Biliblanket: Phototherapy Device for Medical Use - Research Paper

Introduction

A Biliblanket is a movable phototherapy device made up of fiber optic materials woven to form a thin pad and a transferrable illuminator. Although the first Biliblanket was manufactured and patented by Datex-Ohmeda, a General Electric's subsidiary, a variety of phototherapy devices by different manufacturers exist in the market today. Despite the variations, the devices usually have basic structure consisting source of light (lightbox) which serves as a light generator, fiber optic cable that transmits the harnessed light with minimal losses and the light pad usually ten by five inches on which the baby is laid by his or her back, as shown in the following figure. (From https://aeroflowinc.com/wp-content/uploads/2014/10/wallaby-new1.png)

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Based on the types of lighting that can be applied, there are conventional and fiber optic types. The conventional phototherapy is the commonly used method. It applies the illuminators fitted with light sources such as fluorescent lamps and bulbs, Light Emitting Diodes (LEDs), and halogen lighters, among others. On the other hand, the fiber optic devices are less effective hence have limited use despite the higher irradiance levels and triple phototherapy associated with them. This research paper tackles the applications, theory of operation, safety concerns, maintenance requirements, and the common faults associated with the Biliblankets.

Applications: Where Are Biliblankets used?

Biliblanket is common in the field of medical phototherapy for the treatment of at-home children suffering from neonatal jaundice, otherwise known as hyperbilirubinemia. Scientifically, neonatal jaundice is caused by the rise of the bilirubin levels in the blood of an infant child, culminating in discoloration of the skin. Therefore, the biliblankets provide a mechanism of supplying various kinds of regulated light to the baby to help n the breakdown bilirubin in the blood to enable it to reduce to reasonable levels.

Theory of Operation: How Does a Biliblanket work?

The Biliblanket serves to emit either white or blue light, depending on the type of light that the transferrable illuminator is fitted with during manufacture. The light produced usually varies in intensity and flows through the fiber optic to the baby, who is usually placed near or on the blanket (lying on the back). On the baby's skin, the light forces the IXa (4Z, 15Z), native bilirubin group, to experience compound reactions to produce various products as per the rates of reactions exhibited. Such a reversible reaction is faster as compared to the irreversible structural isomerization and results into three configurational isomers such as (Z,E;E,Z;E,E ) or (4Z, 15E;4E, 15Z;4E, 15E) in full. The irreversible structural isomerization yields the Z and E Lumirubin that is much easily soluble in water and hence excreted by the liver in the form of bile and urine. As such, the light-induced conversion of the bilirubin group into Lumirubin E and Z components that are then eliminated by the child's liver is considered as the most crucial stage of the phototherapeutic effect using the Biliblankets. Although photo-oxidation of some isomers occurs, it takes place at a much lower rate making the result is usually a reduced bilirubin level in the child's blood and hence the treatment of their neonatal jaundice condition.

Safety Concerns: How Can a Biliblanket Harm a Patient?

Despite being in use for a long time, the phototherapy using Biliblankets has been proven to have some side effects, most of which are short term. Such include the common effect of automated child-care technologies such as interference with maternal-infant. Therefore, there is a need to interrupt the phototherapy sessions periodically or allow family-centered phototherapy to guarantee breastfeeding or just skin-to-skin contact for parent-child bonding. Other side effects include hyperthermia caused by high irradiance in LED phototherapy, hypocalcemia due to diminished total calcium levels of the neonates, benign skin rashes in up to about 36% of the conventional Biliblanket phototherapy sessions, short-lived Deoxyribonucleic acid (DNA) mutilation, purpuric and bullous eruptions, and riboflavin deficiency. Further, children exposed to Biliblanket phototherapy are most likely to exhibit symptoms of the bronze baby syndrome, dehydration due to phototherapy-induced shifts in the thermal environment of infants, retinal damage, and retinopathy of prematurity (ROP), ileus, loose, watery stools, and lipid peroxidation among other effects. In an attempt to minimize these effects, more expert-monitored Biliblanket phototherapy is encouraged with practices such as the covering of the child's head, using dark tubing, or covering the line with aluminum foil.

Maintenance Requirements: What Is Required to Keep the Biliblanket Working Accurately?

There are several maintenance requirements that need to be upheld for the proper operation of the Biliblanket systems. To begin with, the issue of the bulb replacement when it becomes ineffective is crucial. Many manufacture advice that such an undertaking needs to be left to the certified healthcare dealers only. These health dealers are advised to follow the five steps strictly. These steps include switching off the Biliblanket system by disconnecting the power supply cord and allowing for approximately 10 minutes to allow the bulb cool then locating the bulb replacement door on the left side of the unit.

Further, observation of how the bulb fits into the compartment is made, the lever moved back into its original position, the new bulb inserted appropriately, and the lamp access panel closed by turning the panel screw quarter turn clockwise. During the entire bulb replacement cycle, the bulb access door should be kept closed. Additionally, it is advisable that the Biliblanket system pad is covered with a throwaway cover to prevent contamination or damage. Any obstructions to the airflow in the vests at the top or bottom of the illuminator need to be eliminated, and the moving of the Biliblanket unit when it is in use, using abrasive cleaning items and emersion of the Biliblanket system in water should be prohibited completely. Finally, it is appropriate that the phototherapy activities such as temperature taking, feeding, urine or stools, and treatment times be recorded in their right order.

Common Faults: What Are Some of the Common Issues With a Biliblanket?

During the entire life of a Biliblanket, it is likely to suffer various common faults. The most common one is the dysfunctional illuminator bulbs or the fiber optic connections. Such a defect might be due to the elapse of the lifespan of the components or just minor functional problems, among other causes. Also, due to the developed faults, the readings and the general functioning of the Biliblanket system is likely to be hampered greatly hence a need for swift repair or replacement. It is appropriate to contact certified and licensed healthcare dealers for professional troubleshooting and repair services.

Conclusion

In summary, the Biliblanket can be said to be an effective way of treating neonatal jaundice for both hospital-based and home-based models. However, many health provider insurance companies and households prefer the home-based model in general since it allows for the maximum parent-child contact in addition to lowering the medical care costs. As explained in the theory section, the Biliblanket produces light of varying intensities using its illuminator, transfers the produced light via the fiber optic system to its light pad on which the baby is laid by the back. When the light meets the baby's skin, it facilitates decomposition of the bilirubin in the blood into Lumirubin E and Z components that are dissolved into water and excreted by the liver in the urine and bile. Although the process results in an overall reduction of the bilirubin levels in the child's blood. There are also side effects associated with the use of the Biliblankets and must be continuously get limited through appropriate practices.