Increased insensible water loss in newborn infants nursed under radiant heaters.
Urine osmolality was studied in 38 babies nursed in conventional incubators or cots and 18 nursed under an overhead radiant heat shield. Among 50 babies receiving a similar fluid intake in the first 48 hours of life mean urinary osmolality was significantly higher in the radiant heater group. In babies weighing less than 1500 g a trend towards higher urinary osmolalities was recorded in those nursed under radiant heaters even though they had received amost double the fluid intake of the incubator group. Severe hypernatraemia occurred in four of the five babies weighing less than 1000 g who were nursed under radiant heaters but in none of the seven babies of similar birth weight nursed in incubators. These findings are consistent with previous observations of an increase in insensible water loss in babies nursed under radiant heaters and emphasise the importance of providing enough extra water for these infants and the need for close monitoring of their fluid balance. The latter may be done at the bedside by measuring urinary specific gravity with a hand refractometer. (+info)
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. (+info)
Thermal stability and transition studies with a hybrid warming device for neonates.
OBJECTIVE: The use of both warmer beds and incubators is common in neonatal intensive care units (NICU), and transferring between these two warming devices is a routine and necessary event. This study was designed to evaluate the efficacy of a new hybrid-warming device, the Versalet, in transitioning a preterm animal from a warmer bed to an incubator mode and back. STUDY DESIGN: Nine premature lambs were randomized, following delivery, to receive thermal support from a conventional warming bed and an incubator (control group), or from the Versalet (study group) in the warmer bed and incubator modes. Core and various surface temperatures, as well as physiological parameters were measured first during warming in the radiant warmer bed mode, Versalet or Resuscitaire and then during transition to the incubator mode, Versalet or Isolette, and then back to the warmer bed mode. RESULTS: The animals remained stable during all the transitions. Despite careful planning, adverse events occurred in the control group during transfers. There were no significant differences in the temperature or physiologic profiles during any of the transitions in either group. CONCLUSION: Compared with the standard warming technique used in NICUs (separate warmer bed and incubator), the Versalet provides similar thermal and cardiovascular stability without adverse events during transition to different modes of warming. The degree to which this device would contribute to ease of management and improved outcomes in humans needs to be evaluated in a clinical trial. (+info)
Transmission loss of sound into incubators: implications for voice perception by infants.
OBJECTIVE: To assess the transmission of sound into incubators as a function of talker position (i.e., standing or sitting), incubator port position (i.e., opened or closed), and center frequency (i.e., 125 to 10,000 Hz in one-third octave steps). The second objective was to estimate the audibility of the human voice inside the incubator. STUDY DESIGN: L(eq) measures of signal transmission loss and motor noise were obtained from two incubators. RESULTS: In general, signal transmission loss was greater for the standing-talker position, with front portholes closed, and for high-frequency spectra. Motor noise was greater with both front portholes closed and for lower-frequency spectra. The greatest signal delivery to an infant would be obtained when the speaker is sitting using a raised vocal effort while the incubator ports are opened. CONCLUSION: Measured signal transmission loss and motor noise characteristics of two incubators suggest that only mid-frequency speech spectra would be audible to infants and only at a speech-to-noise ratio of approximately 5 to 10 dB with a raised vocal effort. (+info)
Transporting the incubator: effects upon a region of the adoption of guidelines for high-risk maternal transport.
OBJECTIVE: To inventory maternal transport practices and develop regional transport guidelines. STUDY DESIGN: A survey was administered to perinatal nursing directors of nine community hospitals in a rural region of Virginia. Items included personnel, training, equipment, vehicle, communication, and protocols. Following the survey, regional guidelines were developed using a collaborative process. Their use was promoted in the region. A post-intervention survey documented changes in transport practices. RESULTS: The pre-intervention survey showed wide variability in training and number of personnel and in availability of emergency equipment. Communication was via radio to a dispatcher. No hospital had standing orders or protocols for transport. Guidelines were developed, which included recommendations for personnel, equipment, vehicle, communication methods, and care protocols. Eight of nine hospitals endorsed the guidelines. A follow-up survey revealed practice changes for standing orders/protocols, communication, and equipment. CONCLUSION: Regionwide practice changes can be successfully implemented. Guidelines may be helpful for other regions using primarily one-way maternal transports. (+info)
Effect of thermal environment and caloric intake on head growth of low birthweight infants during late neonatal period.
In order to assess the effects of ambient thermal conditions on postnatal head growth in low birth weight infants, 42 asymtomatic neonates were reared under 4 combinations of caloric intake and thermal environment after the first week of life. Exposure to a subthermoneutral temperature (abdominal skin temperature of 35 degrees C), together with a relatively low caloric intake (120 cal/kg per day), was associated with significant retardation of head growth over a 2-week study period. (+info)
Transport of newborn infants for intensive care.
During the three years 1972-4 222 newborn infants were transported to this hospital for intensive care. They were collected by trained staff using a specially modified transport incubator with an in-built mechanical ventilator and facilities for monitoring body temperature, heart rate, and inspired oxygen concentration. Two of the infants came from home and the rest from 41 hospitals from half a mile (0-8 km) to 50 miles (80-5 km) (median eight miles (12-9 km)) away. The mean birth weight of the infants was 1702 g (range 520-4040 g) and their mean gestational age was 32 weeks (range 24-42 weeks). The principal reasons for referral were low birth weight and severe respiratory illnesses. Altogether 109 (49%) of the infants needed mechanical ventilation in transit and another 38 (17%) needed it later. During the journey the condition of 88 (40%) of the infants was thought to improve, in 125 (56%) it was static and in nine (4%)--four of whom died--it deteriorated. A total of 142 infants (64%) survived the neonatal period. There was no correlation between the distance travelled and the survival rate. Seriously ill newborn infants may be transported safely to a referral centre within a radius of 50 miles, and the risks of the journey are negligible compared with the risks of leaving the infant in a hospital that is not staffed or equipped for neonatal intensive care. (+info)
Stephane Tarnier (1828-1897), the architect of perinatology in France.
Stephane Tarnier studied medicine in Paris and became the doyen of obstetrics in France during the second half of the 19th century. He pioneered many advances and encouraged a perinatal approach to childbirth that was further developed by his disciples, Budin and Pinard. (+info)