Frequenly Asked Questions
1) What are Phototherapy Treatment Units (PTUs) and why are they important?
2) Can you compare PEP Ultra BiliLight vs. Fiberoptic Style Phototherapy?
3) Why are some doctors reluctant to write a prescription for home care treatment of neonatal jaundice?
4) Can you describe continuous vs. intermittent phototherapy?
5) What are thermostatic temperature controls?
1) What are Phototherapy Treatment Units (PTUs) and why are they important? In their publication Guidelines for Pediatric Home Health Care , the American Academy of Pediatrics state that exposing jaundiced babies to higher levels of light is both safe and the most effective treatment for hyperbilirubinemia. Based on these AAP conclusions, how do doctors and dealers determine which neonatal phototherapy device is best for baby?
To calculate an “apples to apples” comparison so as to put all medical devices on the same even playing field for consideration, two variables must be analyzed:
1. The amount of healing light a device emits (irradiance); and
2. The total surface area of a baby receiving this healing light.
By multiplying irradiance x surface area, we calculate a measurement called Phototherapy Treatment Units (PTUs ). The higher the PTUs, the better the medical device because of quicker healing time. Quicker healing time can be crucial when treating infant jaundice.
Below, you can see PTU comparisons of the neonatal phototherapy units being used today:
| Device |
Irradiance
microwatts/cm2/nm |
% Surface Area |
PTUs |
| Wallaby3 (Fiber) |
20 |
13 |
260 |
| Ohmeda BiliBlanket (Fiber) |
35 |
13 |
455 |
| Medela BiliBed |
50 |
10 |
500 |
| Double-Bank Hospital Unit |
15 |
40-80 |
600-1200 |
| PEP Ultra BiliLight |
60 |
40-80 |
2400-4800 |
Conclusion: The PEP Ultra BiliLight provides more healing light therapy than any conventional or fiberoptic medical device on the market today, including double-banking devices used in hospitals.
We are proud to manufacture the best neonatal phototherapy equipment in the world. Over 18 years of leadership in this field and working with outcomes professionals tells us the PEP Ultra BiliLight treats jaundice 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.
2) Can you compare PEP Ultra BiliLight vs. Fiberoptic Style Phototherapy
The PEP Ultra BiliLight provides the most convenient phototherapy treatment available. Parent-infant bonding can be maintained in the first days of life in a more natural, untethered environment than with the use of any fiberoptic system. 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 provides up to12 times more phototherapy treatment units than fiberoptic equipment.
The PEP Ultra BiliLight provides treatment in a controlled environment, which monitors the ambient room temperature around the baby as opposed to the infant being wrapped in or placed on a fiberoptic light that has no built-in safeguards for hypothermia and hyperthermia.
The PEP Ultra BiliLight cures baby faster than any other conventional or fiberoptic phototherapy equipment on the market, including double-banked hospital units. Additionally, PEP’s higher irradiance level results in high bili levels such as 19 – 20 being predictably reduced to 14 – 15 within 24 hours. These results give physicians the confidence to write prescriptions for in-home treatment using PEP units, which translates to more referrals for you. On the other hand, medical professionals tend to admit the infant to a hospital rather than use fiberoptic equipment given the same set of circumstances.
The PEP Ultra BiliLight’s use of intermittent treatment allows for natural contact while nursing and cuddling. Since treatment is only done during the waking hours of the parents, mom & dad can sleep comfortably. Intermittent therapy with the PEP Ultra BiliLight will cure baby faster than 24-hour continuous treatment with a fiberoptic light system.
The PEP Ultra BiliLight has 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. PEP’s lamps last 2,000 hours. You can be confident using the PEP 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. And unlike some fiberoptic units, we will never stop supporting what we manufacture and sell to you.
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
3) Why are some doctors reluctant to write a prescription for home care treatment of neonatal jaundice? Unfortunately, medical professionals not familiar with PEP’s Ultra BiliLight often equate "home care" with "slow care". Through mergers and acquisitions in our industry, there are some behemoth companies in the market place with huge marketing budgets doing an effective job selling their phototherapy devices to pediatricians, family practitioners, and hospitals.
Fiberoptic technology is cutting edge with high-tech computer and communication firms so why not with medical devices? The answer is calculated by multiplying irradiance (microwatts/cm2/nm) times % of skin surface area covered by the light. This value is a measurement known as PTUs (Phototherapy Treatment Units). The number of PTUs determines the amount of healing light a neonatal phototherapy device emits. The greater the number, the better the product. PEP emits up to 4,800 PTUs compared to 260 PTUs and 455 PTUs on current Respironics and Ohmeda models, respectively. Unfortunately, our fiberoptic competitors typically make comparisons of their 2003 models with circa-1970 fluorescent light technology and thereby totally side-step (or avoid) PEP’s Ultra BiliLight.
The same comparison can be applied to Medela’s BiliBed which uses fluorescent technology, not fiberoptics. True, Medela uses the same type of healing light as us; however, we cover between 40 to 80 percent of the infant’s body compared to the Medela BiliBed which irradiates approximately 10 percent surface area. Additionally, PEP uses proprietary lamps that emit 60 microwatts/cm2/nm compared to Medela’s 50 microwatts/cm2/nm. By rotating the baby in our unit, we emit up to 4,800 PTUs whereas the infant in the BiliBed only gets 500 PTUs due to the fact that the baby is restricted ("tied in") to a body suit and only a small portion of the back is receiving healing light therapy.
Many doctors are put in a position to re-admit jaundiced infants into the hospital, especially when bilirubin levels are high, when home care treatment utilizing low PTU-emitting devices are the only available option. This does not have to be the case. Using the PEP Ultra BiliLight not only treats jaundice quicker than hospital double-banking equipment but gives medical professionals the confidence they need to write a prescription to treat baby at home, especially when bilirubin counts are on the high end of the scale. Our unit ensures dealers will not miss opportunities when presented with higher bilirubin levels because the PEP Ultra BiliLight is the best neonatal phototherapy medical device on the market.
4) Can you describe continuous vs. intermittent phototherapy? Originally, most phototherapy was delivered continuously – theoretically to maximize treatment and minimize the length of treatment needed. It 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 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.
5) What are thermostatic temperature controls? Thermostatic Temperature Controls that monitor the environment in the baby bed are another feature unique to the Ultra BiliLight. 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.
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