Neonatal

Every year, an estimated 15 million babies are born preterm in the world, around 520 000 in the US, and this number is rising. They may face a range of health problems and may need to stay in the hospital longer and sometimes in the hospital’s neonatal intensive care unit (NICU). According to WHO, preterm birth complications are the leading cause of death among children under five years of age¹. Premature babies are vulnerable and need special care.

NICUs from the 80s were bright and well- lit. Nowadays, there is a trend to use lower lighting levels². Although fetus development takes place in the dark, fetal diurnal rhythms are entrainable by maternal rhythm mediated via signals such as maternal activity, heart rate, melatonin and cortisol²,³. Keeping preterm patients in a continuously dark or continuously lit environment while in the NICU, deprives them of the circadian stimuli they would have received during gestation.

– Previously, the whole shift would be spent in the dark, now they have a work environment adapted for their tasks instead.

- Annika Rosén, Helsingborg Hospital

Shorten length of stay

In a systematic review by the Cochrane Collaboration the authors suggested better outcomes regarding growth and length of stay with cycled light than with continuous near darkness or bright light⁴. This is an approach also supported by the American Academy of Pediatrics and several researchers⁵,⁶. In one study comparing cycled light for infants born <= 28 weeks postmenstrual age, those exposed to cycled light already at 28 weeks went home an average of 5.5 days earlier than the infants who started cycled lighting at 36 weeks⁷. 

Improve examination accuracy

Clinical examination of the baby and observation of baby and baby’s skin color demands a good perception of color. The color rendering index (CRI) allows to determine color rendering properties of a light source. Taking as a standard the natural light (CRI = 100), this index measures how “true colors” are perceived when illuminated by an artificial light source. Sources of artificial lighting in neonatal care must have a CRI greater than 80². Biocentric Lighting™, as a comparison, provides a CRI of 90.

Cater to individual needs

Light is not only for the babies. Parents and hospital staff also need good light to maintain their circadian rhythm. One of the biggest challenges with light in healthcare is the adaptability of the light solution to a workplace where multiple activities require different solutions for different rooms. The Biocentric lighting system is easily customized to any environment. The light environment provides patients and relatives as well as staff with the light that they need each day, regardless of season.

Sleep is an important factor to promote the wellbeing and recovery of patients.

References

  1. WHO Recommendations on Interventions to Im-prove Preterm Birth Outcomes November.; 2015.
  2. Rodríguez RG, Ph D, Pattini AE, Ph D. Neonatal intensive care unit lighting: update and recommen- dations. Arch Argent Pediatr. 2016;114(04):361-367. doi:10.5546/aap.2016.eng.361
  3. Mirmiran M, Ariagno RL. <Schulze – Unknown – Enhan-cement of Mechanical Ventilation of Neonates by Computer Technology.pdf>. 2000;24(4):247-257. doi:10.1053/sper
  4. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database Syst Rev. 2016;2016(8). doi:10.1002/14651858.CD006982.pub4
  5. McKenna H, Reiss IKM. The case for a chronobiological approach to neonatal care. Early Hum Dev. 2018;126:1-5. doi:10.1016/j.earlhumdev.2018.08.012
  6. Vásquez-Ruiz S, Maya-Barrios JA, Torres-Narváez P, et al. A light/dark cycle in the NICU accelerates body weight gain and shortens time to discharge in preterm infants. Early Hum Dev. 2014;90(9):535-540. doi:10.1016/j.earlhumdev.2014.04.015
  7. Brandon DH, Silva SG, Park J, Malcolm W, Kamhawy H, Holditch-Davis D. Timing for the Introduc- tion of Cycled Light for Extremely Preterm Infants: A Randomized Controlled Trial. Res Nurs Heal. 2017. doi:10.1002/nur.21797