Hyperbilirubinemia of the neonate and the related risk of brain
damage with conseguent important alterations in motor development,
particularly in sick preterm babies, remains a major problem in
nurseries throughout the world. Since its introduction in the
1950's phototherapy has been used for reducing serum bilirubin
concentrations in the newborn with hyperbilirubinemia; however,
only recently the photoprocesses invoked by light on various
substrates including bilirubin have been clari fied in sufficient
detail. Light treatment actually exemplifies the intimate
relationship between the clinical and basic sciences: the better
understanding of the mechanism of phototherapy as a result of
investigations initiated in the laboratory has been extended to the
bedside as new types of lamps or new schedules of treatment. As a
consequence, phototherapy of hyperbilirubinemia has emerged as a
well-established branch of photomedicine, based on molecular photo
biology, scientific method, and creative use of physics and sophis
ticated electrooptical capabilities. The collaboration and exchange
of information between workers in different basic and clinical di
sciplines is likely to stimulate a further optimization of photo
therapy. The purpose of this monograph is to discuss some of the
new aspects of bilirubin metabolism and phototherapeutic treatment.
Bilirubin conjugation in the fetal and early neonatal life, the
mechanism of bilirubin entry into the brain, the measurements of
bilirubin concentration in the skin and serum bilirubin binding
capacity are discussed by a number of prominent neonatologists."
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