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PubMed2001

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.

Acoustics↗
PubMed2003

Preterm infant thermal responses to caregiving differ by incubator control mode.

OBJECTIVE: To determine the influence of caregiving on preterm infant and incubator temperature and to investigate incubator control mode in thermal responses to caregiving. STUDY DESIGN: The intensive within-subject design involved continuous recording of infant and incubator temperature and videotaping throughout a 24-hour period in 40 hospitalized preterm infants. Temperature at care onset was compared with care offset, and 5, 10, 15, and 20 minutes following care offset using ANOVA-RM. RESULTS: Following caregiving, infant and incubator temperature differed significantly over time by incubator control mode. In air servo-control, infant temperature tended to decrease after caregiving, while in skin servo-control infant temperature remained relatively stable. With caregiving, incubator temperature remained consistent in air servo-control and increased in skin servo-control. CONCLUSIONS: The temperature effects of caregiving should be considered relative to maintenance of thermoneutrality and unintentional thermal stimulation.

Body Temperature↗
PubMed1991

Gordon memorial lecture. Physics and physiology of incubation.

1. The earliest mention of artificial incubation occurs in Aristotle's Historia Animalium written in the 4th century BC. A brief survey of the history of incubation is given from that time to the present. 2. Artificial incubation is also practised by birds belonging to the family of the Megapodes: the Brush Turkey and the Mallee Fowl build a mound and maintain the required temperature of the eggs laid in it. 3. The importance of functional eggshell porosity and incubator ventilation rate for maintaining optimal gas tensions in the embryonic medium (the gas space below the shell) is discussed. 4. Among the early scientific studies (reviewed by Landauer, Lundy, Freeman) particular attention is paid to Barott's (1937) systematic work on temperature, relative humidity and oxygen concentration. 5. The requirements of the embryo with regard to temperature, humidity and gaseous environment are defined. The importance of using gas tensions instead of gas concentrations is once again emphasised. 6. The problems of incubation at high altitude are explained and a successful method for hatching eggs at any terrestrial altitude is described. 7. Although hens can be selected for the functional porosity of their eggs, the procedure does not offer any worthwhile advantages. 8. If functional eggshell porosity and embryonic oxygen uptake are known, then optimal incubator ventilation rate can be predicted when a given optimum gas space oxygen tension is assumed.

Altitude↗
PubMed2001

Short-term effects of incubator covers on quiet sleep in stable premature infants.

UNLABELLED: Incubator covers are increasingly being used in neonatal care as part of minimal disturbance strategies. The aim of this study was to examine possible effects of incubator covers on sleep patterns in stable premature infants. Quiet sleep (QS) can be investigated by amplitude-integrated electroencephalography (aEEG) at 32-34 wk gestational age. In nine premature infants (gestational ages 26-32 wk, median 29) QS periods were measured at a postconceptional age of 32-34 wk (median 34) during two consecutive 24 h periods, one period with a padded dark cover over the incubator and one period without the cover, in a randomized order. There were no significant differences between the two 24 h periods (with incubator cover and without cover, respectively) regarding the duration of the QS periods, the percentage of QS of the total recording time (%QS) or the duration of QS intervals. However, there was a positive correlation between postnatal age in days and the mean duration of QS periods when incubator covers were used (r = 0.90, p = 0.001). When the covers were used there was a difference between the girls and the boys in the duration of QS intervals (p = 0.032); the QS intervals increased in the five girls from median (range) 63.2 (49.4-94.6) min to 77.2 (59.3-100.9) min (p = 0.043). There was no difference in the duration of QS periods between girls and boys. CONCLUSION: Incubator covers seem to have some short-term effects on sleep quality in premature infants but the clinical significance and possible long-term effects are not known.

Age Factors↗
PubMed2003

Quantification and control of the spatiotemporal gradients of air speed and air temperature in an incubator.

Around the optimal incubator air temperature only small spatiotemporal deviations are allowed. However, air speed and air temperature are not uniformly distributed in the total volume of the incubator due to obstruction of the eggs and egg trays. The objectives of this research were (1) to quantify the spatiotemporal gradients in temperature and velocity and (2) to develop and validate a control algorithm to increase the uniformity in temperature during the entire incubation process. To improve the uniformity of air temperature, the airflow pattern and the air quality need to be controlled more optimally. These data show that the air temperature between the eggs at a certain position in a large incubator is the result of (1) the mean air temperature of the incubator; (2) the exchange of heat between the egg and its micro-environment, which is affected by the air speed at that certain position; (3) the time-variable heat production of the embryo; and (4) the heat influx or efflux as a result from the movement of hot or cold air in the incubator toward that position, which is affected by the airflow pattern. This implies that the airflow pattern needs to be controlled in a more optimal way. To maximize the uniformity of air temperature, an active and adaptive control of the three-dimensional (3-D) airflow pattern has been developed and tested. It was found to improve the spatiotemporal temperature distribution. The chance of having a temperature reading in the interval from 37.5 to 38.1 degrees C increased by 3% compared to normal operating conditions.

Air Movements↗
PubMed2002

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↗
PubMed1978

Possible effects of kanamycin and incubation in newborn children with low birth weight.

In an acoustico-vestibular follow-up investigation of 91 four- to six-year-old children with birth weight below 2000 g, the same incidence of sensorineural hearing loss (19%) was found in 54 children treated with kanamycin in the neonatal period as in a group of 37 infants not treated with kanamycin. When comparing a group of children treated with both kanamycin and incubator (54 children) with a group treated with incubator only (16 children), no definite signs of synergism between incubator noise and kanamycin were found. However, the 5 cases of moderate or severe hearing loss all belonged to the group treated with both incubator and kanamycin. These 5 children had more severe neonatal complications, especially apnea, cyanotic spells and hyperbilirubinemia, which may increase the severity of the hearing loss. Among 56 incubator treated children with normal hearing (ISO standards) 52% had an audiogram pattern suggesting minor noise-provoked cochlear lesions. Among 18 non-incubator treated children with normal hearing only one child (6%) had a similar pattern. It should be stressed, however, that these children had no clinical symptoms of hearing loss.

Audiometry↗
PubMed1990

Use of tri-gas incubator for routine culture of Campylobacter species from fecal specimens.

We evaluated a tri-gas incubator for Campylobacter isolation to be used instead of an anaerobic jar. Fecal specimens were cultured in duplicate onto charcoal selective medium and incubated at 43 degrees C for 48 h in two different environments: a tri-gas incubator (Forma Scientific) adjusted to provide an atmosphere of 10% CO2, 10% O2, and the balance N2; and evacuated anaerobic jars with a replacement gas mixture of 10% CO2, 5% O2, and 85% N2. A total of 106 Campylobacter jejuni and 8 Campylobacter coli isolates were obtained from 2,348 stool specimens. Of the positive specimens, 113 isolates came from the incubator and 111 isolates came from the anaerobic jars. An additional 32 previously positive specimens were replated onto charcoal selective medium and retested by both methods. We recovered 27 C. jejuni isolates, 26 isolates by each method. The isolates from the incubator typically produced discrete colonies, while the isolates from the anaerobic jar showed some degree of swarming in colony formation. The tri-gas incubator provided a cost-effective method for culturing Campylobacter spp.

Bacteriological Techniques↗
PubMed1993

Observations on the commercial production of ostrich (Struthio camelus) in the United Kingdom: incubation.

Two sets of ostrich eggs (60 and 120 eggs) were imported into the United Kingdom under class 1 quarantine restrictions. Single stage incubation was carried out and the eggs were weighed before and during incubation in order to control weight loss. In the two hatches the weight losses during the incubation of viable eggs were 13.4 per cent and 11.4 per cent, respectively. The development of the eggs was followed by candling and although only dark shadows were observed a pattern could be recognised. For the first set of eggs the average length of incubation was 45.9 days with an interval of 12.7 hours between pipping and hatching. The second set of eggs was incubated at higher temperatures than the first and the main incubation period was 43.3 days with hatching 19.2 hours after pipping. Larger eggs took longer to hatch.

Animals↗
PubMed2003

Use of sound-absorbing panel to reduce noisy incubator reverberating effects.

OBJECTIVES: To assess the amplification and distortion of noise in incubators by measuring noise levels from various sources under various conditions. STUDY DESIGN: We recorded sound pressure levels (SPL) of background noise, baby crying, alarms and porthole closing with the incubator hood open or closed. Then we tried to reduce the sound level in the incubator by applying a sound absorbing panel to the ceiling of the hood. RESULTS: The sound sources analysed produced very high SPL. In free field baby crying and porthole noise were, respectively, 81-83 dB and 70-71 dB, closing the hood they raised to 84-87 and 73-74 dB: this means that the noise perceived by a baby in the incubator had twice the SPL of the same noise emitted in a free field; alarm noise was 56-57 dB inside incubators. Sound emitted inside the hood was also distorted, i.e. it had different features from the same source in a free field. The insulating panel prevented amplification and distortion due to the hood and reduced the SPL of alarms. Only background noise did not decrease with the panel. Sound absorbing panel reduced baby's crying, porthole noise and alarm noise SPL to 82-85, 70-71 and 50-51 dB, respectively. CONCLUSIONS: Incubators are reverberating environments, which amplify the baby's cry and other noises produced inside the hood. The frequency components of noises are altered by the hood. The sound absorbing panel reduced this phenomenon.

Crying↗
PubMed1984

Relative efficacy of radiant and convective heat in incubators in producing thermoneutrality for the premature.

To determine which warming system more closely approximates a neutral thermal environment, the oxygen consumptions of 16 premature babies less than 1500 g were measured in a convectively heated incubator and a radiantly heated incubator. Both systems were controlled to maintain a skin temperature of 36 degrees C. The oxygen consumptions of the infants were not significantly different in the two incubators; thus, there was no detectable advantage to the use of convective or radiant energy in approximating a neutral thermal environment in an incubator for the small premature infant. That proportion of total heat loss from the babies due to radiant losses in the convective incubator was directly calculated from incubator temperature using equations described in the paper, and found to be 68 +/- 3% SE.

Birth Weight↗
PubMedDate not supplied

A comparison of the light-reduction capacity of commonly used incubator covers.

PURPOSE: The use of incubator covers to enhance preterm infants' rest and recovery is common in the NICU. However, the kinds of covers used vary extensively among and within nurseries. Few data exist on the effectiveness of different types of covers in reducing light levels to the infant. This study compared several types of commonly used incubator covers as to efficacy of light reduction. DESIGN: A descriptive, comparative design was used in this study. SAMPLE: Twenty-three incubator covers were tested, including professional, receiving blanket, hand-crocheted, three-layer quilt, and flannel. MAIN OUTCOME VARIABLE: The percentage of light level reduction of different incubator covers under various ambient light level settings. RESULTS: The amount of light reduction provided by incubator covers varies depending on type of fabric as well as percentage of incubator surface shielded by the cover. Dark-colored covers provided greater light reduction than bright/light-colored covers when covers identical in fabric type were compared. The light-reduction efficiency of the covers varied depending on the level of ambient light. Covers provided less light reduction in higher ambient light levels.

Analysis of Variance↗
PubMedDate not supplied

Mannequin-assessed dry-heat exchanges in the incubator-nursed newborn.

For manufacturers of warming devices for newborn infants, knowledge of the partition of the various channels of heat transfer between the neonate and the environment is necessary to regulate them adequately. The goal of this study was to determine the contributions of the different components of dry heat exchange using a thermal mannequin that replicated a full-term neonate. Each mannequin segment could be controlled separately at a selected surface temperature. The mannequin was placed in a reclining position on a mattress in a single-walled incubator (BioMS C2750). Conductive (K), convective (C), and radiative (R) heat exchanges were measured at incubator temperatures (T alpha) of 29 degrees, 32 degrees, and 34 degrees C and at air velocities (Va of 0 to 0.7 m/sec. Conductive heat exchanges varied from 4.5% to 7.9% of total dry heat loss (H). The conductive heat transfer coefficient was 0.21 W/degree C, and the mannequin surface area in contact with the mattress was 10.4% of the total surface area (A). Under natural convection, the convective and radiative heat transfer coefficients were 4.94 and 4.77 W/m2/degree C, respectively. The radiating surface area was 78% of total surface area. Convective heat exchange decreased from 36% to 17%, and radiative heat exchange increased from 60% to 79% of total dry heat loss as incubator temperature increased from 29 degrees to 34 degrees C. When air velocity was raised, convective heat exchange increased, whereas radiative heat exchange decreased. Whatever the incubator temperature, a fivefold increase in convective heat exchange was observed when air velocity increased, whereas radiative heat exchange was unchanged. At an incubator temperature of 34 degrees C and for air velocities between 0.1 and 0.4 m/sec radiative heat exchange is the dominant mode of heat loss. The results suggest that this thermal mannequin is a good tool for assessing dry heat exchange in incubators.

Body Temperature Regulation↗
PubMedDate not supplied

Neonatal response to control of noise inside the incubator.

PURPOSE: The purpose of this study was to test the effect of acoustical foam on the level of noise inside the incubator and examine neonatal response behaviors to changes in environmental noise. METHOD: The study used a repeated measure, within subject, comparative design. Data on 65 premature neonates were collected over a 14-month period at a large teaching hospital in Delaware. Sound levels, oxygen saturation, and infant states were measured and recorded during three study conditions: pre-study neonate in incubator, neonate in incubator with 5 x 5 x 1 inch acoustical foam pieces placed in each of four corners, and post-study recovery of neonate in incubator with foam removed. All state assessments were measured with oxygen saturation and sound level measurements every 2 minutes of the study for a total 40 minutes. FINDINGS: The findings demonstrate a significant treatment effect of acoustical foam on decreasing environmental noise measurements inside the incubator (p = 0.006). Findings also demonstrate significantly changed neonatal state response behaviors with decreasing environmental noise measurements inside the incubator (p = 0.00). CONCLUSIONS: The results of this study support the use of acoustical foam as one method of environmental noise management in the intensive care nursery. Because there was a significant correlation between higher noise levels and oxygen support therapy, the findings suggest that special nursing considerations should be taken when caring for ventilator-dependent infants. Noise control protocols should focus on essential environmental interventions for care of these infants.

Acoustics↗
PubMed2003

Heart period variability of intubated very-low-birth-weight infants during incubator care and maternal holding.

BACKGROUND: Heart rate has been used to measure infants' physiological stability during skin-to-skin holding. Variability in heart period (interbeat interval), a more sensitive measure of autonomic nervous system tone, has not. OBJECTIVE: To describe heart period variability in intubated very-low-birth-weight infants during incubator care and during maternal skin-to-skin holding. DESIGN/METHODS: An experimental, interrupted time series, crossover design was used; infants served as their own controls. Infants were randomly assigned to treatment order: 2 hours of intermittent skin-to-skin holding for 2 consecutive days followed by 2 days of incubator care or vice versa. The analog signal representing heart period was sampled and quantized at 5 Hz via a dedicated computer system in multiple 300-second epochs each day. RESULTS: Fourteen infants with similar characteristics completed the protocol. The mean interbeat interval was 332 ms during skin-to-skin care and 368 ms during incubator care. Power within the low- and high-frequency regions of heart period was not significantly different between skin-to-skin holding and incubator care. Mean low-frequency power was 124.6 ms2 during skin-to-skin holding and ranged from 51.9 ms2 to 71.4 ms2 during all periods of incubator care. Mean high-frequency power was similar during skin-to-skin holding and incubator care (8.8 ms2 and 6.1 ms2). Infants of 32 to 34 weeks' corrected gestational age had increased power in the low- and high-frequency regions. CONCLUSIONS: Heart period variability did not improve during skin-to-skin holding. Gestationally older infants had increased power in the low- and high-frequency regions, suggesting a maturing autonomic nervous system.

Analysis of Variance↗
PubMed1992

[Experimental perinatology--development of extrauterine fetal incubation system].

It goes without saying that the ideal situation for the immature fetus is growth within the normal environment of the maternal organism. Thus, in order to perform incubation that more closely resembles that of the fetus in utero, both in the extracorporeal and intracorporeal environment, an extrauterine fetal incubator, consisting of an artificial womb containing artificial amniotic fluid and a complete artificial placental system with a membrane oxygenator, was developed. Although similar experiments were performed in fetal lambs by Callaghan et al., Alexander et al., and Zapol et al., the fetuses only survived incubation for short periods of time, no longer than 55 hours. Previously, we reported the relatively long-term extrauterine incubation of goat fetuses, where by the longest period of incubation was 236 hours. However, several major problems, remained to be resolved. Here we present the case in which we succeeded in incubating a goat fetus for 3 weeks, followed by a trial birth from an artificial womb.

Animals↗
PubMed1992

A new transport incubator for primary care of low birth weight babies.

A new portable, cheap and indigenous incubator made of polystyrene has been devised for delivery of primary health care services to the newborn babies in the community. Twenty six babies with a mean weight of 1726 g (range 1388-1981g) and gestational age of 35.3 weeks (range 34-38 wks) were continuously evaluated for 2 hours observation period, in naked and clothed conditions. Rectal, abdominal skin, foot, ambient air and nursery temperatures were recorded. The baseline core temperature of the babies was 36.58 (+/- 0.21) degrees C; after incubator care it was recorded s 36.80 (+/- 0.10) degrees C in naked infants. The baseline core temperature of the clothed babies was 36.63 (+/- 0.21) while it was 37.01 (+/- 0.18) after 2 hours of incubator care. An ambient air temperature of 33-34 degrees C in the incubator (thermoneutral temperature range for these babies being 31.0-33.8 degrees C) was achieved within 30-60 minutes of incubator stay (nursery temperature being 28 +/- 0.6 degrees C). No evidence of carbon dioxide narcosis, hypoxia, acidosis, or adverse thermoregulatory behavior was observed. One baby had hypoglycemia (blood sugar less than 35 mg/dl) and another had sweating. There is a scope for providing additional facilities like administration of oxygen, phototherapy, X-rays through the incubator without disturbing the baby.

Body Temperature Regulation↗
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↗