University of Twente Student Theses
Predicting the delivered light dose in phototherapy for neonatal hyperbilirubinemia
Foppen, Rachel (2023) Predicting the delivered light dose in phototherapy for neonatal hyperbilirubinemia.
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| Abstract: | Significance Many newborns become jaundiced in the first days after birth, which is caused by elevated bilirubin levels in the body. This condition is called hyperbilirubinemia. If bilirubin levels become critically high, the main treatment is phototherapy. Although this is an effective treatment, the influence of patient characteristics on the delivered light dose is unknown. Nevertheless, it is known that these patient characteristics influence light penetration into the skin. Aim This thesis aims to quantify the influence of patient characteristics and wavelength on the delivered light dose in phototherapy to treat neonatal hyperbilirubinemia. The investigated patient characteristics are skin pigmentation, blood perfusion of the skin, severity of hyperbilirubinemia, skin maturity, skin thickness, subdermal tissue layer type, and body shape. Approach The influence of different factors on the delivered light dose in phototherapy is investigated with a Monte Carlo model, that simulates light transport through the skin and therefore predicts the delivered dose. Subsequently, the delivered dose is related to an expected TSB decrease after 24 hours of phototherapy, by combining the simulated dose results with a dose-response model from literature. Results The patient characteristics that have the largest influence on the delivered light dose and the resulting expected TSB decrease after 24 hours of phototherapy are skin pigmentation (difference in dose between light and darkly pigmented skin by a factor of 5.7 and a resulting expected TSB decrease between 25.6% for darkly pigmented skin and 40.8% for light skin), severity of hyperbilirubinemia (difference in dose between high and low bilirubin concentrations by a factor of 2.7 and a resulting expected TSB decrease between 29.2% for low bilirubin concentrations and 41.0% for high bilirubin concentrations), epidermal thickness (difference in dose between thin and thick epidermis by a factor of 1.3 and a resulting expected TSB decrease between 35.9% for thick epidermis and 40% for thin epidermis), and body shape (difference in dose between a flat and curved body shape by a factor of 1.9 and a resulting expected TSB decrease between 36.0% for a curved body shape and 48.3% for a flat body shape). Moreover, the wavelength with the highest absorbed dose by bilirubin varies between 460 nm for infants with a light skin and 475 nm for infants with a darkly pigmented skin. Conclusions Based on the Monte Carlo simulations of this study, patient characteristics can significantly influence the delivered dose in phototherapy. Therefore, these patient characteristics also influence the expected TSB decrease after 24 hours of phototherapy. Moreover, the results of this study indicate that the optimal wavelength for phototherapy depends on skin pigmentation |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Programme: | Biomedical Engineering MSc (66226) |
| Link to this item: | https://purl.utwente.nl/essays/95784 |
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