STANFORD UNIVERSITY!

A LIGHT-EMITTING DIODE-BASED PHOTOTHERAPY WRAP FOR

TREATMENT OF JAUNDICED NEWBORNS !
HENDRIK J. VREMAN,1 RAMI VARDI,2 RONALD J. WONG,1 DAVID K. STEVENSON1!
1DEPARTMENT OF PEDIATRICS, STANFORD UNIVERSITY SCHOOL OF MEDICINE, STANFORD, CA!
SCHOOL OF MEDICINE!
2BRIGHT LIGHT LED, INC., CANOGA PARK, CA!

INTRODUCTION!
•  The efficacy of phototherapy (PT) devices for the control of newborn
hyperbilirubinemia is affected by: (1) the quality of emitted light
(400-520nm, peak 460±10nm); (2) light intensity (irradiance, expressed as
µW/cm2/nm); and (3) the % treatable body surface area.!
•  Many studies have reported the inadequacy of PT devices because they
lacked optimization in some or all these qualities.!
•  Recently, sophisticated light-emitting diodes (LEDs) have become available
that deliver high intensity, relatively narrow wavelength light within the
optimum wavelength range and peak using relatively little, low voltage,
(3VDC and 3Watt) power.!
•  The LEDs are small enough for the construction of lightweight flexible
circuit pads (wraps) of unlimited size and shape.!
•  We are developing such a contact PT device (Fig. 1), which can be used
as a pad or wrap, like a blanket, around a jaundiced newborn. !
OBJECTIVE!
• To develop a phototherapy device that optimizes
the three qualities that determine efficacy.!
MATERIALS & METHODS!
•  The LED wrap was produced under special order by Quantum using
n=1344 LEDs with spectral qualities given in Figs. 2 to 7. !
•  Irradiance (µW/cm2/nm) on the wrap footprint (Fig. 3) and preterm
baby silhouette irradiance was determined according to Vreman et al
(Acta Paediatr 2008;97:308) (Fig. 5) using a BiliBlanket Meter II (GE
Health Care).!
•  Spectral qualities were determined with an Ocean Optics
Spectrometer, Model S2000.!
•  Additional technical details are provided in the Table.!

RESULTS!
We have produced a fairly robust first prototype full-body wrap device (50x80cm), which emits blue light with a spectral width of 410–
550nm and a bandwidth and peak of 454–480 and 464nm, respectively. These qualities comform with the recommendations of the 2004
American Academy of Pediatrics Guideline. The wrap is thin, flexible, light weight, for delivery of truly surround PT. Concerns of body heat
and moisture management are being studied as are unique issues (disinfection) related to repeat use of such contact devices between
patients in a clinical setting. The rapidly decreasing price of LEDs with increasing light output bodes well for the eventual production of PT
devices for single patient use. !
Peak = 464 nm! 1!
1!
37!
2!
39!
3!
41!
4!
44!
5!
42!
6!
40!
7!
42!
8!
44!
9!
43!
10!
43!
11!
43!
12!
50!
13!
49!
14!
48!
15!
43!
16!
48!
17!
43!
18!
42!
19!
45!
20!
46!
21!
34!
22!
50!
23!
54!
24!
52!
25!
36!
26!
59!
27!
48!
28!
50!
29!
50!
30!
50!

2! 31! 35! 42! 34! 48! 40! 42! 39! 40! 43! 34! 49! 45! 52! 47! 45! 42! 48! 44! 38! 30! 49! 56! 53! 52! 47! 46! 46! 51! 46!

3! 39! 37! 47! 49! 41! 39! 49! 38! 54! 39! 46! 41! 47! 46! 43! 52! 44! 43! 51! 42! 43! 61! 52! 60! 44! 43! 57! 43! 49! 49!

4! 34! 37! 36! 44! 41! 39! 40! 35! 43! 37! 41! 43! 43! 44! 39! 42! 37! 36! 37! 44! 45! 46! 50! 46! 42! 51! 47! 42! 42! 57!

5! 41! 33! 36! 50! 37! 35! 41! 34! 52! 38! 44! 40! 40! 55! 51! 44! 45! 37! 51! 56! 55! 50! 59! 45! 46! 62! 49! 44! 60! 59!

6! 40! 41! 38! 47! 38! 43! 44! 42! 35! 37! 42! 35! 36! 54! 38! 43! 47! 38! 37! 38! 50! 41! 52! 56! 41! 44! 58! 40! 43! 34!

7! 32! 34! 39! 36! 35! 36! 36! 34! 37! 36! 35! 35! 42! 41! 37! 45! 37! 37! 34! 42! 43! 38! 46! 44! 37! 46! 44! 40! 42! 48!

Bandwidth (FWHM)=250nm! 8! 32! 33! 36! 35! 31! 35! 35! 33! 35! 34! 34! 33! 46! 47! 38! 36! 38! 34! 34! 36! 40! 39! 45! 44! 40! 36! 40! 40! 40! 45!

(448–473nm)! 9!

10!
37!

36!
32!

43!
42!

33!
39!

31!
34!

38!
43!

35!
41!

37!
33!

38!
38!

39!
42!

36!
37!

40!
36!

37!
45!

39!
44!

53!
43!

43!
47!

52!
35!

39!
42!

38!
42!

39!
36!

39!
46!

44!
42!

43!
43!

46!
48!

50!
41!

43!
40!

43!
53!

46!
54!

52!
42!

49!
53!

60!

11! 38! 38! 33! 32! 35! 35! 33! 37! 36! 35! 45! 36! 33! 40! 33! 36! 41! 34! 38! 40! 35! 46! 40! 41! 46! 39! 43! 36! 39! 51!

12! 42! 39! 35! 33! 41! 41! 32! 44! 35! 38! 46! 42! 31! 39! 36! 41! 43! 33! 40! 38! 38! 42! 47! 42! 43! 44! 43! 44! 46! 48!

13! 35! 38! 33! 31! 46! 37! 36! 41! 35! 36! 38! 36! 34! 39! 54! 39! 38! 34! 32! 40! 42! 41! 49! 50! 37! 46! 49! 45! 42! 40!

Spectral Width=410–550nm! 14! 32! 32! 32! 30! 31! 41! 34! 34! 36! 34! 33! 32! 34! 39! 31! 33! 35! 36! 37! 36! 37! 39! 52! 41! 44! 37! 44! 62! 49! 48!

15! 32! 34! 32! 30! 41! 46! 40! 34! 34! 37! 32! 30! 35! 35! 36! 33! 38! 36! 35! 39! 37! 41! 46! 42! 38! 38! 40! 52! 53! 48!

16! 33! 35! 32! 31! 41! 47! 40! 35! 34! 33! 35! 30! 34! 35! 35! 34! 36! 33! 34! 34! 36! 36! 36! 40! 40! 35! 45! 45! 37! 37!

17! 39! 36! 32! 32! 42! 46! 40! 40! 35! 34! 40! 34! 34! 36! 36! 39! 39! 34! 38! 34! 34! 41! 43! 47! 46! 42! 48! 44! 34! 36!

18! 33! 31! 32! 32! 34! 36! 36! 34! 35! 36! 44! 34! 36! 34! 34! 39! 37! 32! 34! 37! 42! 44! 42! 52! 49! 46! 48! 46! 41! 34!

19! 33! 32! 30! 29! 33! 30! 34! 34! 49! 44! 36! 36! 37! 34! 34! 34! 40! 35! 39! 40! 52! 50! 49! 52! 62! 45! 62! 45! 49! 52!

Fig. 4. Optimal Light

Fig. 2. Prototype PT Wrap (v.1). Fig. 3. Maximal 2D Body Surface Area Emission Spectrum. Spectral Fig. 5. Optimal Irradiance.
Fig. 1. The Idea. Patent, 2003.! Dimensions: 50x80x0.3cm. Weight: Coverage. Wrap, powered up, with preterm-size range: 422–547nm. Bandwidth: 455–
Footprint=41±7µW/cm2/nm;!
1490g, including power supply.! doll (25VDC, 75 Watt).! 473nm. Peak: 464nm.! Preterm silhouette=40±5µW/cm2/nm.!

TABLE. TECHNICAL DETAILS OF PROTOTYPE I!

A! B! C! •  Size: 50 x 90 cm x 3-mm thick!
•  Weight: 1470 g (including power supply of 550 g)!
•  Power: Input = 100 – 240 VAC; 2.5 – 3.0A; 75 Watt!
•  LEDs: 3VDC x 1Watt; Royal Blue (Quantum); n =1344
(connected in arrays of n = 8; 25VDC; spacing of
15x20mm)!
•  Spectrum: !Range = 422 – 547nm!
!Bandwidth = 455 – 475nm!
!Peak = 464nm!
•  Mean irradiance: 40.7±6.6 (40%); 29 – 96 µW/cm2/nm!
•  Preterm Footprint: 39.6±5.6 (15%); 31 – 55 µW/cm2/nm!
Fig. 6. Possible Wrap Configurations and Type of PT Deliverable. (A) 2D planar; (B) Triple-sided; (C) Fig. 7. Compactness. Wrap rolled
•  Temperature: 31°C with ambient temperature of 18°C!
Surround, 360°! up for storage or for travel.!

•  A subsequent prototype device has recently

been produced (v.2) with more advanced
features such as:! A! B! C! D!
–  Water proof connectors!
–  More advanced LEDs (2 diodes/LED)!
–  Decreased spacing of LEDs!
–  Rows of LEDs staggered!
–  Addition of reflective background!
–  Addition of a dimmer switch!
•  These features yielded a device that can deliver up to
75µW/cm2/nm (max=120µW/cm2/nm), uniform irradiance, Fig. 8. (A) Waterproof panel; (B) Staggered rows of LEDs; (C) Mix of white and blue LEDs; (D) Panels are expandable to accommodate
while maintaining acceptable temperature (31°C).! larger infants to provide maximal body surface area delivery. !

CONCLUSIONS!
•  In contrast to combinations of halogen- or LED-based lamps and fiberoptic cable and pad PT devices (also called blankets), the use of surface-
mount LEDs on flexible circuits, offer significant advantages towards the production of safe and highly effective contact devices that optimize
the three qualities most critical to PT efficacy.!
•  Prototype v.1 wraps can be joined for treatment of larger patients, such as those with Crigler-Najjar Syndrome.!
•  Based on the results of our in vitro action spectrum work (see Poster #7), a wrap device may be more efficacious when it emits blue/green light
of 500nm. LEDs with this wavelength range are readily available.!

ACKNOWLEDGEMENTS! This work was supported by Vreman Family funds, th Christopher Hess Research Fund, and the Mary L Johnson Research Fund.!