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PubMed2005

[Centralized management strategy of the infant incubators in NICUs].

There are many problems existing at present in the incubator applications and management. Among them, the prominent problems are their cleaning and disinfection. We hope to find, through the centralized management and clinical engineering, an efficient strategy in order to get more reasonable and better maintenance, cleaning and training for infant incubators in NICUs. Scientific management will provide an excellent service to infant patients.

Incubators, Infant↗
PubMed1983

Air versus skin temperature servocontrol of infant incubators.

Air temperature servocontrol was compared with skin temperature servocontrol and manual control as methods for regulating the heat output of a single-walled incubator (Air-Shields C-86) (1) when optimally used in the laboratory and (2) when operated by staff nurses in the nursery. The subjects were eight premature infants with birth weights between 1.07 and 1.54 kg. When the three methods were used to produce neutral air and skin temperatures during 2-hour measurement periods in the laboratory, there were no differences in mean air, skin, or rectal temperature, metabolic heat production, or body heat loss. There were also no differences among the three methods in mean air, skin, or rectal temperature when used by the nurses in the nursery for periods of 24 hours. When incubator wall temperature is stable, air temperature servocontrol can be used as effectively as skin temperature servocontrol to operate infant incubators.

Body Temperature Regulation↗
PubMed1983

Infant incubators and radiant warmers.

Incubators and radiant warmers are used to maintain the body temperature of newborn infants. This is best done so that the energy expended for metabolic heat production is minimized. The heat output of these devices is usually regulated by servocontrol to keep the skin temperature constant at a site on the abdomen where a thermistor probe is attached. In incubators, air temperature can also be controlled as an alternative to skin temperature servocontrol. Increased ambient humidity, heat shields and clothing have been used to decrease the evaporative or nonevaporative heat loss of infants in incubators under certain conditions. Double-walled incubators, by adding a second inner layer of Plexiglas, reduce radiant heat loss. They may also reduce total heat loss, but only if air temperature is controlled rather than skin temperature. The minimal oxygen consumption under a radiant warmer is the same or perhaps slightly higher than it is for the same infant in an incubator. Compared with incubators, the partition of body heat loss is quite different under radiant warmers. Radiant warmers increase convective and evaporative heat loss and insensible water loss but eliminate radiant heat loss or change it to net gain. A heat shield of thin polyethylene film can be used with a radiant warmer to reduce heat loss by convection and evaporation. The major advantage of the radiant warmer is the easy access it provides to critically-ill infants without disturbing the thermal environment. Its major disadvantage is the increase in insensible water loss produced by the radiant warmer. Most infants can be safely and adequately cared for in either incubator or radiant warmer bed.

Body Temperature↗
PubMed1994

A theoretical model of infant incubator dynamics.

A spatially lumped mathematical model was developed and used for a computer simulation of the neonate-incubator system for parametric analysis of the factors that influence neonatal thermo-regulation. The simulation examined the effects of the following parameters: (1) size of the infant; (2) respiratory rate; (3) metabolic rate; (4) heart rate; (5) thermal properties of the mattress; (6) specific heat capacity of the incubator wall; (7) air flow rate; (8) heater control mechanisms.

Air Movements↗
PubMed1988

Electrically heated simulator for relative evaluation of alternative infant incubator environments.

A 10.9-cm diameter, copper ellipsoid was electrically heated to provide a simulation of sensible heat transfer from a newborn infant. The use of this simulator to determine mean radiant temperature and convective heat-transfer coefficient was demonstrated in three commercial incubators: the Isolette (Model C-86, Narco/Air Shields); the Armstrong Care-ette (Ohio Medical Products); and the I. C. (Ohmeda). The relative performance of these environmental therapeutic devices in shielding an infant against radiant heat loss was judged by the deviation of mean radiant temperature from incubator air temperature, which was varied from 32-36 degrees C. Whereas the I. C. incubator exhibited a radiant temperature always 0.5 degrees C less than air temperature, the Care-ette incubator showed radiant temperatures of 4.0-5.5 degrees C below air temperature, and the Isolette displayed radiant temperatures of 2.7-4.7 degrees C (inner wall removed) and 2.0-3.8 degrees C (inner wall inserted) below air temperature. The relative performance of the incubators in preventing convective heat loss was judged from the magnitude of the convective heat-transfer coefficient, hv. The I. C. incubator had an hv = 4.52 W/m2/degrees C; the Care-ette, 5.55 W/m2/degrees C; and the Isolette 7.19 W/m2/degrees C (inner wall removed) and 6.23 W/m2/degrees C (inner wall inserted). Although an ellipsoid simulator is not an anatomically correct substitute for an infant, it does provide a reliable and convenient comparison of steady-state heat transfer characteristics of alternative environmental devices.

Body Temperature Regulation↗
PubMed1986

Activity, cardiac and respiratory responses of blindfold preterm infants in a neonatal intensive care unit.

The purposes of the present study were to examine 24-h periods in the life of preterm infants incubated in a Neonatal Intensive Care Unit (NICU) using indices of activity, cardiac and respiratory responses, and to examine the effects of blindfolding incubated infants upon these behavioural indices. Ten healthy preterm infants were individually observed for 2 days a week for a 24-h period, using a continuous video recording system. Each infant was blindfolded with an eye-mask and a black head-cap for approximately equal to 10 h during a night out of the 2 days. Analyses on activity, cardiac and respiratory responses were done for (1) 20 min sampled from every other hour during the 2 days, and (2) for 1 h during the night, both a blindfolded day and unblindfolded, respectively. The results showed that activity was less and respiration rate lower when blindfolded than when unblindfolded. Respiration rate was also found to be stable when blindfolded.

Birth Weight↗
PubMed1978

Minimal oxygen consumption in infants cared for under overhead radiant warmers compared with conventional incubators.

Infants under radiant warmers have large increases in insensible water loss compared with infants in single wall incubators. To answer the question of whether or not a minimal rate of oxygen consumption could be achieved under overhead radiant warmers, we measured oxygen consumption, carbon dioxide production, and abdominal skin, cheek, rectal, thigh, and environmental temperature in ten healthy newborn infants in incubators and radiant warmers, using each infant as his/her own control. The minimal VO2 ranged from 4.41 to 8.87 and from 4.35 to 9.06 cc/kg/minute in the incubator and radiant warmer, respectively. The differences were clearly not significant (paired Student t-test, P greater than 0.60). There were no significant differences between the respiratory quotients, VCO2, or abdominal skin, check, rectal or environmental temperatures. These data support the hypothesis that a thermoneutral environment can be provided with a radiant warmer and imply that large increases in insensible water loss can occur without affecting minimal oxygen consumption.

Birth Weight↗
PubMed1994

[A comparison of different respiratory gas-humidifier systems for the respiratory therapy of premature infants in incubators].

OBJECTIVE: 7 humidifier systems for neonatology were subjected to a performance test in our laboratory. DESIGN: In 18 measurement combinations, flow (2,6,16 l/minute), respiratory gas temperature (34 and 37 degrees C) and incubator temperature (33, 35, 37 degrees C) were varied. RESULTS: In only 70.6% of 126 measurements the minimum international standard for the absolute humidity in the respiratory gas (30 mg H2O/l air) was achieved or exceeded. In 3 systems this level was not reached in 9 resp. 10 of 18 measurements. Only 1 device that functions according to the "membrane humidification" principle fulfills the requirements with regard to constant high air humidity. In 36 of 126 ( = 28.6%) measurement combinations the respiratory gas temperature near the endotracheal tube varied > 1 degrees C from the system temperature setpoint. CONCLUSION: No controlled clinical tests regarding the importance and long term effects of different levels in the inspiratory air are so far available for the ventilatory treatment of neonates.

Humans↗