To cover or not to cover: lipids and phototherapy

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Hello all!

One hospital that I worked at covered lipid tubing with aluminum foil when a baby was under phototherapy and another didn't, so I'm wondering what everyone else does.

All input will be greatly appreciated!

Thanks :nuke:

Specializes in NICU, CVICU.

Thanks for all of the responses!

Here's the reasoning behind it:

Lipids are light sensitive, over 24 hours there is an amount of hyperperoxides that are formed and when the baby is under phototherapy that amount increases by 60%. The recommendations that I've found are dark tubing or simply covering the lipids with foil to block them from the light.

(Here's a link to Neonatal Network with a blurb about why hyperperoxides aren't good for our babes: http://www.neonatalnetwork.com/nn3/Abstracts/NNmarch01.htm)

One thing I haven't heard of is the DEHP tubing. Does that refer to the dark tubing or something else?

Once again, thanks for all the input!:yeah:

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Specializes in NICU, PICU, PACU.

That article is from 2001, I wonder if there is anything within the last few years.

We don't cover anything, the amount of tubing in the bed isn't that much and it only holds 0.2mls.

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Specializes in Level II & III NICU, Mother-Baby Unit.

If I understand it correctly, DEHP is a chemical used in plastics (like tubings and IV bags) which makes the plastic softer and more pliable. Unfortunately this chemical has been proven to cause baby boys to be sterile males as adults and who knows what else! Search the chemical on a web browser and you will find loads of information on the subject. I believe that over the past 5 or more years that most hospitals have stopped supplying these DEHP products in NICUs and on Pediatric units. Look on the packaging of the products your unit uses and see if you see that your babies are being exposed and if they are I suggest you bring this to the attention of your management and purchasing department along with some literature to back it up. Our babies depend on us for so many things, don't they?

Thanks for the information on the lipids-phototherapy connection!!

By the way, I was wondering if the reason the other posters to this thread cover their hyperal bags with dark covers is because there is MVI or some other light sensitive additive in the bag? I'd love to learn more about that; thanks in advance.

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Specializes in NICU.

By the way, I was wondering if the reason the other posters to this thread cover their hyperal bags with dark covers is because there is MVI or some other light sensitive additive in the bag? I'd love to learn more about that; thanks in advance.

From what I've been told - yes it is because of the MVI in the TPN bags that require them to be shielded from the light. (Same reason the multi-use bottles of oral MVI are also made from brown glass)

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Specializes in NICU.
From what I've been told - yes it is because of the MVI in the TPN bags that require them to be shielded from the light. (Same reason the multi-use bottles of oral MVI are also made from brown glass)

Which would make sense, because the stock TPNs we use for babies on DOL 1 (or who get made NPO in the middle of the night when the TPN pharmacy is closed) don't have MVI in them, and they don't get covered.

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Specializes in NICU.
Which would make sense, because the stock TPNs we use for babies on DOL 1 (or who get made NPO in the middle of the night when the TPN pharmacy is closed) don't have MVI in them, and they don't get covered.

Same here - but our pharmacy still sends us the covers. They want us always covering it so we "stay in the habit of doing so" at all times.

A year or so ago, our pharmacy was running low on the MVI that they used because it was on backorder (or something like that). So to save their stock until more came in, they added it to the TPN every other day. Even then, they had us cover it every day so that we would stay in the habit of doing so.

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Specializes in NICU- now learning OR!.
That article is from 2001, I wonder if there is anything within the last few years.

We don't cover anything, the amount of tubing in the bed isn't that much and it only holds 0.2mls.

At my old job our lipids were in the TPN...we put foil on all TPN when photo is involved. For the same reasoning as the article mentioned....it oxidizes the lipids which isn't good for the baby. Even if it is a small amount in the tubing (and I truly believe it is more than 0.2 mls!) the rates on these little babies is so "slow" that the IV fluid is exposed to the light for quite some time.

:twocents:

Jenny

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