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Further observations on noise levels in infant incubators.

The purpose of this study was to conduct an acoustic analysis of incubator noise under two conditions: when the incubator was associated with different types of life-support equipment; and when impulse noise was created by striking the side of the incubator or by opening and closing the doors of the storage unit. It was found that the life-support equipment increased the overall noise levels of incubators by as much as 15 to 20 dB. Much of this increased energy was in the high frequency region. Impulse signals created by striking the side of the incubator ranged from 130 to 140 dB. A representative impulse for opening the incubator was 92.8 dB, whereas closing the door produced a peak amplitude of 114 dB.

Hearing Loss, Noise-Induced↗

Childhood leukemia and magnetic fields in infant incubators.

In studies of magnetic field exposure and childhood leukemia, power lines and other electrical installations close to the children's homes constitute the most extensively studied source of exposure. We conducted a study to assess whether exposure to magnetic fields in infant incubators is associated with an increased leukemia risk. We identified all children with leukemia born in Sweden between 1973 and 1989 from the national Cancer Registry and selected at random one control per case, individually matched by sex and time of birth, from the study base. We retrieved information about treatment in infant incubators from medical records. We made measurements of the magnetic fields inside the incubators for each incubator model kept by the hospitals. Exposure assessment was based on measurements of the magnetic field level inside the incubator, as well as on the length of treatment. For acute lymphoblastic leukemia, the risk estimates were close to unity for all exposure definitions. For acute myeloid leukemia, we found a slightly elevated risk, but with wide confidence intervals and with no indication of dose response. Overall, our results give little evidence that exposure to magnetic fields inside infant incubators is associated with an increased risk of childhood leukemia.

Adolescent↗

Three-dimensional visualization of air flow in infant incubators using computational fluid mechanics.

An application of three-dimensional (3D) computational fluid mechanics to the air flow in infant incubators is presented. The air flows in two numerical models were simulated by directly solving the Navier-Stokes equations for incompressible gases. The method used was a finite-volume method incorporating a body-fitted coordinate system. The basic model was based on a real infant incubator, which was slightly simplified and included a model of a baby. The number of computation grids was 56 (width) x 21 (depth) x 21 (height) = 24,696. There were several very-large-scale eddies in the incubator free space. In addition to the global structure, small-scale eddies were shown to be produced at many locations scattered in the free space. From these results, it is evident that the conventional assumption of steady and uniform flows in incubators is not always justified when considering heat loss from the body of a baby in an incubator.

Air Movements↗

An application of computational fluid mechanics to the air flow in an infant incubator.

An application of the computational fluid mechanical method to the air flow in a two-dimensional model of an infant incubator was described. The air flow in a numerical model was simulated and the Navier-Stokes equations were directly solved using a finite-volume method incorporating a body-fitted coordinate system on a mini-supercomputer. The model was based on a real infant incubator, slightly simplified for the sake of computing speed, and included a model of a baby. The number of computation grids was 101 x 61 = 6161. The calculation was carried out under the condition of unsteady, starting airflow and the results were examined by the means of color graphics animation. There were several very large scale eddies in the incubator free space, and their global structure did not show strong changes once they were established. Although the global structure did not change, small scale eddies were shown to be produced around the air inlet and convected down through the free space of the incubator. From these results, we believe that assuming steady and uniform flow in the incubator may not always be relevant when considering heat loss of a baby in an incubator. The steady and uniform flow has been previously assumed either implicitly or explicitly by most of the authors.

Air↗

A prototype infant incubator for heliox therapy.

Heliox (Hx) gas has been shown to improve pulmonary function in infants, but methods for its delivery are invasive and problematic. To this end, we modified an Isolette (Hill-Rom Air-Shields) infant incubator (Hxl) to deliver Hx respiratory gas mixtures noninvasively while providing thermal stability for neonatal care in the Neonatal Intensive Care Unit (NICU). In vitro tests and in vivo animal studies were performed to compare the original design specifications and established baseline performance criteria for the Hxl design. The experimental environments at 50% and 80% relative humidity (RH) consisted of helium (He) with 21% and 50% O2 and control (C) of 21% and 50% O2 with the balance nitrogen (N). Elapsed times to steady state (SS) and recovery time back to SS (OCDss) due to opening and closing the door were recorded for each variable. All rabbits survived and appeared comfortable during all experimental conditions. These data show that the newly designed Isolette provides similar thermal, O2, CO2, and RH responses as the control incubator. Based on these positive safety/efficacy studies, study of the therapeutic impact of Hxl care on neonatal growth and development is in progress.

Administration, Inhalation↗

Comparison of heated water-filled mattress and space-heated room with infant incubator in providing warmth to low birthweight newborns.

BACKGROUND: Prevention of excessive heat loss is fundamental to survival of low birthweight (LBW) newborns. The use of infant incubators (INC) is beyond the resources of developing countries, and the space-heated room (SHR) has been the only feasible means of providing thermal protection to LBW newborns. Recently a thermostatically controlled, heated, water-filled mattress (HWM) has been developed as a potentially simpler and affordable alternative. METHODS: In a neonatal care ward of a referral hospital in Addis Ababa, 62 < 1 week old newborns, weighing 1000-1999 g, who were well enough to breathe comfortably in room air and tolerate oral feeds, were randomly allocated to INC, HWM or SHR and followed for 3 weeks. The level of cold stress as assessed by core-to-skin temperature gradient and the rate of weight gain were the main outcome measures. RESULTS: The level of cold stress was lowest in the INC, intermediate in the HWM and highest in the SHR. Relative to the INC group, the HWM group exhibited a modest increase in the occurrence of clinically important hyperthermic or hypothermic deviations in core temperature (rate ratio (RR) = 2.3; 95% CI: 0.9, 5.6), and the SHR displayed a definite increase (RR = 4.0; 95% CI: 1.7, 9.3). During the first week, the rate of weight gain was highest in the INC group (3.6 g/kg/day), lowest in the SHR group (-2.3 g/kg/day, P < 0.05 versus INC) and intermediate in the HWM group (1.6 g/kg/day, P > 0.1 versus INC). CONCLUSION: Care in the SHR produced clinically significant thermal stresses and was associated with deficient early neonatal growth, but the use of HWM may constitute a feasible and clinically acceptable alternative in providing warmth to LBW newborns during the neonatal period.

Beds↗

Study of extremely low frequency electromagnetic fields in infant incubators.

OBJECTIVES: The aim of the work was to present the results of measurements of extremely low frequency electromagnetic fields (ELF EMF), namely the magnetic flux density, inside infant incubators, and to compare these results with the data published by other authors who point out to a possible association between leukemia or other diseases observed in newborns kept in incubators after the birth and the ELF EMF exposure in the incubator. The measured magnetic flux densities were compared with the reference values for this frequency range indicated in the European Union (EU) recommendations. MATERIALS AND METHODS: The repeated measurements in incubators were made with a calibrated magnetometer EFA 300 in the frequency range of 5-30 kHz. Effective values of magnetic flux densities of ELF EMF were determined taking account of the reference values. RESULTS: The results of many repeated measurements showing the values of magnetic flux density in modern incubators with plastic supporting frame, were compared with those obtained in old type incubators with iron skeleton. A power frequency of 50 Hz was detected in the incubator and the ELF EMF values were by over two orders lower than the EU reference values. CONCLUSIONS: The paper emphasizes the need to take a special care of newborns kept in incubators even if only the sub-reference values are detected. The EU reference values are intended for the adult human population. A baby in an incubator has much smaller dimensions, higher electric conductivity and maybe trigger another mechanism of response to ELF EMF than that indicated in this paper.

Electromagnetic Fields↗

Modification of an infant incubator for exposure of experimental animals to nitrous oxide.

Research with N2O is hampered because it is a gas and must be inhaled by the test subject rather than injected. Described herein is the development of a practical and efficient exposure chamber for such research. A Model C-35 Isolette infant incubator was modified by installation of a manifold system for distribution and opposed-suction fans for a circulation of the gas mixture (N2O in oxygen). An exponential model was developed, predicated on gas concentration uniformity, to track the increasing concentration of N2O during chamber filling and to predict the time required for the chamber to assume a steady-state level of N2O. This model requires that three things be known: the volumetric flow rate of administered gas mixture, the concentration of N2O in that mixture, and the volume of the chamber. The model predicts that X(t)/X infinity = 1 - exp(-t/tau), where X(t) is the concentration of N2O of an instant t; X infinity, the concentration of N2O administered; and tau, the time constant--the ratio of chamber volume to volumetric flow rate. This model was confirmed via mass spectroscopy analysis of gas from the chamber during filling.

Air↗

Web-based remote monitoring of infant incubators in the ICU.

A web-based real-time operating, management, and monitoring system for checking temperature and humidity within infant incubators using the Intranet has been developed and installed in the infant Intensive Care Unit (ICU). We have created a pilot system which has a temperature and humidity sensor and a measuring module in each incubator, which is connected to a web-server board via an RS485 port. The system transmits signals using standard web-based TCP/IP so that users can access the system from any Internet-connected personal computer in the hospital. Using this method, the system gathers temperature and humidity data transmitted from the measuring modules via the RS485 port on the web-server board and creates a web document containing these data. The system manager can maintain centralized supervisory monitoring of the situations in all incubators while sitting within the infant ICU at a work space equipped with a personal computer. The system can be set to monitor unusual circumstances and to emit an alarm signal expressed as a sound or a light on a measuring module connected to the related incubator. If the system is configured with a large number of incubators connected to a centralized supervisory monitoring station, it will improve convenience and assure meaningful improvement in response to incidents that require intervention.

Computer Communication Networks↗

A combined study of heat and mass transfer in an infant incubator with an overhead screen.

The main objective of this study is to investigate the major physical processes taking place inside an infant incubator, before and after modifications have been made to its interior chamber. The modification involves the addition of an overhead screen to decrease radiation heat losses from the infant placed inside the incubator. The present study investigates the effect of these modifications on the convective heat flux from the infant's body to the surrounding environment inside the incubator. A combined analysis of airflow and heat transfer due to conduction, convection, radiation and evaporation has been performed, in order to calculate the temperature and velocity fields inside the incubator before and after the design modification. Due to the geometrical complexity of the model, computer-aided design (CAD) applications were used to generate a computer-based model. All numerical calculations have been performed using the commercial computational fluid dynamics (CFD) package FLUENT, together with in-house routines used for managing purposes and user-defined functions (UDFs) which extend the basic solver capabilities. Numerical calculations have been performed for three different air inlet temperatures: 32, 34 and 36 degrees C. The study shows a decrease of the radiative and convective heat losses when the overhead screen is present. The results obtained were numerically verified as well as compared with results available in the literature from investigations of dry heat losses from infant manikins.

Algorithms↗