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[Studies on noise stress caused by infant incubators (author's transl)].

The following acoustic effects of incubators were investigated: Noise level and vibration measurements inside incubators. Noise emanation into the vicinity of incubators. Deadening of incubator noise by the hood. The noise intensity inside the incubators was also registered under conditions of intensive care using sound emitting therapeutic and monitoring equipment. The results show that the noise level of incubator motors can be tolerated. This applies to well-serviced incubators only, however. The hood muffles outside noise, particularly in the range of greatest hearing acuity. But there is no protection against noisy intensive-care systems within the incubator. The infants own noise production is considered to contribute substantially to the noise within an incubator.

Humans

Mercury vapor contamination of infant incubators: a potential hazard.

In a survey of 42 infant incubators 18 showed detectable concentrations of mercury vapor. In 12 instances the concentrations of mercury vapor in the thermometer holder exceeded industrial safety standards. In 16 incubators the contamination was traced to broken mercury-in-glass thermometers used to monitor incubator ambient temperatures. Use of alcohol thermometers or thermistors in place of mercury-in-glass thermometers would eliminate this potential hazard.

Air Pollutants

Infant incubators.

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Body Temperature

Air temperature recordings in infant incubators.

Air temperatures were continuously recorded inside four incubators with proportional heating control and six incubators with on/off heating cycles, during routine use. The air temperatures in the former were constant throughout, with a gradient between the roof and above-mattress air temperature not exceeding 1 degree C. In contrast, the recordings from the latter models showed a regular cyclical oscillation, the duration of the cycle varying from 14 to 44 minutes. Each incubator had a characteristic profile. The roof air temperature could vary by as much as 7-1 degrees C and the above-mattress air temperature by as much as 2-6 degrees C during the cycle. The oscillation persisted in the air temperatures recorded inside an open-ended hemicylindrical heat shield when used inside these incubators, but was markedly reduced inside a closed-ended heat shield, Carbon dioxide concentration did not increase significantly inside the latter.

Body Temperature

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

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

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

Neonatal exposure to methyl chloroform in tape remover.

Methyl chloroform (MC) is commonly used solvent found in some adhesive tape remover products used in intensive care nurseries. Since volatile substances can accumulate inside an infant incubator, we measured levels of MC following simulated use of 2 commercially available adhesive tape remover pads. Readily detectable levels of MC could be found in incubator air for several minutes. Although adult occupational neurotoxic thresholds are higher, increased toxic susceptibility of the neonate CNS indicates caution should be observed.

Air

Thermal effects of hooding incubators.

OBJECTIVE: To determine the effect of covering infant incubators on incubator wall and air temperatures, as well as on infant temperatures. DESIGN: A within-subject ABA design, in which blankets covering the incubators were removed for a 30-minute period and then replaced. SETTING: A neonatal intensive-care unit. PARTICIPANTS: Eight medically stable infants (gestational age, 28-33 weeks; birth weight, 913-1,947 g; and postnatal age, 2-39 days). INTERVENTIONS: Incubator wall and air temperatures as well as infant temperatures were measured during three study conditions: incubators covered (30 minutes), uncovered (60 minutes), and re-covered (30 minutes). MAIN OUTCOME MEASURES: Incubator air and wall temperature; infant temperature. RESULTS: All incubator walls decreased in temperature after being uncovered; the decrease ranged from 0.6-2.2 degrees C. CONCLUSION: Although infants maintained relatively stable body temperatures during the uncovered period, the energy cost to their thermoregulatory efforts is unknown.

Body Temperature

[Surgical closure of persistent ductus arteriosus in small premature infants in an incubator].

In premature neonates a patent ductus arteriosus causes often other complications thus the immediate closure of the patent ductus arteriosus should be preferred or recommended. Performing the surgical closure of the ductus within the incubator can avoid complications during transportation from the premature neonates intensive care unit to the operating room. 25 very small premature neonates or those with another burden in addition were operated upon in the incubator on the premature infants intensive care unit of our hospital during the period from January 1987 to April 1989. No complications occurred during the operation, especially not caused by the strange circumstances for the operating team. Wound infections because of possible bacterial contamination of the incubator or the room were not observed during the postoperative period.

Ductus Arteriosus, Patent

Effects of low humidity on small premature infants in servocontrol incubators. I. Decrease in rectal temperature.

19 small premature infants in servocontrol incubators, whose abdominal skin temperature was 36.0 +/- 0.3 degrees C, were subjected to alternate high- and low-humidity environments. With low humidity, rectal temperature dropped significantly below abdominal skin temperature. Skin was the predominant site of evaporative heat loss. The temperature was lower on naked skin than on an area covered by adhesive tape. Thus, servocontrol with low humidity increases evaporative heat loss and engenders a cycle of events that results in paradoxical body temperature decrease as the incubator temperature increases.

Abdomen