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Treatment of hyperbilirubinemia in the newborn Phototherapy exposes a newborn's skin to visible light between 430-490 nm and induces a degradation of the bilirubin molecule that has accumulated at the level of the skin. The Giraffe SPOT PT phototherapy system uses halogen white light instead of fluorescent blue-green light. Phototherapy consists of using the energy from this light to modify the bilirubin molecule, making it water soluble. The light absorbed from the skin tissues transforms unconjugated bilirubin into two isomers through photo-chemical and photoisomerization reactions. These photoproducts then pass from the tissues, bound to serum albumin, to the bloodstream. They are transported and excreted from the liver into the bile without undergoing conjugation or requiring special transport for their excretion. Gastroentestinal and urinary elimination remain important to the process of reducing bilirubin load. The effectiveness of phototherapy is related to the area of skin exposed and the intensity of the light at the skin. It is possible to obtain an improved skin coverage and more intensive phototherapy by using two phototherapy light units. However, when using a halogen light it is important to respect the manufacturer's recommendation for safe minimal distance from the lamp to the newborn. The Giraffe SPOT PT phototherapy system The intensity of the light delivered with the Giraffe SPOT PT system is 57.6 uW/cm2/nm ± 25% when the light is placed at a distance of 38 cm from the newborn. This spectral irradiance (intensity) equates to "intensive phototherapy" because it emits a light intensity of over 30 uW/cm2/nm. To assure effective therapy, a regular maintenance plan is provided by the department of biomedical engineering for ensuring adequate light intensity. Drager Isolette 8000 incubator The Drager Isolette 8000 incubator uses a forced air system to maintain the infant's body temperature. The temperature can be managed by using either the air temperature of the incubator or the infant's temperature. When phototherapy is directed over an incubator, the skin control mode is preferred because this automatic compensatory mechanism keeps the infant's body temperature within normal limits when the lights are on. (Stokowski, 2011).