Biliblanket


A biliblanket is a portable phototherapy device used to treat neonatal jaundice. BiliBlanket is a trademark of General Electric's Datex-Ohmeda subsidiary, but its name has become the generic, colloquial term for a range of similar products and the term used in the medical professions. The name "biliblanket" combines the words bilirubin and blanket, and this device is also known as home phototherapy system, bilirubin blanket, or phototherapy blanket.
Compared to conventional forms of phototherapy, biliblankets use a fiberoptic system, allowing them to be used in the hospital or at home for phototherapy treatment. Biliblankets have been preferred by nurses and parents due to the feasibility in accessing and handling the baby. The baby is tied to the machine, unless they can wheel it around, and there is a stiff pad between the parent and baby.
Phototherapy for jaundice involves a blue/white light of varying intensity placed close to the skin or touching it through a special, light-permeable fabric. The Biliblanket system consists of three components: an illuminator, fiberoptic pad, and disposable cover/vest. The fiberoptic pad is used to transport blue/white light from the light source directly onto the baby's skin. The light waves are absorbed by the baby's skin and blood, which will breakdown bilirubin, allowing it to be eliminated.

Mechanism

is not uncommon in newborn babies and presents itself as yellow discoloration of the skin and whites of the eyes. It can also cause babies to seem sick, difficult to awaken, make high-pitch cries, or not being able to be fed or gain weight. Normally, bilirubin is an orange yellow bile pigment that is produced as a byproduct of hemoglobin as red blood cells break down. Bilirubin is then metabolized in the liver, recycled, and excreted in the bowel movements. When a baby has jaundice or hyperbilirubimia, it can mean that the baby's body is producing excess bilirubin or that the liver is too immature to be able to eliminate bilirubin fast enough. Feeding, in particular breastfeeding, the baby often in the first few days of birth can help lower the chances of developing jaundice, since the baby will pass more stool and the milk provides energy to the liver to allow metabolism of bilirubin. Uncontrolled levels of bilirubin can be harmful to the baby. Most neonatal jaundice shows during the first week after birth. Nevertheless, when bilirubin levels become exceedingly high, the substance may move out of the blood, cross the blood brain barrier, and collect in brain tissue, damaging the baby's brain cells, a condition known as acute bilirubin encephalopathy. If acute bilirubin encephalopathy is not addressed promptly, Kernicterus syndrome can develop and cause permanent brain damage. In rare situations, a baby may experience seizures, deafness, cerebral palsy and/or mental retardation. Thankfully, jaundice can be prevented and treated in the majority of cases. Jaundice is more dangerous in certain cases such as babies who are born prematurely, babies who are underweight, babies who are going through an infection, babies who experienced a difficult delivery and/or have bruises and babies who have a blood group that is not compatible with their mothers.
Jaundice in some babies can disappear within one to two weeks without treatment; however for babies with more severe jaundice, treatment is required. A Biliblanket is a phototherapy home treatment that consists of a portable illuminator and fiber-optic pad. It uses a pad of woven fibers to carry light to a baby in order to treat neonatal jaundice. It uses visible light to transform bilirubin into a more water-soluble form that allows it to dissolve easily in water and can be eliminated. This therapy lowers the serum bilirubin level. The baby is placed on the fiber-optic pad, which has a disposable cover in direct contact with the baby's skin. This fiber-optic pad exposes the skin to light, and bilirubin is eliminated when light is absorbed. The Biliblanket releases waves of blue/white light, when these are absorbed in the skin, bilirubin breaks down and is eliminated from the baby's blood stream.
This lowers the yellowing effect in the baby's eyes and skin. Afterwards, blood needs to be tested to observe bilirubin levels and decide whether the Biliblanket is still needed. Majority of babies that need a Biliblanket use it for several days, but it depends on each baby's condition. Even though a Biliblanket may cause loose stools and skin rashes, it is considered safe for the most part. This device is mostly used for 2 to 3 days only. In severe situations, intravenous fluids may be needed to be given to the patient. When a baby is receiving treatment, they only wear protective eye patches and a diaper so most of the skin and absorb the light.
Phototherapy uses photons of energy that are infused and absorbed by bilirubin located in superficial capillaries and subcutaneous tissues and interstitial spaces of the skin. Photochemical reactions then transform bilirubin into nontoxic isomers that are more polar, water-soluble and therefore, can be excreted without being further metabolized by the liver. Urinary and gastrointestinal elimination remain important to the process of reducing the bilirubin load.

Proper Use

The whole setup consists of the light generator, termed the light box, the fibre-optic cable through which the light is carried, and the light pad, which is a 25cmx13cm pad that is attached to the baby.
It is important to make sure that the light-source machine is placed on a flat, level, hard surface such as a table or nightstand. A disposable cover is placed onto the light pad and should be changed if the cover becomes soiled. For effective therapy, the baby’s skin should be directly exposed to the light pad as much as possible. The light pad should be on all the time except during baths. The light pad is usually placed on the undressed baby’s back with a diaper on. Clothing may be worn, but the clothing should be placed over the light pad, and the light pad should still be in direct contact with the baby’s skin. Never place the light pad onto the baby’s head. The baby can sleep, eat, or be held with the light pad on.
In some cases, it is recommended that the baby's eyes are covered with eye patches during phototherapy treatment to prevent the risk of retinal damage. In adults, it has been shown that prolonged exposure to blue/white light can cause retinal damage.
The Biliblanket is safe and can be used for 24 hours a day as long as therapy is required. However, the duration of phototherapy will vary from individual to individual based on the baby's current condition and disease state. It will also depend on the physician’s clinical judgement.
Blood tests may be required during phototherapy to assess the bilirubin levels and determine if normal levels have been reached and whether or not phototherapy can be stopped. Once the bilirubin levels are normal, the baby's skin will return to its normal color.

Side Effects

One common side effect that is experienced by babies who are receiving phototherapy treatment is more frequent and loose stools. The color of these stools are usually a greenish color; however, this is normal because that is the way bilirubin is removed from the body. As bilirubin levels return to normal and phototherapy is no longer needed, the frequency of bowel movements and the color of the stools will return back to normal. If side effects persist even after phototherapy treatment has ended, contact a physician.
Other side effects include:

Short-term

Advances in technology have led to the invention of biliblankets, which allow for home phototherapy treatment instead of conventional phototherapy in hospitals. Hospital phototherapy requires eye protection for the baby, since it uses many sources of light shining directly on the baby.