Light blue led for bilirubin treatment in newborns
Automatic photherapy prototype
Flavio Pineda-López, Paúl Ayala Taco, Katherine Cajas Narváez,
Silvana Vargas Salinas, Roberto Pineda López, Derlín Morocho, Rosario Pineda López.
Universidad de las Fuerzas Armadas ESPE
Sangolquí, Ecuador
Abstract—Placing the lamps of a phototherapy equipment at
a suitable distance from the neonate, and scheduling the
treatments to be applied depending on the degree of
hyperbilirubinemia in the patient, are a problem in large
hospitals that do not have enough personnel specialized in
pediatrics, which causes that these equipment is used improperly
or not used. In this project we have implemented a prototype
capable of sensing the temperature, control the exposure time,
and automatically control the positioning of the lamp on the
baby's crib. We were working in the development of a photo
sensor that measures in the face of the baby's bilirubin level to
determine the exposure time.
The results have been satisfactory in the test carried out in
the Ecuador publics hospital in hyperbilirubinemia neonates
effectively reduce high levels of bilirubin in shorter time, than
with the conventions equipment, verify that the blue light is more
efficient for the treatment of hyperbilirubinemia.
Keywords—Bilirrubinosis, Phototherapy, Newborns.
I. INTRODUCTION
On a commercial level have been developed phototherapy
systems that have a pedestal to hold the head with lamps warm
light that emit a light intensity necessary for process the
components of bilirubin, causing bilirrubinosis. The head
adjustment and hours of radiation are controlled manually by
medical personnel.
Some researchers have been working on techniques to
improve these systems is so has developed a system that uses
blue LED in an array of 55 LEDs attached by an Elastomers
[1], the results are optimistic, but the system is not practical for
use in newborns. Other researchers have worked in a signal
processing system to extract the bilirubin from diffuse
reflectance spectrometer in human skin [2].
In [3] it has been proposed a technique to estimate from
blood bilirubin using two wavelengths from the blood sample.
It has been used halogen light or fluorecente limiting the
intensity to achieve levels of 810.8 uW / cm2 [4], which has
limited the intensity.
In [5] Non-Invasive Biomedical System for the
Quantification of Bilirubin in Neonates by measuring not
invasive of the components of bilirubin in blood samples by
emitting a light and capture in a Spectrometer, they have been
developed in [6 ] Expert System for the diagnosis of Neonatal
Jaundice for use by Medical Field Personnel through the
development of an expert and in [7] System to noninvasive
978-1-5090-6363-5/17/$31.00 ©2017 IEEE
point-of-care system That Utilizes diffuse reflectance
spectroscopy to Quantifying bilirubin from skin reflectance
spectra.
The contribution of this work is the incorporation of a
bilirubin sensor for to determine the level of bilirubin in the
newborn, based on skin pigmentation and determine the
treatment to be performed, the prototype automatically
positions the lamp to the optimal distance according to the
clinical picture of the newborn and determines the treatment
time and intensity of light depending on the degree of
bilirrubinosis having the newborn.
II. TECHNICAL REVIEW
A. Bilirrubinosis o Hiperbilirrubinemia
The bilirrubinosis known as hyperbilirubinemia, this is a
common clinical condition in neonates (newborns with more
than 35 gestation weeks). It is characterized by yellowing of
the skin and eyes (jaundice) due to a high concentration of
bilirubin in the blood is not processed by the liver and excreted
by the newborn [8].
Bilirubin is increased from 5 to 13mg / dl between the
second and fifth day of birth and becomes normal between five
and seven days. However, this period is shortened with the use
of phototherapy, especially in infants who have high levels of
bilirubin [9].
The hyperbilirubinemia [10], is presented with a quantity of
plasma bilirubin higher than normal value, greater than 5 mg/dl
of the expected value for age in the newborn [11].
Newborns are prone to hyperbilirubinemia because they
have greater number of erythrocytes, have little intestinal flora,
liver hematomas, bleeding at birth or poor feeding and liver
function is insufficient to process all the bilirubin produced.
The diagnosis requires a detailed investigation of each
patient and therefore offers an approximate detection
mechanism to be compared with laboratory data and medical
history performed by a specialist.
The treatments are the application of medicaments by
injection, and application exchange transfusion phototherapy.
The related articles recommend articles recommended the
use of phototherapy. The diagnosis requires a detailed
investigation of each patient and therefore offers an
approximate detection mechanism to be compared with Linear actuator. - provides the necessary force to the lifting
laboratory data and medical history performed by a specialist. mechanism to move the lamp up or down. The origin of force
can be pneumatic, hydraulic or driving force.
The treatments are the application of medicaments by
injection, and application exchange transfusion phototherapy. Elevation mechanism. - adjusts the height of the lamp
The related articles recommend articles recommended the use according to the place of location of the newborn, so that
of phototherapy. ensures therapeutic effect according to the code of the newborn
and thermo cribs.
B. Phototherapy Lamp body. - By a hinge may be oriented in all directions,
Phototherapy is a procedure based on the capacity that has you can even rotate upward to have a lateral irradiation.
the light to act on bilirubin level of the skin to accelerate their
elimination and prevent its toxic accumulation in the brain. The Support structure. - It provides stability and allows the
most effective and safe for treating hyperbilirubinemia mobility of the structure. The figure 2 shows the mechanical
treatment is considered, as this is a non-invasive method, low structure of the prototype.
impact and high effectiveness.
Intervenes in three chemical reactions: photoisomerization,
isomerization and photo-oxidation, to excrete bilirubin in urine,
without hepatic conjugation. Adverse effects of phototherapy
are minimal and not present in most cases [12].
For effective phototherapy wave length of blue light from
400 to 500 nm; light penetrates 2mm from the contact surface,
the penetration rate is around 5%, so that the light acts on the
serum bilirubin present in the skin. Treatment of neonatal
phototherapy dosimetry it is based on Bhutani monogram,
indicating the optimal dose according to the patient's age.

III. DESIGN AND IMPLEMENTATION OF THE PHOTOTHERAPY

PROTOTYPE
Phototherapy unit is a medical device designed noninvasive
treatment bilirrubinosis in neonates, accelerates the excretion
of bilirubin newborn exposure to blue light, in a period less
than seven days. The device has an exhibition area to ensure
complete coverage of the newborn, adaptability to any space
requirement; the vertical displacement of the lamp for use in Fig. 2. Outline of the structure
cribs, thermo crips and pediatric bassinets; an indicator of Electronic design
treatment duration, and assigning the type of light intensity and
The semi phototherapy is mobile, static operation during
duration, according to age and bilirubin.
treatment; It is powered directly from the mains to 120V.
However, electronic devices, LED lights and blanket require
A. Hardware Design 5V and 12V power dc respectively; conditioning and control
The prototype hardware has a mechanical structure and an for a printed circuit was developed. For the safety standard IEC
electronic circuit that are detailed below. 601.1, a battery capable of supplying the necessary voltage for
the electronics, to avoid interruption integrates. The electronic
Mechanical structure board consists of three main stages: motor control, lights and
battery. In addition, a color sensor is connected to evaluate the
The phototherapy unit is mobile pedestal lamp inclination
process of phototherapy. The control board unit phototherapy
and height adjustable, so it can be placed on the thermos cribs,
is Arduino Mega 2560, which connects a touch screen as a user
pediatric bassinet or crib, it can vary the distance between the
interface, elaborate circuit board module and a real time clock.
focus and the newborn. The figure 1 shows the block diagram
The figure 3 shows the block diagram of the electronic system.
of the mechanical system.
LINEAR ELEVATION HEAD LAMP
LINEAR ELEVATION HEAD LAMP ACTUATOR MECHANISM
ACTUATOR MECHANISM

SUPPORT
SUPPORT STRUCTURE
STRUCTURE

Fig. 3. Block diagram of the electronic system

Fig. 1. Block diagram of the mechanical structure
 Interface. - Means of communication with the user,
consisting of a touch screen display functions, tactile and
storage and a keyboard for entering patient data.
Control unit. - Electronic board with a microprocessor
Arduino Mega 2560, input / output, development environment,
lamp controls, actuator and connecting peripherals. The figure
4 shows the connection scheme.
B. Software Design
The phototherapy, suggests the type of treatment (light
intensity) according to the values of bilirubin and age of the
newborn based on Bhutani Monogram, previously entered by
touch screen. Bilirubin during treatment with the variation in
skin pigmentation to maintain or change the dose of
phototherapy, with the approval of the attending physician
staff is evaluated. The distance between the lamp and the
neonate may be modified depending on patient location:
pediatric bacinetes, termocunas or others. Three components
arise for software design prototype as shown in Figure 6.

Fig. 6. Connection scheme sensors and external modules with Arduino Mega
Fig. 4. Connection scheme sensors and external modules with Arduino
Mega C. Phototherapy prototype implementation
Alimentation. - Voltage circuit supplying DC power to the The figure 7 shown the phototherapy prototype assembly,
electronic circuits of the control modules, control unit and the LED array and the ultrasonic sensor in the lamp, and the
sensors. touch screen installed in the mechanical structure.
Trigger circuit. - Circuit that activates the linear actuator
and lamp from the module control unit.
Lamp. - LED array provides light for phototherapy
treatment.
Sensor. - This consists of a color sensor to determine the
level of bilirubin and evaluate the process of phototherapy and
an ultrasonic sensor to detect the distance between the patient Fig. 7.b. Light blue led lamp
and the lamp.
Bilirubin sensor is based on a microcontroller ATMEL, a
photo resistive cell and two LEDs, one red and one blue. The
LDR (Light Dependent Resistor) reduces resistance when the
light radiation within the wavelength band sends a signal.
Based on this by sending a specific length as is the red LED on
a surface like the skin is received as this light has penetrated
the skin. Relating the signal sent by this sensor with an
approximate value of bilirubin since being greater the higher
concentration will be the relationship between the bands long Fig. 7.a. Phototherapy prototype Fig. 7.c. Electronic Circuit
wave red and blue. The figure 5 shows the circuit diagram of
the bilirubin sensor and the ultrasonic sensor.
IV. TEST AND RESULTS
The test scenarios corresponds to the intermediate risk zone,
moderate phototherapy; the effectiveness of phototherapy for
the treatment of bilirubin is checked at a distance of 30 cm
between the lamp and the patient with a moderate light
intensity, irradiation of 15 μW / cm2 / nm, and the high risk
zone, intensive phototherapy at a distance of 30 cm between
the lamp and the patient with a high-intensity light irradiation
of 30 μW / cm2 / nm. The Figure 8 shows the test scenarios.
Fig.5. Scheme sensor bilirubin and Ultrasonic sensor.
 automatically of the prototype calculates according to the
bilirubin level the treatment period and the intensity of the
blue light radiation.

Fig. 8. Test scenarios.
The results of the tests with the transcutaneous sensor are
indicated in the table 1 The measurements generate errors that
demonstrate the efficiency of the sensor.
TABLE I. Table of measurements of blood bilirubin
V. CONCLUSIONS
The phototherapy treatment with blue light emitted by led
diodes in the blue spectrum of 460-480 nm with a radiation of
35 μW / cm2 / nm demonstrated a high efficiency in the
decrease of bilirubin and in the well-being of the newborn,
because does not generate heat and offers complete coverage
of the exposed skin of the patient.

Patient Bilirubin (mg/dl) Error The transcutaneous bilirubin measuring device showed high
(%) accuracy, with a margin of error of ± 1.50 mg / dl compared to
Sanguineous Transcutaneos
bilirubin blood tests.
1 15,20 13,33 12,30
2 11,16 10,33 7,43
This study demonstrated the high efficiency of the
treatment of phototherapy with blue light emitted by diodes
3 15,57 13,67 12,20 (LEDS), reducing in 18,11% the bilirubin in a period of 24
4 12,75 10,67 16.31 hours with a moderate treatment (moderate light) and a
5 16,24 14,00 13,79
bilirubin decrease of 48.21% with an intense treatment
(intense light) without the generation of heat.
6 8,41 8,33 0,95

Phototherapy tests were applied to six newborn. Three
newborn received moderately treated in a 24-hour period with
a decrease in bilirubin in patient 1: from 15.57 mg / dl to 12.75
mg / dl, in patient 2: 16.25 Mg / dL at 13.10 mg / dL and in
patient 3 from 17.85 mg / dL at 14.50 mg / dL.
Intensive treatment was applied to the remaining three
newborn in a 24-hour period with a decrease in bilirubin in the
patient 4: 16.24 mg / dl at 8.41 mg / dl, in patient 5: from
19.10 Mg / dL to 11.05 mg / dL, and in patient 6: from 15.35
mg / dL to 7.12 mg / dL. The figure 9.a) shows the patient
blood bilirubin in moderate phototherapy for a value of initial
bilirubin 15.57 mg/dl the bilirubin concentration fell to 12.75
mg/dl at 24 hours of treatment. The figure 9.b) shows the
patient blood bilirubin in intensive phototherapy for an initial
value of 16.24 mg /dl the bilirubin concentration fell to 8.41
mg/dl at 24 hours of treatment.
Fig. 9. Patient blood bilirubin a) in intensive and b) moderate phototherapy.
With intensive therapy the reduction of bilirubin
concentration is faster in neonates, so that the programming
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