed almost always were double”

“…(Fiberoptic) patients’ treatment (each physiologic jaundice bilirubin levels of 16-19, gestations of 37-40 weeks, and ages of 24-72 hours) varied from 4-7 days; while treatment in our experience with the PEP Bed is 2-3 days. As an ABO incompatible infant may require longer treatment, we elected not to treat any ABO incompatible infants with the (fiberoptic) lights because of this experience”

“..We treat close to 1000 cases of jaundice each year. I think we have a little bit of experience, and the (fiberoptic) light is just not good for us. “

“I appreciate very much your good service and cannot speak highly enough about the lights that you have produced at PEP. I can wholeheartedly support the product, and I think you can tell I do by the number of lights you have sold us…”

Sincerely,
Ray Richens (Retired)
Director of Sales
Interwest Medical / Praxair Healthcare Services

Originally, most phototherapy was delivered continuously – theoretically to maximize treatment and minimize the length of treatment needed. vIt soon became obvious that the feeding and nurturing needs of baby must be accommodated during each day, so even the strictest of “continuous” regimens was never truly continuous. As we came to appreciate the importance of bonding and stimulation, and as home phototherapy gained acceptance, the concept of intermittent phototherapy became more desirable.

Studies showed that emitting blue light on baby’s skin broke down most of the bilirubin under the skin within a few minutes. However, it takes one to three hours for new bilirubin to migrate to the skin. Recognizing this pattern of slow migration and fast breakdown of bilirubin allowed experts to conclude that intermittent therapy was likely to be as effective as continuous therapy. Clinical trials were run with light regimens of 15 minutes on and 15 minutes off, 15 minutes on and 30 minutes off, 15 minutes on and 60 minutes off, and 1 hour on and 4 hours off.

All of these regimens were as effective as continuous phototherapy. Now, most physicians want to see baby “under the lights” a good portion of the day, but parents are encouraged to intermittently remove their baby from treatment for feeding, cuddling, etc. In home phototherapy, parents are often instructed to turn the phototherapy equipment off at night so everyone can get a good night’s sleep.

In their Guidelines for Pediatric Home Health Care , the American Academy of Pediatrics makes two important points:

  1. Intermittent phototherapy is as effective as continuous therapy; and
  2. Higher levels of light are safe, most effective and shorten treatment time.

Only the PEP Bright Embrace and Ultra BiliLight takes full advantage of these guidelines:

  1. The light output of a PEP Ultra BiliLight is the highest available (60mw/cm2/nm); PEP units treat more of baby’s skin surface area (40%) than any other portable unit. So, PEP’s PTUs (Phototherapy Treatment Units), which equals irradiance times surface area being treated, are up to 12 times higher than other units – and 4 times higher than double-banked hospital units. The PEP Ultra BiliLight is the only device that delivers more treatment than hospital units. This means intermittent therapy is most effective with a PEP device.
  2. Only PEP’s design leaves baby completely untethered, so baby can be placed in or taken out of treatment with ease. No wrap-around fiberoptic cables and no restrictive suits to deal with. No other unit offers this unrestricted ability for parent-baby bonding, cuddling, playing, and feeding.
  3. By using intermittent therapy, baby can have different sides exposed to the light in a PEP Ultra BiliLight – effectively increasing the surface area being treated to 80% – and increasing the PTUs to 8 to 24 times greater than other devices that continuously treat the same small patch of baby’s skin.
  4. Intermittent therapy with a PEP Ultra BiliLight is great for both baby and parents. And clinicians are comfortable knowing PEP provides the fastest treatment and the most convenient intermittent phototherapy.
Thermostatic Temperature Controls that monitor the environment in the baby bed are another feature unique to the PEP Bright Embrace. These controls heat and cool baby as needed. They sense the temperature in the baby bed, guard against both extremes of temperature and alert the parents when they need to adjust the temperature of baby’s room.

On the low end of the scale, if the temperature in the baby bed drops below a nominal 75 degrees, our built-in heating unit will engage and maintain a minimum temperature of 75 degrees. At the same time, warning systems will alert the parents that room conditions have cooled to the point where the heater is necessary and that they should move the unit to a warmer location or turn up the room thermostat.

On the high end of the scale, if the temperature in the baby bed rises to a nominal 98 degrees, the treatment lights will flash to alert the parents to effect a change in the environment—turn down the thermostat—turn up the air conditioner, etc. If no such action is taken, after a few minutes the unit will shut itself off, discontinuing treatment. At this point the home environment is too warm and baby should be readmitted to the hospital.

These features help in addressing physicians’ concerns regarding hypothermia and hyperthermia, provide a more stable temperature environment for baby, and create the feeling in the parents that they have provided the very best in home phototherapy for their baby.